Chapter 26, Chapter 25 EMT, Chapter 24 EMT, Chapter 22 EMT, Chapter 21 EMT, Chapter 20 EMT Psychiatric EMG, Chapter 19 EMT, Chapter 18, EMT Basic Chapter 13, EMT Chapter 10 Review, EMT-B ch. 8, Chapter 5 EMT, EMT Chapter 4, Chp 3, SACAGAWEA FINAL EXAM

Which of the following is considered an obvious sign of death and would not require the initiation of CPR

...

To ensure that you will deliver the appropriate number of chest compressions during one rescuer adult CPR, you should compress the patients chest at a rate of least______ per minute

100

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of: A. 12. B. 13. C. 14. D. 15.

14.

What is the correct ratio of compressions to ventilation a when performing two rescuer child CPR

15:2

An apneic infant or child should be ventilated a maximum of ______ times per minute

20

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? A. 2 B. 3 C. 4 D. 5

3

In two rescuer adult CPR, you should deliver a compression to ventilation ratio of:

30:2

The cervical spine is composed of _____ vertebrae. A. 5 B. 6 C. 7 D. 8

7

10. Which of the following are noticeable characteristics of a 9-month-old infant? A. places objects in the mouth, pulls himself or herself up B. knows his or her name, can walk without any assistance C. responds to his or her name, crawls around efficiently D. walks without help, becomes frustrated with restrictions

A

11. Which of the following medication routes has the slowest rate of absorption? A. oral B. rectal C. inhalation D. sublingual

A

12. Which of the following medication routes would be the MOST appropriate to use in an unconscious patient when intravenous access cannot be obtained? A. intraosseous (IO) B. intramuscular C. subcutaneous D. transcutaneous

A

13. An infant or small toddler would MOST likely gain trust in an individual who: A. provides an organized, routine environment. B. maintains eye contact, even if the person is a stranger. C. frequently changes the infant or toddler's regular routine. D. does not tower over him or her and avoids painful procedures.

A

17. A mucosal atomizer device (MAD) is used to deliver certain medications via the: A. intranasal route. B. inhalation route. C. sublingual route. D. transdermal route.

A

17. Which of the following is a physical change that typically occurs in the adolescent age group? A. Secondary sexual development begins. B. Muscle and bone growth both decrease. C. The normal pulse rate steadily increases. D. The systolic blood pressure decreases.

A

19. Which of the following statements regarding psychosocial development in the adolescent age group is correct? A. Antisocial behavior and peer pressure peak around 14 to 16 years of age. B. Family conflict decreases as the adolescent gains control of his or her life. C. Adolescents are less fixated on their public image than younger children. D. Because they think rationally, adolescents are at the lowest risk for suicide.

A

20. Activated charcoal is an example of a(n): A. suspension. B. solution. C. elixir. D. gel.

A

22. What medication form does oral glucose come in? A. gel B. liquid C. suspension D. fine powder

A

24. Which of the following statements regarding middle adults is correct? A. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer. B. Women in the middle adult age group typically experience menopause in their late 50s or early 60s. C. Significant impairments in hearing and vision begin to occur in persons between the ages of 41 and 44 years. D. Increased cholesterol levels in the middle adult age group often do not respond to exercise and diet.

A

27. 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: A. confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given. B. contact medical control, apprise him or her of the patient's chief complaint and vital signs, and request permission to give him aspirin. C. ensure that the patient's systolic blood pressure is at least 100 mm Hg since aspirin dilates the blood vessels and can cause a drop in blood pressure. D. assist the patient in taking one of his prescribed nitroglycerin, assess his vital signs, and give him aspirin if he is still experiencing chest discomfort.

A

28. In ___________ administration, you are administering medication to yourself or your partner. A. peer-assisted B. patient-assisted C. EMT-administered D. paramedic-administered

A

29. You suspect that a 75-year-old man has internal injuries after he fell and struck his ribs and abdomen on the corner of a table. When assessing and treating an injured patient of this age, you must recall that: A. his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output. B. it is not uncommon to observe heart rates in excess of 150 beats/min in elderly patients with internal injuries. C. blood pressure is usually adequately maintained because the blood vessels of older people can contract easily. D. functional blood volume in patients of this age steadily increases due to increased production of red blood cells.

A

3. You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that: A. small infants are nose breathers and require clear nasal passages at all times. B. assisted ventilations in infants often need to be forceful to inflate their lungs. C. the infant's proportionately small tongue often causes an airway obstruction. D. an infant's head should be placed in a flexed position to prevent obstruction.

A

30. With increasing age, the heart must work harder to move the blood effectively because: A. the blood vessels become stiff. B. the arteries dilate significantly. C. diastolic blood pressure decreases. D. the blood thickens as a person ages.

A

31. The process of binding or sticking to a surface is called: A. adsorption. B. absorption. C. suspension. D. digestion.

A

32. Breathing is often more labor intensive in older adults because the: A. elasticity of the lungs decreases. B. surface area of the alveoli increases. C. overall size of the airway decreases. D. diaphragm and intercostal muscles enlarge.

A

34. The medical term for an extremely low blood glucose level is: A. hypoglycemia. B. hyperglycemia. C. hypotension. D. hypertension.

A

37. When given to patients with cardiac-related chest pain, nitroglycerin: A. relaxes the walls of the coronary arteries. B. increases myocardial contraction force. C. increases blood return to the right atrium. D. constricts the veins throughout the body.

A

37. Which of the following statements regarding age-related changes in the nervous system is correct? A. Interconnections between brain cells often prevent a loss of knowledge or skill, despite a loss of neurons. B. The metabolic rate in the brain increases with age, but the consumption of oxygen decreases significantly. C. Generally speaking, the brain increases in size by 10% to 20% by the time a person reaches 80 years of age. D. Because of a decrease in the number of brain cells, a person's level of intelligence decreases with age.

A

4. After taking diphendydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n): A. side effect. B. untoward effect. C. therapeutic effect. D. unpredictable effect.

A

4. Infants are often referred to as "belly breathers" because: A. their rib cage is less rigid and the ribs sit horizontally. B. an infant's ribs are brittle and are less able to expand. C. their intercostal muscles are not functional. D. their diaphragm does not receive impulses from the brain.

A

44. A 37-year-old male is found unconscious in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of: A. asthma. B. heart disease. C. hypertension. D. allergic reactions.

A

5. Which of the following is an example of a brand (trade) name of a drug? A. Tylenol B. ibuprofen C. furosemide D. nitroglycerin

A

A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should: A. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. B. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside. C. let them know that because of the circumstances of their child's death, they will not be permitted to see him at this time. D. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer.

A

A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should: A. assess the rate, regularity, and quality of her carotid pulse. B. advise your partner that the patient's blood pressure is low. C. immediately take her blood pressure to see if she is hypotensive. D. conclude that she is perfusing adequately since she is conscious.

A

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 breaths/min and regular. You should: A. administer 100% oxygen via a nonrebreathing mask. B. insert a nasal airway in case her mental status decreases. C. perform a secondary assessment and then begin treatment. D. assist her breathing with a bag-mask device and 100% oxygen.

A

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, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should: A. administer oxygen, give her 324 mg aspirin, and assess her further. B. obtain a SAMPLE history and contact medical control for advice. C. give her 100% oxygen, attach the AED, and transport immediately. D. give her one nitroglycerin and reassess her systolic blood pressure.

A

A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should: A. retreat and notify law enforcement personnel. B. tell the family member that it is not your fault. C. subdue the family member until the police arrive. D. ignore the family member and assess the patient.

A

A decrease in the blood pressure may indicate: A. a loss of vascular tone. B. arterial constriction. C. increased blood volume. D. forceful cardiac contraction.

A

A generalized seizure is characterized by: A. severe twitching of all the body's muscles. B. a blank stare and brief lapse of consciousness. C. unconsciousness for greater than 30 minutes. D. a core body temperature of greater than 103°F (40°C)

A

A nasopharyngeal airway is inserted: A. with the bevel facing the septum if inserted into the right nare. B. into the larger nostril with the tip pointing away from the septum. C. with the bevel pointing downward if inserted into the left nare. D. into the smaller nostril with the tip following the roof of the nose.

A

A patient with high blood pressure would be expected to have skin that is: A. flushed and red. B. mottled and cool. C. pale and moist. D. cyanotic and dry

A

A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is: A. epilepsy. B. a brain tumor. C. a serious infection. D. intracranial bleeding.

A

A properly sized blood pressure cuff should cover: A. two thirds the length from the armpit to the crease in the elbow. B. one half the length between the armpit to the crease in the elbow. C. one third the length from the armpit to the crease at the elbow. D. the entire upper arm between the armpit and the crease at the elbow.

A

According to the National EMS Scope of Practice Model, an EMT should be able to: A. assist a patient with certain prescribed medications. B. insert a peripheral intravenous (IV) line and infuse fluids. C. administer epinephrine via the subcutaneous route. D. interpret a basic electrocardiogram (ECG) rhythm and treat accordingly.

A

According to the National EMS Scope of Practice Model, an EMT would require special permission from the medical director and the state EMS office in order to: A. perform blood glucose monitoring. B. apply and interpret a pulse oximeter. C. use an automatic transport ventilator. D. give aspirin to a patient with chest pain.

A

An absence seizure is also referred to as a: A. petit mal seizure. B. grand mal seizure. C. total body seizure. D. generalized motor seizure.

A

An acute myocardial infarction (AMI) occurs when: A. myocardial tissue dies secondary to an absence of oxygen. B. the heart muscle progressively weakens and dysfunctions. C. coronary artery dilation decreases blood flow to the heart. D. the entire left ventricle is damaged and cannot pump blood.

A

An adult patient who is NOT experiencing difficulty breathing will: A. be able to speak in complete sentences without unusual pauses. B. assume a position that will facilitate effective and easy breathing. C. exhibit an indentation above the clavicles and in between the ribs. D. have a respiratory rate that is between 20 and 24 breaths/min

A

An appropriate demonstration of professionalism when your patient is frightened, demanding, or unpleasant is to: A. continue to be nonjudgmental, compassionate, and respectful. B. demand the patient to be quiet and cooperative during transport. C. ignore the patient's feelings and focus on his or her medical complaint. D. reassure him or her that everything will be all right, even if it will not be.

A

An unconscious patient found in a prone position must be placed in a supine position in case he or she: A. requires cardiopulmonary resuscitation (CPR). B. begins to vomit. C. regains consciousness. D. has increased tidal volume.

A

An unstable patient should be reassessed at least every: A. 5 minutes. B. 10 minutes. C. 15 minutes. D. 20 minutes

A

As an EMT, it is important to remember that the signs and symptoms of cumulative stress: A. may not be obvious or present all the time. B. usually manifest suddenly and without warning. C. cannot be identified and can cause health problems. D. are most effectively treated with medications.

A

As an EMT, the performance of your duties will be compared to that of: A. another EMT. B. the general public. C. the medical director. D. a paramedic supervisor.

A

As you assess the head of a patient with a suspected spinal injury, your partner should: A. maintain stabilization of the head. B. look in the ears for gross bleeding. C. prepare the immobilization equipment. D. assess the rest of the body for bleeding

A

Carbon monoxide blocks the ability of the blood to oxygenate the body because it: A. binds with the hemoglobin in the red blood cells. B. fills the lungs with secretions. C. causes the body to expel too much carbon dioxide. D. destroys the number of circulating red blood cells.

A

Cardiogenic shock following AMI is caused by: A. decreased pumping force of the heart muscle. B. a profound increase in the patient's heart rate. C. hypovolemia secondary to severe vomiting. D. widespread dilation of the systemic vasculature.

A

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: A. slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid. B. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid. C. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid. D. increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.

A

Clinical signs of labored breathing include all of the following, EXCEPT: A. shallow chest movement. B. use of accessory muscles. C. supraclavicular retractions. D. gasping attempts to breathe

A

Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT: A. distrust of the EMT. B. mental disorders. C. history of chronic disease. D. fear of medical personnel.

A

Deoxygenated blood from the body returns to the: A. right atrium. B. right ventricle. C. left atrium. D. left ventricle.

A

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A. 2 B. 3 C. 4 D. 6

A

End-tidal carbon dioxide (ETCO2) is defined as the: A. maximal concentration of CO2 at the end of an exhaled breath. B. maximum amount of CO2 that remains in the lungs at all times. C. total amount of CO2 that remains in the lungs between breaths. D. amount of CO2 that a person breathes in during a single inhalation

A

External bleeding from an extremity can usually be controlled by a combination of: A. direct pressure and elevation. B. direct pressure and a tourniquet. C. elevation and chemical ice packs. D. elevation and pressure point control

A

Gas exchange in the lungs is facilitated by: A. adequate amounts of surfactant. B. water or blood within the alveoli. C. surfactant-destroying organisms. D. pulmonary capillary constriction.

A

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? A. It forces the alveoli open and pushes more oxygen across the alveolar membrane. B. It pushes thick, infected pulmonary secretions into isolated areas of the lung tissue. C. It decreases intrathoracic pressure, which allows more room for the lungs to expand. D. It prevents alveolar collapse by pushing air into the lungs during the inhalation phase.

A

If an action or procedure that was performed on a patient is not recorded on the written report: A. it was not performed in the eyes of the law. B. it can be qualified by the EMT in charge. C. it cannot be used in establishing negligence. D. it was performed haphazardly by the EMT.

A

If you use a waterless handwashing substitute in the field, it is important to: A. wash your hands with soap and water at the hospital. B. immediately dry your hands with a paper towel. C. wait at least 5 minutes before touching another patient. D. avoid donning another pair of gloves for at least 10 minutes.

A

In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease? A. recent travel B. HIV status C. sexual practices D. drug allergies

A

In contrast to monophasic defibrillation, biphasic defibrillation: A. requires a lower energy setting. B. delivers all shocks at 360 joules. C. begins with 300 joules and escalates. D. is only effective for ventricular tachycardia.

A

In contrast to viral hepatitis, toxin-induced hepatitis: A. is not a communicable disease. B. typically does not cause yellow skin. C. is a far more transmittable disease. D. can be prevented with a vaccination.

A

In responsive patients that are older than 1 year of age, you should palpate the pulse at the ________ artery. A. radial B. carotid C. brachial D. femoral

A

In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min. A. 60, 100 B. 50, 110 C. 40, 120 D. 30, 130

A

In the eyes of the court, an incomplete or untidy patient care form indicates: A. that inadequate patient care was administered. B. potential falsification of the patient care form. C. that thorough documentation was not required. D. that the EMT was too busy providing patient care.

A

Major risk factors for AMI include all of the following, EXCEPT: A. hypoglycemia. B. hypertension. C. diabetes mellitus. D. elevated cholesterol.

A

Nitroglycerin relieves cardiac-related chest pain by: A. dilating the coronary arteries and improving cardiac blood flow. B. increasing the amount of work that is placed on the myocardium. C. contracting the smooth muscle of the coronary and cerebral arteries. D. constricting the coronary arteries and improving cardiac blood flow.

A

Normal skin color, temperature, and condition should be: A. pink, warm, and dry. B. pale, cool, and moist. C. pink, warm, and moist. D. flushed, cool, and dry

A

Obtaining continuing medical education is the responsibility of the: A. individual EMT. B. State Bureau of EMS. C. EMS training officer. D. EMS medical director.

A

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: A. referred pain. B. radiating pain. C. visceral pain. D. remote pain.

A

Pain that moves from its point of origin to another body location is said to be: A. radiating. B. referred. C. palliating. D. provoking.

A

Patients with tuberculosis pose the greatest risk for transmitting the disease when they: A. cough. B. vomit. C. are bleeding. D. have a fever.

A

Prompt transport of a patient with a suspected AMI is important because: A. the patient may be eligible to receive thrombolytic therapy. B. 90% of the cardiac cells will die within the first 30 minutes. C. nitroglycerin can only be given in the emergency department. D. many patients with an AMI die within 6 hours.

A

Putrefaction is defined as: A. decomposition of the body's tissues. B. profound cyanosis to the trunk and face. C. blood settling to the lowest point of the body. D. separation of the torso from the rest of the body.

A

Quid pro quo, a type of sexual harassment, occurs when the harasser: A. requests sexual favors in exchange for something else. B. touches another person without his or her consent. C. stares at certain parts of another person's anatomy. D. makes rude remarks about a person's body parts.

A

Reassessment is performed to determine all of the following, EXCEPT: A. the reason why the patient called EMS. B. the patient's response to your treatment. C. whether or not the patient is deteriorating. D. the nature of any newly identified problems.

A

Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct? A. A mentally competent adult can withdraw his or her consent to treat at any time. B. Any patient who refuses EMS treatment must legally sign a patient refusal form. C. Because of your suspicions, the best approach is to transport him to the hospital. D. Once a patient is in the ambulance, he or she cannot legally refuse EMS treatment.

A

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: A. have chronic hypertension. B. regularly take illegal drugs. C. have had a stroke in the past. D. are older than 40 years of age.

A

The "Golden Period" begins when an injury occurs and ends when: A. the patient receives definitive care. B. the patient is admitted to the ICU. C. you depart the scene for the hospital. D. you arrive at the emergency department

A

The EMT's scope of practice within his or her local response area is defined by the: A. medical director. B. state EMS office. C. EMS supervisor. D. local health district.

A

The MOST common and significant complication associated with an acute abdomen is: A. peritonitis. B. high fever. C. severe pain. D. internal bleeding.

A

The MOST common error associated with the use of the AED is: A. failure of the EMT to ensure the battery is charged. B. malfunction of the AED's internal computer processor. C. inappropriately placed adhesive defibrillation electrodes. D. inability of the EMT to recognize ventricular fibrillation.

A

The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to: A. perform a careful and thorough assessment. B. establish the patient's medical history early. C. take note of the patient's general appearance. D. ask if bystanders are familiar with the patient

A

The __________ cartilage is a firm ring that forms the inferior part of the larynx. A. cricoid B. thyroid C. laryngeal D. pyriform

A

The ____________ deals with the well-being of the EMT, career progression, and EMT compensation. A. human resources department B. office of the medical director C. EMS administrator or chief D. local public health department

A

The compliance monitoring component of an infection control plan should: A. ensure that employees understand what they should do and why it is important. B. identify who to notify after an exposure and where treatment should be provided. C. consist of a list of tasks that pose a risk for contact with blood or other body fluids. D. address issues such as medical waste collection, storage, and ambulance disinfection.

A

The determination that prompt surgical care in the hospital is more important than performing time- consuming procedures in the field on a major trauma patient is based MOSTLY on: A. EMS research. B. local protocols. C. the lead EMT's decision. D. regional trauma guidelines.

A

The diaphragm functions as an involuntary muscle when a person: A. sleeps. B. coughs. C. takes a deep breath. D. holds his or her breath.

A

The general adaptation syndrome is characterized by which of the following phases? A. alarm response, reaction and resistance, and recovery B. delayed reaction, alarm response, and physical recovery C. reaction and resistance, euphoria, and physical exhaustion D. immediate reaction, psychological exhaustion, and recovery

A

The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is: A. overlooking a potentially serious medical condition. B. making the entire EMS system look unprofessional. C. demeaning or humiliating the patient and his family. D. discouraging the patient from calling EMS in the future.

A

The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT: A. family history of hepatitis. B. postvaccine antibody titers. C. vaccine safety and efficacy. D. record keeping and tracking.

A

The iliac arteries immediately subdivide into the: A. femoral arteries. B. peroneal arteries. C. anterior tibial arteries. D. posterior tibial arteries.

A

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: A. brain. B. kidneys. C. abdomen. D. legs.

A

The leaf-shaped structure located superior to the larynx is called the: A. epiglottis. B. vallecula. C. cricoid ring. D. thyroid cartilage

A

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: A. brain stem. B. cerebrum. C. cerebellum. D. cerebral cortex.

A

The nasal cannula is MOST appropriately used in the prehospital setting: A. when the patient cannot tolerate a nonrebreathing mask. B. if the patient's nasopharynx is obstructed by secretions. C. if long-term supplemental oxygen administration is required. D. when the patient breathes primarily through his or her mouth.

A

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called: A. external respiration. B. cellular metabolism. C. pulmonary ventilation. D. alveolar ventilation.

A

The purpose of defibrillation is to: A. stop the chaotic, disorganized contraction of the cardiac cells. B. cause a rapid decrease in the heart rate of an unstable patient. C. improve the chance of cardiopulmonary resuscitation (CPR) being successful in resuscitation. D. prevent asystole from deteriorating into ventricular fibrillation.

A

The purpose of the pin-indexing system that has been established for compressed gas cylinders is to: A. ensure that the correct regulator is used for the cylinder. B. help you determine what type of oxygen regulator to use. C. prevent destroying or stripping the threads on the cylinder. D. reduce the cylinder pressure to a safe and more useful range.

A

The spinal cord exits the cranium through the: A. foramen magnum. B. vertebral foramen. C. foramen lamina. D. cauda equina.

A

The spread of HIV and hepatitis in the health care setting can usually be traced to: A. careless handling of sharps. B. a lack of proper immunizations. C. excessive blood splashing or splattering. D. a noncompliance with standard precautions.

A

The standards for prehospital emergency care and the individuals who provide it are typically regulated by the: A. state office of EMS. B. regional trauma center. C. American Heart Association. D. National Registry of EMTs.

A

To select the proper size oropharyngeal airway, you should measure from the: A. corner of the mouth to the earlobe. B. center of the mouth to the posterior ear. C. corner of the mouth to the superior ear. D. angle of the jaw to the center of the mouth.

A

Typical chief complaints in patients with an infectious disease include: A. fever, rash, nausea, and difficulty breathing. B. crushing chest pain, vomiting, and weakness. C. headache, low back pain, and arm numbness. D. joint pain, muscle aches, and blurred vision.

A

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: A. assess the scene for potential hazards. B. determine if you need additional help. C. request a paramedic unit for assistance. D. gain immediate access to the patient.

A

Vector-borne transmission of an infectious organism occurs via: A. animals or insects. B. smoke or dust. C. direct contact. D. inanimate objects.

A

What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? A. 5,600 mL B. 6,000 mL C. 7,400 mL D. 8,000 mL

A

What part of the patient assessment process focuses on obtaining additional information about the patient's chief complaint and any medical problems he or she may have? A. history taking B. general impression C. primary assessment D. secondary assessment

A

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: A. blood can pass from the atria to the ventricles. B. blood returning from the body can fill the atria. C. the impulse can spread through the Purkinje fibers. D. the SA node can reset and generate another impulse.

A

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: A. ensure that the patient can see you approaching him. B. approach him from behind and ask him not to move. C. stand behind him and immediately stabilize his head. D. assess his mental status by having him move his head

A

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem? A. history taking B. rapid body scan C. baseline vital signs D. primary assessment

A

When assessing a patient's abdomen, you will typically evaluate for all of the following, EXCEPT: A. subcutaneous emphysema. B. open wounds or eviscerations. C. gross bleeding and tenderness. D. rigidity and obvious bleeding

A

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: A. wiggle his or her toes on command. B. feel you touching the extremity. C. note any changes in temperature. D. identify different types of stimuli.

A

When caring for a patient with an altered mental status and signs of circulatory compromise, you should: A. limit your time at the scene to 10 minutes or less, if possible. B. perform a detailed secondary assessment prior to transporting the patient. C. transport immediately and begin all emergency treatment en route to the hospital. D. have a paramedic unit respond to the scene if it is less than 15 minutes away.

A

When caring for a patient with documented hypoglycemia, you should be MOST alert for: A. a seizure. B. an acute stroke. C. respiratory distress. D. a febrile convulsion.

A

When decontaminating the back of your ambulance after a call, you should: A. allow surfaces to air dry unless otherwise indicated in the product directions. B. use a bleach and water solution at a 1:2 dilution ratio to thoroughly wipe all surfaces. C. clean all surfaces and patient contact areas with a mixture of alcohol and water. D. spray the contaminated areas and then immediately wipe them dry with a towel.

A

When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located, you should: A. begin resuscitation at once. B. contact medical control first. C. determine the patient's illness. D. notify the coroner immediately.

A

When interviewing a patient, you can show him or her that you understand the situation by: A. repeating statements back to him or her. B. using medical terminology whenever possible. C. maintaining constant eye contact with him or her. D. interrupting him or her as needed for clarification.

A

When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: A. when the patient last appeared normal. B. if there is a family history of a stroke. C. if the patient has been hospitalized before. D. the patient's overall medication compliance.

A

When palpating the carotid pulse of a responsive older patient, you should: A. avoid compressing both carotid arteries simultaneously. B. ensure that his or her head is in a hyperextended position. C. avoid gentle pressure so that weak pulses can be detected. D. firmly compress the artery because the pulse is often weak

A

When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should: A. focus on his or her chief complaint. B. examine him or her from head to toe. C. prepare the patient for transport first. D. only palpate tender areas of the abdomen.

A

When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A. constricting. B. enlarging. C. dilating. D. fluttering

A

Where would you MOST likely find information regarding a patient's wishes to be an organ donor? A. driver's license B. insurance card C. Social Security card D. voter registration card

A

Which of the following MOST accurately describes a simple partial seizure? A. a seizure that begins in one extremity B. a seizure that causes the patient to stare blankly C. a seizure that is not preceded by an aura D. a generalized seizure without incontinence

A

Which of the following MOST accurately describes the cause of an ischemic stroke? A. blockage of a cerebral artery B. acute atherosclerotic disease C. rupture of a cerebral artery D. narrowing of a carotid artery

A

Which of the following factors will cause a decreased minute volume in an adult? A. shallow breathing B. increased tidal volume C. respirations of 20 breaths/min D. slight decrease in respiratory rate

A

Which of the following general statements regarding consent is MOST correct? A. A patient can consent to transport but can legally refuse to be treated. B. Patients who are intoxicated are generally allowed to refuse treatment. C. Expressed consent is valid only if given in writing by a family member. D. All patients older than 18 years can legally refuse treatment or transport.

A

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? A. a rapid heart rate B. syncope or dizziness C. heart rate less than 60 beats/min D. generalized weakness

A

Which of the following is a metabolic cause of a seizure? A. poisoning B. head trauma C. brain tumor D. massive stroke

A

Which of the following is an example of a primary prevention strategy? A. community awareness programs that emphasize the dangers of drinking and driving B. the construction of a guardrail on a dangerous curve following a fatal motor vehicle crash C. protecting a patient's spine from further injury after a fall from a significant height D. teaching a group of new parents how to perform one- and two-rescuer infant CPR

A

Which of the following maneuvers should be used to open a patients airway when a spinal injury is suspected? A. jaw-thrust B. tongue-jaw lift C. head tilt-neck lift D. head tilt-chin lift

A

Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint? A. naloxone (Narcan) B. aspirin C. albuterol D. oral glucose

A

Which of the following organs or tissues can survive the longest without oxygen? A. muscle B. heart C. liver D. kidneys

A

Which of the following organs would MOST likely bleed profusely if injured? A. liver B. stomach C. appendix D. gallbladder

A

Which of the following patients does NOT have an altered mental status? A. a patient with an acute allergic reaction and dizziness B. a diabetic who opens his eyes when you ask questions C. a patient with a head injury who is slow to answer questions D. a patient who overdosed and moans when he is touched

A

Which of the following patients is breathing adequately? A. a conscious male with respirations of 19 breaths/min and pink skin B. a conscious female with facial cyanosis and rapid, shallow respirations C. a conscious male with respirations of 18 breaths/min and reduced tidal volume D. an unconscious 52-year-old female with snoring respirations and cool, pale skin

A

Which of the following questions is used to determine a patient's chief complaint? A. "What seems to be the matter?" B. "When did the chest pain begin?" C. "Are you having trouble breathing?" D. "Do you have a history of diabetes?"

A

Which of the following scenarios MOST accurately depicts abandonment? A. A paramedic transfers patient care to an EMT. B. An AEMT transfers patient care to a paramedic. C. A physician assumes patient care from an EMT. D. An EMT gives a verbal report to an emergency room nurse.

A

Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? A. seesaw breathing B. rapid respirations C. pursed-lip breathing D. accessory muscle use

A

Which of the following statements regarding hepatitis A is correct? A. Hepatitis A can only be transmitted by a patient who has an acute infection. B. Infection with hepatitis A causes chronic illness with a high mortality rate. C. Hepatitis A is primarily transmitted via contact with blood or other body fluids. D. Although there is no vaccine against hepatitis A, treatment is usually successful.

A

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A. SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure. B. Most cases of SARS are caused by a bacterium that is spread from person to person via direct contact with infected blood. C. SARS is caused by a virus that occurs naturally in the bird population, although it usually does not cause illness in humans. D. Although SARS can cause pneumonia and other respiratory infections, it rarely causes death, even in immunocompromised patients.

A

Which of the following statements regarding the AED and defibrillation is correct? A. The AED will not analyze the rhythm of a moving patient. B. Defibrillation is the first link in the American Heart Association chain of survival. C. The AED will shock any rhythm not accompanied by a pulse. D. CPR should be performed for 5 minutes before using the AED.

A

Which of the following statements regarding the secondary assessment is correct? A. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint. B. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient's condition. C. A secondary assessment should be performed, even if you must continually manage life threats that were identified in the primary assessment. D. During the secondary assessment, the EMT's primary focus should be on taking the patient's vital signs and obtaining a SAMPLE history.

A

Which of the following statements would NOT be appropriate to say to the family of a dying patient? A. "Things will get better in time." B. "It is okay to be angry and sad." C. "This must be painful for you." D. "Tell me how you are feeling."

A

Which of the following would cause the greatest increase in cardiac output? A. increased heart rate and increased stroke volume B. decreased stroke volume and increased heart rate C. decreased heart rate and increased stroke volume D. decreased stroke volume and decreased heart rate

A

While trying to make a family member feel better after a loved one has died, your partner uses trite statements. The family members may view this as: A. your partner's attempt to diminish their grief. B. a show of respect for the person who has died. C. coaching them through the grieving process. D. your partner's caring and supportive attitude.

A

With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in: A. children who are younger than 6 years of age. B. patients who are significantly hypotensive. C. children who are older than 6 years of age. D. patients with decreased peripheral perfusion

A

You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should: A. begin ventilations using the mouth-to-mask technique. B. hyperextend the patient's head and reattempt ventilations. C. continue attempted ventilations and transport immediately. D. suction the patient's airway for 30 seconds and reattempt ventilations.

A

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: A. begin high-quality CPR and apply the AED without delay. B. have your partner perform CPR while you question the bystanders. C. perform two-rescuer CPR for 5 minutes and request ALS backup. D. immediately apply the AED pads and analyze his cardiac rhythm.

A

You and your partner arrive at the side of a 60 year old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should: A. begin CPR and apply the AED as soon as it is available. B. immediately apply the AED and analyze her cardiac rhythm. C. begin CPR at a compression to ventilation ratio of 15:2. D. apply the AED if there is no response after 10 cycles of CPR.

A

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. B. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly.

A

You are assessing a woman who was thrown from her horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should: A. crouch down in a position so that only your feet are touching the ground. B. sit down, bend your knees, and hold your crossed arms close to your body. C. quickly cover the patient with a blanket and then lie down flat on the ground. D. immediately lie down on your side and draw your knees into your abdomen.

A

You are caring for a 35-year-old female with pregnancy-related complications. She is clearly experiencing significant stress and is crying uncontrollably. Your MOST appropriate action would be to: A. demonstrate courtesy and speak with a professional tone of voice. B. discourage her from expressing fears until a counselor is available. C. explain to her that "everything will be all right" in order to calm her down. D. restrain her if she is extremely emotional and will not calm down.

A

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should: A. suction her oropharynx and apply 100% oxygen. B. insert an oral airway, apply oxygen, and transport. C. use a bag-mask device to assist her ventilations. D. place her on her side and prepare for rapid transport.

A

You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include: A. oxygen via a nonrebreathing mask, left lateral recumbent position, and transport. B. assisted ventilation with a bag-mask device, right lateral recumbent position, and transport. C. an oral airway, assisted ventilation with a bag-mask device, Fowler's position, and transport. D. oxygen via a nonrebreathing mask, supine position with legs elevated 6″ to 12″, and transport.

A

You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert, but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should: A. provide treatment up to your level of training and transport the child at once. B. recognize that you cannot begin treatment without expressed parental consent. C. transport the child to the closest hospital and let them provide any treatment. D. administer oxygen only until you receive parental consent for further treatment.

A

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 9-1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should: A. ensure that he is aware of the risks of refusing medical care. B. err in the best interest of the patient and transport him at once. C. have him sign a refusal of care form and then return to service. D. tell him that he is having a heart attack and needs medical care.

A

You are dispatched to the scene of a crash involving a large tanker truck. While you are en route, dispatch advises you that there are multiple patients and that the fire department is en route as well. As you approach the scene, you should: A. maintain a safe distance and try to read the placard with binoculars. B. cordon off the area and quickly remove all of the injured patients. C. immediately begin evacuating residents that live near the crash site. D. don PPE and quickly triage all patients.

A

You are transporting a 40-year-old male with respiratory distress. The patient tells you that he recently had a positive tuberculosis (TB) skin test and is currently being evaluated for possible TB. You should: A. apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself. B. remain at least 3 feet away from the patient and apply a surgical mask on him. C. apply a sterile surgical mask on yourself and a HEPA respirator on the patient. D. apply a nasal cannula on the patient and a sterile surgical mask on yourself.

A

You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should: A. reevaluate the rate and volume of your ventilations. B. perform a head-to-toe assessment to look for bleeding. C. increase the volume of your ventilations and reassess his blood pressure. D. ensure that you are delivering one breath every 3 to 5 seconds.

A

You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight-fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: A. remove her dentures, resume ventilations, and assess for adequate chest rise. B. attempt to replace her dentures so that they fit tightly and resume ventilations. C. leave her dentures in place, but carefully monitor her for an airway obstruction. D. remove her dentures at once and increase the rate and volume of your ventilations.

A

You arrive at the scene of a motor vehicle versus pedestrian accident. The patient, a 13-year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene in approximately 15 minutes. What should you do? A. Transport the child immediately and have the parents meet you at the hospital. B. Treat the child at the scene and wait for the parents to arrive and give consent. C. Begin transport at once and have the parents meet you en route to the hospital. D. Withhold treatment until the parents arrive and give you consent for treatment.

A

You respond to the home of a 59-year-old man who is unconscious, has slow, shallow breathing, and has a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient; however, they are unable to locate it. You should: A. begin treatment and contact medical control as needed. B. honor the patient's wishes and withhold all treatment. C. transport the patient without providing any treatment. D. decide on further action once the DNR order is produced.

A

You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should: A. start CPR and attach the AED as soon as possible. B. ask the family if the patient has a terminal disease. C. perform CPR and transport the patient immediately. D. notify dispatch and request a paramedic ambulance.

A

You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, is in obvious respiratory distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate livesaving treatment, you should: A. perform a rapid scan of her entire body and prepare for immediate transport. B. assess her vital signs, secure her to a backboard, and transport her immediately. C. fully immobilize her spine, load her into the ambulance, and assess her vital signs. D. identify the specific areas of her injuries and focus your assessment on those areas.

A

Which of the following statements regarding cervical collars is correct? A. Once a cervical collar is applied, you can cease manual head stabilization. B. A cervical collar is used in addition to, not instead of, manual immobilization. C. Cervical collars are contraindicated in patients with numbness to the extremities. D. The patient's head should be forced into a neutral position to apply a cervical collar.

A cervical collar is used in addition to, not instead of, manual immobilization.

CPR should be initiated when

A valid living will is unavailable

Femoral shaft fractures can result in up to _____ mL of internal blood loss. A. 1,000 B. 1,500 C. 2,000 D. 4,000

A. 1,000

Which of the following scenarios is an example of a direct injury? A. A passenger fractures her patella after it strikes the dashboard. B. A skier dislocates his knee after a twisting injury to the ankle. C. A person lands on his or her feet and fractures the lumbar spine. D. A child dislocates his elbow after falling on his outstretched arm.

A. A passenger fractures her patella after it strikes the dashboard.

Which of the following statements regarding compartment syndrome is correct? A. Compartment syndrome typically develops within 6 to 12 hours after an injury. B. Compartment syndrome occurs because of increased pressure within the bone cavity. C. In most cases, compartment syndrome develops within a few minutes after an injury. D. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

A. Compartment syndrome typically develops within 6 to 12 hours after an injury.

7. Following blunt abdominal trauma, a 30-year-old male complains of referred pain to the left shoulder. This finding is called the: A. Kehr sign. B. Cullen sign. C. Grey Turner sign. D. Brudzinski sign.

A. Kehr sign.

Which of the following statements regarding the hypoxic drive is MOST correct? A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.

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

Which of the following patients is in decompensated shock? A. a 20-year-old female with absent radial pulses and dilated pupils B. a 23-year-old restless male with cool, clammy skin and tachycardia C. a 28-year-old female with pale skin and rapid, shallow respirations D. a 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg

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

Hyperventilation could be associated with all of the following, EXCEPT: A. a narcotic overdose. B. a respiratory infection. C. an overdose of aspirin. D. high blood glucose levels.

A. a narcotic overdose.

In what area of the lungs does respiration occur? A. alveoli B. trachea C. bronchi D. capillaries

A. alveoli

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes: A. applying direct pressure with a dry, sterile dressing. B. covering the avulsion with moist, sterile dressings. C. requesting a paramedic to administer pain medication. D. administering 100% oxygen via a nonrebreathing mask.

A. applying direct pressure with a dry, sterile dressing.

In moving joints, the ends of the bones are covered with: A. articular cartilage. B. synovial tendons. C. muscular fascia. D. gliding cartilage.

A. articular cartilage.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: A. assess distal pulse, motor, and sensory functions. B. gently attempt to move his arm toward his body. C. place a pillow under his arm and apply a swathe. D. flex his arm at the elbow and then apply a sling.

A. assess distal pulse, motor, and sensory functions.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: A. assist her ventilations with a bag-mask device. B. apply a pulse oximeter and obtain vital signs. C. administer oxygen via a nonrebreathing mask. D. obtain a complete list of all of her medications.

A. assist her ventilations with a bag-mask device.

When worn properly, a seatbelt should lie: A. below the anterior superior iliac spines of the pelvis and against the hip joints. B. across the abdominal wall at the level of the diaphragm and below the hip joints. C. above the anterior posterior iliac spines of the pelvis and below the hip joints. D. across the abdominal wall at the level of the umbilicus and against the hip joints.

A. below the anterior superior iliac spines of the pelvis and against the hip joints.

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should: A. bind his legs together on the backboard, keep him warm, and transport without delay. B. apply traction splints to both of his legs, keep him warm, and transport without delay. C. splint each of his deformed femurs with long board splints and transport immediately. D. apply the PASG to stabilize his femurs and transport at once.

A. bind his legs together on the backboard, keep him warm, and transport without delay.

Alkalosis is a condition that occurs when: A. blood acidity is reduced by excessive breathing. B. dangerous acids accumulate in the bloodstream. C. the level of carbon dioxide in the blood increases. D. slow, shallow breathing eliminates too much carbon dioxide.

A. blood acidity is reduced by excessive breathing.

When perfusion to the core of the body decreases: A. blood is shunted away from the skin. B. decreased cardiac contractility occurs. C. blood is diverted to the gastrointestinal tract. D. the voluntary nervous system releases hormones.

A. blood is shunted away from the skin.

The musculoskeletal system refers to the: A. bones and voluntary muscles of the body. B. nervous system's control over the muscles. C. connective tissue that supports the skeleton. D. involuntary muscles of the nervous system.

A. bones and voluntary muscles of the body.

When caring for a patient with a possible fracture of the scapula, the EMT should: A. carefully assess the patient for breathing problems. B. apply rigid board splints across the chest and back. C. assume that minimal force was applied to the back. D. recognize that scapular fractures are life threatening.

A. carefully assess the patient for breathing problems.

The MOST commonly fractured bone(s) in the body is the: A. clavicle. B. scapula. C. radius and ulna. D. midshaft femur.

A. clavicle.

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should: A. closely monitor him and reassess him frequently. B. perform a comprehensive secondary assessment. C. begin documenting the call on the patient care form. D. forgo the hospital radio report because of his condition.

A. closely monitor him and reassess him frequently.

Weakening of the airway in patients with chronic bronchitis is the result of: A. destruction of protective mechanisms that remove foreign particles. B. loss of the lubricating substance that facilitates alveolar expansion. C. airway irritation caused by a marked decrease in mucus production. D. acute constriction of the bronchioles caused by an external irritant.

A. destruction of protective mechanisms that remove foreign particles.

You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient 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: A. determine if she was injured when she fainted. B. provide emotional support regarding her sister. C. advise her that she needs to go to the hospital. D. obtain baseline vital signs and a medical history.

A. determine if she was injured when she fainted.

Accumulation of blood in the abdominal cavity will MOST likely cause: A. distention. B. referred pain. C. diffuse bruising. D. nausea or vomiting.

A. distention.

Neurogenic shock occurs when: A. failure of the nervous system causes widespread vasodilation. B. the spinal cord is severed and causes massive hemorrhaging. C. there is too much blood to fill a smaller vascular container. D. massive vasoconstriction occurs distal to a spinal cord injury.

A. failure of the nervous system causes widespread vasodilation.

A sign of kidney damage following blunt trauma is: A. hematuria. B. hemoptysis. C. hematemesis. D. hematochezia.

A. hematuria.

Shock is the result of: A. hypoperfusion to the cells of the body. B. the body's maintenance of homeostasis. C. temporary dysfunction of a major organ. D. widespread constriction of the blood vessels.

A. hypoperfusion to the cells of the body.

Asthma is caused by a response of the: A. immune system. B. endocrine system. C. respiratory system. D. cardiovascular system.

A. immune system.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: A. instruct him to hold his breath for as long as he comfortably can. B. immediately reapply the oxygen mask and reassess his condition. C. advise him to exhale forcefully to ensure medication absorption. D. allow him to breathe room air and assess his oxygen saturation.

A. instruct him to hold his breath for as long as he comfortably can.

All of the following are hollow abdominal organs, EXCEPT for the: A. liver. B. bladder. C. ureters. D. stomach.

A. liver.

Bruising to the right upper quadrant of the abdomen following blunt trauma is MOST suggestive of injury to the: A. liver. B. spleen. C. kidney. D. stomach.

A. liver.

Placing a pregnant patient in a supine position during the third trimester of pregnancy: A. may decrease the amount of blood that returns to the heart. B. often causes hypotension secondary to cardiac compression. C. results in spontaneous urinary incontinence if the bladder is full. D. is recommended if the patient has severe abdominal discomfort.

A. may decrease the amount of blood that returns to the heart.

The MOST common and significant complication associated with fractures or dislocations of the knee is: A. neurovascular compromise. B. internal bleeding and shock. C. ligament and cartilage damage. D. total depletion of synovial fluid.

A. neurovascular compromise.

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A. nondisplaced pelvic fracture B. open fractures of a long bone C. an amputation of an extremity D. multiple closed long bone fractures

A. nondisplaced pelvic fracture

Hypovolemic shock caused by severe burns is the result of a loss of: A. plasma. B. platelets. C. whole blood. D. red blood cells.

A. plasma.

Patients develop septic shock secondary to: A. poor vessel function and severe volume loss. B. an infection that weakens cardiac contractions. C. failure of the blood vessels to adequately dilate. D. weak vessel tone due to nervous system damage.

A. poor vessel function and severe volume loss.

The primary purpose for splinting a musculoskeletal injury is to: A. prevent further injury. B. maximize distal circulation. C. make the patient comfortable. D. facilitate ambulance transport.

A. prevent further injury.

The pectoral girdle consists of the: A. scapulae and clavicles. B. clavicles and rib cage. C. sternum and scapulae. D. acromion and clavicles.

A. scapulae and clavicles.

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing: A. septic shock. B. pump failure. C. a local infection. D. decompensated shock.

A. septic shock.

Dyspnea is MOST accurately defined as: A. shortness of breath or difficulty breathing. B. a complete cessation of respiratory effort. C. a marked increase in the exhalation phase. D.labored breathing with reduced tidal volume.

A. shortness of breath or difficulty breathing.

Which of the following joints allows no motion? A. skull sutures B. sacroiliac joint C. shoulder joint D. sternoclavicular joint

A. skull sutures

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should: A. splint the elbow in the position found and transport. B. gently manipulate the elbow to improve circulation. C. gently straighten the elbow and apply an air splint. D. apply a heat pack to the elbow to reduce swelling.

A. splint the elbow in the position found and transport.

Deformity caused by a fracture would MOST likely be masked by: A. swelling. B. guarding. C. crepitus. D. ecchymosis.

A. swelling.

The act of pulling on a body structure in the direction of its normal alignment is called: A. traction. B. reduction. C. stabilization. D. immobilization.

A. traction.

The most appropriate treatment for a patient with mild upper airway obstruction includes:

Administering oxygen and transporting immediately

50. During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 7. B. 8. C. 9. D. 10.

Answer: A Question Type: Critical Thinking Page: 767

47. According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. D. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.

Answer: A Question Type: General Knowledge Page: 765

9. Which of the following processes occurs during the inflammation phase of the healing process? A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. B. White blood cells are forced away from the injury site, thus allowing an increase in the flow of red blood cells, resulting in increased blood flow. C. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection. D. The veins and arteries at the injury site constrict and platelets aggregate, which stops bleeding and causes a temporary increase in the size of the wound.

Answer: A Question Type: General Knowledge Page: 807

71. What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? A. 5,600 mL B. 6,000 mL C. 7,200 mL D. 8,000 mL

Answer: A Question Type: Critical Thinking Page: 162

15. A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should: A. contact medical control if needed, transport the patient, and monitor him for signs of deterioration. B. ask him if he has epinephrine and request approval from medical control to administer it to the patient. C. avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe. D. begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.

Answer: A Question Type: Critical Thinking Page: 650

20. You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should: A. ask her if she has prescribed epinephrine. B. obtain a complete set of baseline vital signs. C. ascertain if she has a family history of allergies. D. ask her when her last allergic reaction occurred.

Answer: A Question Type: Critical Thinking Page: 652

20. You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: A. initiate ventilatory assistance. B. contact the poison control center. C. perform a rapid head-to-toe exam. D. apply oxygen via a nonrebreathing mask.

Answer: A Question Type: Critical Thinking Page: 677

36. During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. This patient's clinical presentation is MOST consistent with: A. a heroin overdose. B. alcohol intoxication. C. a closed head injury. D. an overdose of diazepam (Valium).

Answer: A Question Type: Critical Thinking Page: 681

15. A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: A. open the patient's airway and assess his respirations. B. ask the police to handcuff the patient for safety purposes. C. provide care after determining what Dilaudid is used for. D. wait for the police to examine him before providing care

Answer: A Question Type: Critical Thinking Page: 705

21. In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to: A. diffuse and control the situation and safely transport the patient. B. diagnose the patient's problem and provide definitive treatment. C. transport the patient directly to a specialized psychiatric facility. D. determine the underlying cause of the problem and offer advice.

Answer: A Question Type: Critical Thinking Page: 707

24. 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? A. Ask the patient if she has developed a suicidal plan. B. Leave the scene and have a neighbor check in on her. C. Have law enforcement place her in protective custody. D. Encourage the patient to remain quiet during transport.

Answer: A Question Type: Critical Thinking Page: 708-709

16. The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: A. transport to a trauma center. B. a focused exam of her forearm. C. transport to a community hospital. D. a secondary assessment at the scene.

Answer: A Question Type: Critical Thinking Page: 752

26. A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A. compression of the head against the roof B. lateral bending of the neck during the crash C. impact of the head against the steering wheel D. whiplash injury to the neck during the rollover

Answer: A Question Type: Critical Thinking Page: 755

28. A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. stabilize her entire spine. B. obtain baseline vital signs. C. inspect the helmet for cracks. D. leave her bicycle helmet on.

Answer: A Question Type: Critical Thinking Page: 756

37. A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience? A. head injury B. cardiac contusion C. pulmonary contusion D. multiple rib fractures

Answer: A Question Type: Critical Thinking Page: 759

32. A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should: A. control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately. B. remove the steel rod, control the bleeding, apply an automated external defibrillator (AED), begin CPR, and transport to a trauma center. C. stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center. D. control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.

Answer: A Question Type: Critical Thinking Page: 820

51. A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. A. 18% B. 27% C. 36% D. 45%

Answer: A Question Type: Critical Thinking Page: 825

56. A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should: A. rapidly assess the patient after ensuring that the power line is not live. B. apply insulated gloves and assume manual control of his c-spine. C. quickly but carefully move the patient away from the power line. D. manually stabilize his head as your partner assesses for breathing.

Answer: A Question Type: Critical Thinking Page: 827

58. A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: A. begin CPR and apply the AED. B. begin CPR and transport at once. C. assess for entry and exit wounds. D. fully immobilize his spinal column.

Answer: A Question Type: Critical Thinking Page: 828

31. A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: A. irrigating his right eye laterally. B. flushing his eye starting laterally. C. irrigating both eyes simultaneously. D. covering both eyes and transporting.

Answer: A Question Type: Critical Thinking Page: 860

39. A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A. close her eyes and cover them with a moist dressing. B. secure her eyes open so you can reassess her pupils. C. inspect her eyes and gently remove impaled objects. D. irrigate her eyes with water to prevent mucosal drying.

Answer: A Question Type: Critical Thinking Page: 869

42. A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: A. leaning him forward and pinching his nostrils together. B. packing the nasopharynx with moist, sterile dressings. C. applying a gauze pad in between his lower lip and gum. D. placing him supine and pinching his nostrils together.

Answer: A Question Type: Critical Thinking Page: 870

45. A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. D. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

Answer: A Question Type: Critical Thinking Page: 872-873

1. The nose, chin, umbilicus (navel), and spine are examples of ___________ anatomic structures. A. midline B. proximal C. superior D. midaxillary

Answer: A Question Type: General Knowledge Page: 144

4. A fracture of the humerus just above the elbow would be described as a: A. distal humerus fracture. B. proximal elbow fracture. C. distal forearm fracture. D. proximal humerus fracture.

Answer: A Question Type: General Knowledge Page: 144-145

11. The ___________ of the heart is the inferior portion of the left ventricles. A. apex B. base C. dorsum D. septum

Answer: A Question Type: General Knowledge Page: 145

20. Which of the following is NOT a facial bone? A. mastoid B. maxilla C. mandible D. zygoma

Answer: A Question Type: General Knowledge Page: 148

21. The ___________ is made up of the maxilla and zygoma, as well as the frontal bone of the cranium. A. orbit B. occiput C. mastoid D. sphenoid

Answer: A Question Type: General Knowledge Page: 148

25. The ___________ portion of the spinal column is joined to the iliac bones of the pelvis. A. sacrum B. coccyx C. lumbar D. thoracic

Answer: A Question Type: General Knowledge Page: 148

28. The most superior portion of the sternum is called the: A. manubrium. B. costal arch. C. angle of Louis. D. xiphoid process.

Answer: A Question Type: General Knowledge Page: 149

30. What three bones make up the shoulder girdle? A. clavicle, scapula, humerus B. acromion, clavicle, scapula C. acromion, scapula, humerus D. acromion, humerus, clavicle

Answer: A Question Type: General Knowledge Page: 149

33. The bones of the forearm are called the: A. radius and ulna. B. tibia and radius. C. humerus and ulna. D. radius and humerus.

Answer: A Question Type: General Knowledge Page: 150

42. The elbow is an example of a ____________ joint. A. hinge B. saddle C. gliding D. ball-and-socket

Answer: A Question Type: General Knowledge Page: 152

44. Which of the following statements regarding smooth muscle is correct? A. A person has no voluntary control over smooth muscle. B. Smooth muscle is found exclusively within blood vessels. C. The biceps and quadriceps are examples of smooth muscle. D. Smooth muscle is under control of the voluntary nervous system.

Answer: A Question Type: General Knowledge Page: 153

47. A by-product of involuntary muscle contraction and relaxation is: A. heat. B. oxygen. C. nitrogen. D. lactic acid.

Answer: A Question Type: General Knowledge Page: 154

49. The vocal cords are located in the: A. larynx. B. pharynx. C. oropharynx. D. nasopharynx

Answer: A Question Type: General Knowledge Page: 155

55. The diaphragm and intercostal muscles contract during: A. inhalation. B. exhalation. C. respiration. D. ventilation.

Answer: A Question Type: General Knowledge Page: 158

62. The backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called the: A. hypoxic drive. B. pneumotaxic drive. C. hypocarbic drive. D. oxyhemoglobin drive.

Answer: A Question Type: General Knowledge Page: 160

63. The dorsal respiratory group (DRG) is a part of the brain stem and is responsible for: A. initiating inspiration. B. inhibiting deep inspiration. C. controlling expiration. D. decreasing respiratory depth.

Answer: A Question Type: General Knowledge Page: 160

64. Which of the following signs of respiratory distress is typically unique to infants and children? A. seesaw respirations B. unequal breath sounds C. unequal chest expansion D. irregular breathing pattern

Answer: A Question Type: General Knowledge Page: 161

70. If an average-sized patient's chest barely moves during inhalation, even if his or her respiratory rate is normal, you should suspect that: A. minute volume is decreased. B. inspiratory reserve is increased. C. overall tidal volume is increased. D. expiratory reserve volume is decreased.

Answer: A Question Type: General Knowledge Page: 162

72. Signs of adequate breathing in the adult include all of the following, EXCEPT: A. a reduction in tidal volume. B. respirations of 20 breaths/min. C. bilaterally clear breath sounds. D. rhythmic inhalation and exhalation.

Answer: A Question Type: General Knowledge Page: 162

76. Which of the following statements regarding the heart is correct? A. It is under control of the autonomic nervous system. B. It can tolerate an interruption of oxygen for 5 minutes. C. It receives its blood supply from the pulmonary arteries. D. It relies on an external electrical source to correctly function.

Answer: A Question Type: General Knowledge Page: 163

77. The primary function of the right atrium is to: A. receive blood from the vena cava. B. pump blood to the pulmonary artery. C. receive blood from the pulmonary veins. D. pump blood to the lungs for reoxygenation.

Answer: A Question Type: General Knowledge Page: 164

79. The left side of the heart receives oxygenated blood from the lungs through the: A. pulmonary veins. B. pulmonary arteries. C. inferior venae cavae. D. superior venae cavae.

Answer: A Question Type: General Knowledge Page: 164

83. The electrical impulse of the heart normally begins at the: A. sinoatrial node. B. bundle of His. C. Purkinje fibers. D. atrioventricular node.

Answer: A Question Type: General Knowledge Page: 165

85. The major artery that supplies all other arteries with blood is the: A. aorta. B. carotid. C. brachial. D. femoral.

Answer: A Question Type: General Knowledge Page: 166

86. Which of the following are central pulses? A. femoral and carotid B. brachial and radial C. temporal and pedal D. popliteal and ulnar

Answer: A Question Type: General Knowledge Page: 166

91. Capillary sphincter closure during internal or external bleeding is detrimental because: A. waste products are not removed and nutrients are not delivered to the cells. B. available blood is shunted off to another venule while still carrying oxygen. C. high levels of oxygen remain in the cell and can cause significant damage. D. carbon dioxide and other waste can enter the cell, but oxygen cannot enter.

Answer: A Question Type: General Knowledge Page: 168

94. Which of the following statements regarding plasma is correct? A. Plasma transports the blood cells and nutrients. B. Approximately 45% of the blood is composed of plasma. C. Plasma has no role in the body's blood-clotting mechanism. D. Most of the body's plasma is contained within the large veins.

Answer: A Question Type: General Knowledge Page: 169

97. What is the function of platelets? A. initial formation of a blood clot B. transport of oxygen and nutrients C. defense against invading organisms D. transport of cellular waste materials

Answer: A Question Type: General Knowledge Page: 170

102. ___________ pressure is the pressure exerted by a liquid and occurs when blood is moved through the artery at relatively high pressures. A. Hydrostatic B. Osmotic C. Oncotic D. Diffusion

Answer: A Question Type: General Knowledge Page: 171

105. An increase in heart rate and contractility occurs due to stimulation of: A. beta-1 receptors. B. beta-2 receptors. C. alpha-1 receptors. D. alpha-2 receptors.

Answer: A Question Type: General Knowledge Page: 173

109. The central nervous system is composed of the: A. brain and spinal cord. B. brain and sensory nerves. C. motor and sensory nerves. D. spinal cord and sensory nerves.

Answer: A Question Type: General Knowledge Page: 174

111. The largest portion of the brain, which is commonly referred to as the "gray matter," is called the: A. cerebrum. B. cerebellum. C. brain stem. D. diencephalon.

Answer: A Question Type: General Knowledge Page: 174

112. The part of the brain that controls the left side of the body is the: A. right side cerebrum. B. left side cerebrum. C. left parietal lobe. D. right temporal lobe.

Answer: A Question Type: General Knowledge Page: 174

117. The connecting nerve, a nerve of the peripheral nervous system, functions by: A. connecting the sensory and motor nerves and bypassing the brain. B. connecting motor nerves directly to the walls of the blood vessels. C. connecting sensory nerves directly to the posterior cerebral cortex. D. connecting the spinal cord directly to the target muscle or organ.

Answer: A Question Type: General Knowledge Page: 176

119. Which of the following skin layers contains sweat and oil glands, hair follicles, blood vessels, and nerve endings? A. dermis B. epidermis C. sebaceous D. subcutaneous

Answer: A Question Type: General Knowledge Page: 178

122. Which of the following organs is NOT part of the digestive system? A. kidney B. pancreas C. stomach D. gallbladder

Answer: A Question Type: General Knowledge Page: 179

123. The __________ fills the entire anteroposterior depth of the right upper quadrant (RUQ) of the abdomen. A. liver B. spleen C. pancreas D. stomach

Answer: A Question Type: General Knowledge Page: 180

131. Abnormalities in metabolism are MOST likely caused by dysfunction of the: A. pancreas. B. thyroid gland. C. adrenal gland. D. parathyroid gland.

Answer: A Question Type: General Knowledge Page: 184

133. Which of the following statements regarding the kidneys is correct? A. The kidneys eliminate toxic waste products from the body and control its balance of water and salt. B. Both kidneys are located in the anterior abdominal cavity and lie in between the liver and the spleen. C. Since the kidneys require little oxygen, only 5% of your blood volume passes through them each minute. D. A series of small blood vessels attach the kidneys directly to the superior vena cava and renal arteries.

Answer: A Question Type: General Knowledge Page: 185

1. Which of the following MOST accurately defines an allergic reaction? A. an exaggerated immune system response to any substance B. destruction of the immune system by an external substance C. a release of erythrocytes in response to a foreign substance D. a direct negative effect on the body by an external substance

Answer: A Question Type: General Knowledge Page: 647

4. The two MOST common signs of anaphylaxis are: A. wheezing and widespread urticaria. B. watery eyes and localized itching. C. expiratory stridor and tachycardia. D. hypertension and swollen hands.

Answer: A Question Type: General Knowledge Page: 647

5. Urticaria is the medical term for: A. hives. B. burning. C. swelling. D. a wheal.

Answer: A Question Type: General Knowledge Page: 647

6. The foreign substance responsible for causing an allergic reaction is called a(n): A. allergen. B. antibody. C. histamine. D. leukotriene.

Answer: A Question Type: General Knowledge Page: 647

8. Which of the following statements regarding fire ants is correct? A. Fire ants often bite a person repeatedly. B. Fire ant bites rarely cause anaphylaxis. C. Fire ant bites typically occur on the face. D. Most people are allergic to fire ant toxin.

Answer: A Question Type: General Knowledge Page: 648

26. Epinephrine is indicated for patients with an allergic reaction when: A. wheezing and hypotension are present. B. the patient is anxious and tachycardic. C. a paramedic is present at the scene. D. the reaction produces severe urticaria.

Answer: A Question Type: General Knowledge Page: 654

30. Immediately after giving an epinephrine injection, you should: A. properly dispose of the syringe. B. record the time and dose given. C. reassess the patient's vital signs. D. notify medical control of your action.

Answer: A Question Type: General Knowledge Page: 656

34. Common side effects of epinephrine include all of the following, EXCEPT: A. drowsiness. B. tachycardia. C. headache. D. dizziness.

Answer: A Question Type: General Knowledge Page: 659

3. Heroin is an example of a(n): A. opioid. B. hypnotic. C. cholinergic. D. sympathomimetic.

Answer: A Question Type: General Knowledge Page: 670

9. A poison that enters the body by __________ is the MOST difficult to treat. A. injection B. ingestion C. inhalation D. absorption

Answer: A Question Type: General Knowledge Page: 671

11. Which of the following statements regarding inhaled poisons is correct? A. Lung damage may progress after the patient is removed from the environment. B. Carbon monoxide is very irritating to the upper airway and may cause swelling. C. Burns around the eyes are the most common indication of an inhalation poisoning. D. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema.

Answer: A Question Type: General Knowledge Page: 672

14. Most poisonings occur via the __________ route. A. ingestion B. injection C. inhalation D. absorption

Answer: A Question Type: General Knowledge Page: 674

18. As you enter the residence of a patient who has possibly overdosed, you should: A. be alert for personal hazards. B. look for drug paraphernalia. C. observe the scene for drug bottles. D. quickly gain access to the patient.

Answer: A Question Type: General Knowledge Page: 676

22. Airborne substances are diluted with: A. oxygen. B. syrup of ipecac. C. activated charcoal. D. an alkaline antidote.

Answer: A Question Type: General Knowledge Page: 678

24. Common names for activated charcoal include all of the following, EXCEPT: A. Fructose. B. Actidose. C. LiquiChar. D. InstaChar.

Answer: A Question Type: General Knowledge Page: 679

27. Before giving activated charcoal, you should: A. obtain approval from medical control. B. have the patient drink a glass of milk. C. mix it with an equal amount of water. D. mix the suspension by stirring the bottle.

Answer: A Question Type: General Knowledge Page: 679

32. A hypnotic drug is one that: A. induces sleep. B. prevents amnesia. C. increases the pulse. D. increases the senses.

Answer: A Question Type: General Knowledge Page: 680

44. An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause: A. liver failure. B. gastric ulcers. C. kidney failure. D. central nervous system (CNS) depression.

Answer: A Question Type: General Knowledge Page: 686

4. In contrast to a behavioral crisis, a psychiatric emergency occurs when a person: A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others. B. experiences feelings of sadness and despair for longer than a month. C. exhibits impaired functioning due to a chemical or genetic disturbance. D. experiences a sudden attack of panic secondary to a stressful situation.

Answer: A Question Type: General Knowledge Page: 702

14. When assessing a patient with a behavioral crisis, you should: A. be direct and clearly state your intentions. B. frisk the patient for the presence of weapons. C. spend as little time with the patient as possible. D. ask the police to handcuff the patient for safety.

Answer: A Question Type: General Knowledge Page: 704

23. The single most significant factor that contributes to suicide is: A. depression. B. drug abuse. C. advanced age. D. a chronic illness.

Answer: A Question Type: General Knowledge Page: 708

25. People at risk for suicide include all of the following, EXCEPT: A. married males older than 30 years. B. those with a recent diagnosis of a serious illness. C. children with parents addicted to alcohol. D. substance abusers.

Answer: A Question Type: General Knowledge Page: 709

4. Force acting over a distance defines the concept of: A. work. B. latent energy. C. kinetic energy. D. potential energy.

Answer: A Question Type: General Knowledge Page: 748

9. Two of the MOST common mechanisms of injury for blunt trauma are: A. falls and motor vehicle collisions. B. low-caliber gunshot wounds and falls. C. gunshot wounds and vehicle ejections. D. motor vehicle collisions and stabbings.

Answer: A Question Type: General Knowledge Page: 750

15. If one or more occupants in the same vehicle are killed in a crash, the EMT should: A. suspect that all living occupants experienced the same serious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. rapidly assess only the survivors who have experienced obvious trauma.

Answer: A Question Type: General Knowledge Page: 752

19. When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A. door B. dashboard C. windshield D. steering wheel

Answer: A Question Type: General Knowledge Page: 753

22. The cervical spine is MOST protected from whiplash-type injuries when the: A. headrest is appropriately positioned. B. air bag correctly deploys upon impact. C. patient tenses up at the time of impact. D. rear end of the vehicle is initially struck.

Answer: A Question Type: General Knowledge Page: 754

31. Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. the speed of the fall. B. the surface struck. C. the height of the fall. D. the primary impact point.

Answer: A Question Type: General Knowledge Page: 758

32. When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall. B. any fall in the elderly is considered to be high-energy trauma. C. elderly patients who fall usually have a secondary head injury. D. bilateral hip fractures usually occur when an elderly person falls.

Answer: A Question Type: General Knowledge Page: 758

3. The germinal layer of the epidermis contains pigment granules that are responsible for skin: A. color. B. texture. C. moisture. D. temperature.

Answer: A Question Type: General Knowledge Page: 806

6. All of the following body structures are lined with mucous membranes, EXCEPT for the: A. lips. B. nose. C. anus. D. mouth.

Answer: A Question Type: General Knowledge Page: 806

17. In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is: A. infection. B. hypothermia. C. nerve damage. D. vessel damage.

Answer: A Question Type: General Knowledge Page: 809

22. Which of the following statements regarding penetrating injuries is correct? A. External bleeding may be minimal but internal injuries can be extensive. B. The degree of internal injury can often be estimated by the external injury. C. It is important to distinguish between entrance and exit wounds in the field. D. The depth of a penetrating injury should be thoroughly assessed by the EMT.

Answer: A Question Type: General Knowledge Page: 810

34. In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: A. an air embolism. B. a spinal fracture. C. an ischemic stroke. D. nerve fiber damage.

Answer: A Question Type: General Knowledge Page: 821

38. Burns are classified according to: A. depth and extent. B. location and pain. C. degree and location. D. extent and location.

Answer: A Question Type: General Knowledge Page: 823

39. Which of the following is a severe burn in a 35-year-old patient? A. circumferential partial-thickness burn to the chest B. full-thickness burn to 5% of the body surface area (BSA) C. partial-thickness burn to 20% of the BSA D. superficial burn covering 50% of the BSA

Answer: A Question Type: General Knowledge Page: 823

48. According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA. A. 1% B. 2% C. 4% D. 6%

Answer: A Question Type: General Knowledge Page: 825

57. Which of the following statements regarding electrical burns is correct? A. Entrance wounds are small relative to the amount of internal tissue damage. B. Respiratory or cardiac arrest following an electrical burn is very uncommon. C. The exit wound caused by electrical burns is smaller than the entrance wound. D. The size of the entry and exit wounds is a reliable indicator of internal damage.

Answer: A Question Type: General Knowledge Page: 827

61. Functions of dressings and bandages include all of the following, EXCEPT: A. immobilization of the injury. B. prevention of contamination. C. protection from further injury. D. control of external hemorrhage.

Answer: A Question Type: General Knowledge Page: 836

5. The mastoid process is located approximately: A. 1″ posterior to the external opening of the ear. B. ½″ anterior to the external opening of the ear. C. 1″ inferior to the external opening of the ear. D. 1″ posterior to the angle of the mandible.

Answer: A Question Type: General Knowledge Page: 852

14. The opening in the center of the iris, which allows light to move to the back of the eye, is called the: A. pupil. B. sclera. C. cornea. D. conjunctiva.

Answer: A Question Type: General Knowledge Page: 853-854

17. The optic nerve endings are located within the: A. retina. B. sclera. C. pupil. D. cornea.

Answer: A Question Type: General Knowledge Page: 854

19. The skin and underlying tissues of the face: A. have a rich blood supply and bleed profusely. B. swell minimally when exposed to blunt trauma. C. are well protected by the maxillae and mandible. D. contain a relatively small number of nerve fibers.

Answer: A Question Type: General Knowledge Page: 855

21. Facial injuries should be identified and treated as soon as possible because: A. of the risk for airway problems. B. bleeding must be controlled early. C. the spine may be injured as well. D. swelling may mask hidden injuries.

Answer: A Question Type: General Knowledge Page: 856

35. The term "hyphema" is defined as: A. blood in the anterior chamber of the eye. B. an acute rupture of the globe of the eye. C. inflammation of the iris, cornea, and lens. D. compression of one or both optic nerves.

Answer: A Question Type: General Knowledge Page: 867

26. As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: A. open his airway and assess his breathing status. B. perform an immediate head-to-toe assessment. C. assess his pulse for rate, regularity, and quality. D. apply high-flow oxygen and assess his injuries.

Answer: A Question Type: Critical Thinking Page: 817

39. During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the tertiary phase. B. during the secondary phase. C. during the primary phase. D. as a direct result of the pressure wave.

Answer: A Question Type: General Knowledge Page: 760

37. You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include: A. assisted ventilation, naloxone (Narcan), and rapid transport. B. oxygen via a nonrebreathing mask and rapid transport. C. assisted ventilation, flumazenil (Romazicon), and rapid transport. D. oxygen via a nasal cannula, atropine, and rapid transport.

Answer: A Question Type: Critical Thinking Page: 681-682

23. You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID? A. a shuffling gait when walking B. bright red blood in the urine C. a history of ectopic pregnancy D. vaginal passage of blood clots

Answer: A Question Type: Critical Thinking Page: 732

26. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. advise her that she cannot clean herself up because this will destroy evidence. C. ask her if there is anyone you can contact, such as a friend or relative. D. perform a limited hands-on assessment to detect life-threatening injuries.

Answer: A Question Type: Critical Thinking Page: 733

17. In general, injected poisons are impossible to dilute or remove because they: A. are usually absorbed quickly into the body. B. are usually fatal within 30 minutes of exposure. C. absorb slowly into the body, despite their potency. D. react with the blood, which increases their toxicity.

Answer: A Question Type: General Knowledge Page: 676

5. When assessing a patient who is displaying bizarre behavior, the EMT should: A. consider that an acute medical illness may be causing the patient's behavior. B. avoid asking questions about suicide because this may give the patient ideas. C. check his or her blood glucose level only if he or she has a history of diabetes. D. carefully document his or her perception of what is causing the patient's behavior.

Answer: A Question Type: General Knowledge Page: 702

4. When a female has reached menarche: A. she is capable of becoming pregnant. B. she can no longer produce an ovum. C. she usually requires hormone therapy. D. menstrual periods become less frequent.

Answer: A Question Type: General Knowledge Page: 726

11. As a woman approaches menopause: A. her menstrual periods may become irregular and vary in severity. B. she cannot become pregnant because of fluctuating hormone levels. C. she usually experiences abdominal cramping without vaginal bleeding. D. her risk of developing PID lowers significantly.

Answer: A Question Type: General Knowledge Page: 727

12. Which of the following conditions would MOST likely lead to PID if left untreated? A. chlamydia B. ovarian cysts C. genital herpes D. ectopic pregnancy

Answer: A Question Type: General Knowledge Page: 727

15. In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. may be relatively painless. B. is typically not as severe. C. can be controlled in the field. D. often presents with acute pain.

Answer: A Question Type: General Knowledge Page: 728

16. Whenever possible, a female sexual assault victim should be: A. given the option of being treated by a female EMT. B. encouraged to take a shower and change her clothes. C. thoroughly assessed, even if no signs of injury exist. D. asked to provide a brief description of the perpetrator.

Answer: A Question Type: General Knowledge Page: 729

17. When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A. has gathered patient history information. B. has obtained a complete set of vital signs. C. ascertains if the patient was ever pregnant. D. has formed a general impression of the patient.

Answer: A Question Type: General Knowledge Page: 729

27. The physical examination of a sexual assault victim should be: A. limited to a brief survey for life-threatening injuries. B. performed in the presence of at least two police officers. C. as detailed as possible so all injuries can be documented. D. deferred until the patient can be evaluated by a physician.

Answer: A Question Type: General Knowledge Page: 733

6. The Adam's apple is: A. the upper part of the larynx that is formed by the thyroid cartilage. B. the lower part of the larynx that is formed by the cricoid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. below the thyroid cartilage and forms the upper part of the trachea.

Answer: A Question Type: General Knowledge Page: 852

41. Signs of a pulmonary blast injury include: A. vomiting blood. B. coughing up blood. C. an irregular pulse. D. multiple rib fractures.

Answer: B Question Type: General Knowledge Page: 761

13. Which of the following statements regarding crush syndrome is correct? A. With crush syndrome, massive blood vessel damage occurs following severe soft-tissue injuries, such as amputation of an extremity. B. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. C. Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely because toxins are quickly eliminated from the body. D. Provided that a patient with a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal.

Answer: B Question Type: General Knowledge Page: 808

16. A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? A. Ask the patient if he has any diphenhydramine (Benadryl) tablets that you can administer. B. Administer oxygen, transport at once, and request a paramedic intercept. C. Remain at the scene with the patient and request a paramedic ambulance. D. Quickly determine if there are any bystanders who may carry epinephrine.

Answer: B Question Type: Critical Thinking Page: 650

18. A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should: A. perform a rapid secondary assessment. B. assist her ventilations with 100% oxygen. C. administer 0.3 mg of epinephrine. D. place her supine with her legs elevated 6″ to 12″.

Answer: B Question Type: Critical Thinking Page: 651

19. A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: A. perform a detailed secondary assessment. B. maintain his airway and assist his ventilations. C. ask his wife if he has any known allergies. D. apply the automated external defibrillator (AED) in the event that cardiac arrest occurs.

Answer: B Question Type: Critical Thinking Page: 651

35. A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: A. position her legs well above the level of her heart. B. administer oxygen and transport her to the hospital. C. request a paramedic unit to administer epinephrine. D. advise her to see her physician as soon as possible.

Answer: B Question Type: Critical Thinking Page: 659

19. Your unit is dispatched to the county jail for an 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: A. might become violent. B. may vomit and aspirate. C. may experience a seizure. D. is severely hypoglycemic.

Answer: B Question Type: Critical Thinking Page: 677

41. You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include: A. thoroughly suctioning her oropharynx. B. assisted ventilation with a bag-mask device. C. performing a rapid secondary assessment. D. requesting a paramedic to give her atropine.

Answer: B Question Type: Critical Thinking Page: 685

7. A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should: A. transport the patient to a psychiatric facility. B. inquire about the possibility of head trauma. C. conclude that the patient's blood sugar is high. D. allow the patient to refuse transport if she wishes.

Answer: B Question Type: Critical Thinking Page: 703

11. 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: A. ask the husband to attempt to reason with his wife. B. remain in a safe place and request law enforcement. C. get in your ambulance and leave the scene immediately. D. go upstairs with caution and attempt to talk to the patient.

Answer: B Question Type: Critical Thinking Page: 704

16. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should: A. conclude that the patient has Alzheimer's disease. B. ask the daughter how her father normally behaves. C. carefully restrain the patient and transport at once. D. advise the patient that his behavior is unacceptable.

Answer: B Question Type: Critical Thinking Page: 705

19. You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system? A. an irregular pulse B. rapid eye movement C. excessive tearing or crying D. consistent eye contact

Answer: B Question Type: Critical Thinking Page: 706

20. While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma. B. neck and facial injuries. C. blunt trauma to the head. D. lower extremity fractures.

Answer: B Question Type: Critical Thinking Page: 753

30. A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A. lateral impact to the spine B. energy transmission to the spine C. direct trauma to the spinal column D. secondary fall after the initial impact

Answer: B Question Type: Critical Thinking Page: 758

45. A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: A. injury to the cervical spine. B. potential airway compromise. C. damage to internal structures. D. alterations in his mental status.

Answer: B Question Type: Critical Thinking Page: 763

15. A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has: A. internal hemorrhage. B. compartment syndrome. C. a severe closed fracture. D. damage to the radial nerve.

Answer: B Question Type: Critical Thinking Page: 808

23. During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a: A. handgun. B. shotgun. C. .22-caliber pistol. D. .357 magnum.

Answer: B Question Type: Critical Thinking Page: 811

25. During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should: A. perform a focused physical exam of his abdomen. B. administer oxygen and prepare for rapid transport. C. place him in a sitting position and give him oxygen. D. conclude that he is experiencing intracranial bleeding.

Answer: B Question Type: Critical Thinking Page: 815

37. During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct? A. You should contact the police and have the patients arrested. B. The 39-year-old female is at high risk for an infection. C. The patient struck in the mouth should be immobilized. D. The 44-year-old female is at high risk for an infection.

Answer: B Question Type: Critical Thinking Page: 822

25. You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: A. is allergic to any medications. B. has a history of eye surgeries. C. regularly sees a family physician. D. noticed the change during a meal.

Answer: B Question Type: Critical Thinking Page: 858

28. You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. quickly suction his oropharynx. B. turn the backboard onto its side. C. reassess his breathing adequacy. D. alert the hospital of the situation.

Answer: B Question Type: Critical Thinking Page: 859

30. A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: A. acute retinitis. B. conjunctivitis. C. a detached retina. D. a corneal abrasion.

Answer: B Question Type: Critical Thinking Page: 860

33. A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: A. flush both eyes with an alcohol-based solution and transport. B. irrigate both eyes continuously for 20 minutes with plain water. C. neutralize the acid chemical in his eye with an alkaline chemical. D. mix baking soda with water and irrigate his eyes with the solution.

Answer: B Question Type: Critical Thinking Page: 864

34. A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: A. carefully examine her eye and remove any foreign objects if needed. B. avoid applying pressure to the globe when you are covering the eye. C. ask her to move the injured eye to assess the integrity of the optic nerve. D. apply firm direct pressure to the injured eye and cover the opposite eye.

Answer: B Question Type: Critical Thinking Page: 866

36. Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: A. a lacerated globe. B. a blowout fracture. C. a ruptured eyeball. D. optic vessel compression.

Answer: B Question Type: Critical Thinking Page: 867

43. A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: A. applying a tight pressure dressing. B. padding between the ear and the scalp. C. packing the ear with sterile gauze pads. D. covering the wound with a moist dressing.

Answer: B Question Type: Critical Thinking Page: 871

5. The topographic term used to describe the location of body parts that are closer toward the midline or center of the body is: A. lateral. B. medial. C. midaxillary. D. midclavicular.

Answer: B Question Type: General Knowledge Page: 144-145

6. The topographic term used to describe the part of the body that is nearer to the feet is: A. dorsal. B. inferior. C. internal. D. superior.

Answer: B Question Type: General Knowledge Page: 144-145

9. Which of the following anatomic terms is synonymous with the word "dorsal"? A. medial B. posterior C. palmar D. anterior

Answer: B Question Type: General Knowledge Page: 144-145

10. A young male jumped from a tree and landed feet first. What aspect of his body has sustained the initial injury? A. palmar B. plantar C. dorsal D. ventral

Answer: B Question Type: General Knowledge Page: 145

26. The most distal four spinal vertebrae, which are fused together, form the: A. ilium. B. coccyx. C. sacrum. D. ischium.

Answer: B Question Type: General Knowledge Page: 148

27. Select the areas of the spinal column in descending order. A. cervical, thoracic, sacral, lumbar, coccyx B. cervical, thoracic, lumbar, sacral, coccyx C. cervical, thoracic, coccyx, lumbar, sacral D. cervical, lumbar, thoracic, sacral, coccyx

Answer: B Question Type: General Knowledge Page: 148

29. The inferior cartilaginous tip of the sternum is called the: A. sternal notch. B. xiphoid process. C. angle of Louis. D. jugular notch.

Answer: B Question Type: General Knowledge Page: 149

31. The ____________ is a muscular dome that forms the inferior boundary of the thorax, separating the thorax from the abdomen. A. costal arch B. diaphragm C. mediastinum D. costovertebral angle

Answer: B Question Type: General Knowledge Page: 150

34. The supporting bone of the arm is the: A. ulna. B. humerus. C. radius. D. clavicle.

Answer: B Question Type: General Knowledge Page: 150

36. Each pelvic bone is formed by the fusion of the: A. sacrum and ischium. B. ilium, ischium, and pubis. C. pubis and acetabulum. D. ilium, pubis, and sacrum.

Answer: B Question Type: General Knowledge Page: 150

40. Anterior to the knee is a specialized bone called the: A. tibia. B. patella. C. femur. D. calcaneus.

Answer: B Question Type: General Knowledge Page: 151

41. The distal aspect of the tibia forms the: A. lateral condyle. B. medial malleolus. C. Achilles tendon. D. lateral malleolus.

Answer: B Question Type: General Knowledge Page: 151

43. A person's bones would become brittle if he or she was deficient in: A. sodium. B. calcium. C. potassium. D. magnesium.

Answer: B Question Type: General Knowledge Page: 153

50. The leaf-shaped flap of tissue that prevents food and liquid from entering the trachea during swallowing is called the: A. uvula. B. epiglottis. C. vallecula. D. pharynx.

Answer: B Question Type: General Knowledge Page: 155

51. The firm cartilaginous ring that forms the inferior portion of the larynx is called the: A. costal cartilage. B. cricoid cartilage. C. thyroid cartilage. D. laryngo cartilage.

Answer: B Question Type: General Knowledge Page: 155

53. As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the: A. pleura. B. alveoli. C. bronchi. D. capillaries.

Answer: B Question Type: General Knowledge Page: 157

56. Negative pressure breathing involves: A. relaxing the respiratory muscles. B. a drop in pressure within the chest cavity. C. pushing or forcing air into the lungs. D. increasing airway resistance during breathing.

Answer: B Question Type: General Knowledge Page: 158

60. Which of the following statements regarding the medulla oblongata is correct? A. The medulla reduces the rate and depth of breathing if it detects an increase in carbon dioxide levels. B. The medulla is sensitive to pH changes and sends messages via the phrenic nerve to contract the diaphragm. C. The medulla's primary role is to increase your level of oxygen, not to decrease your level of carbon dioxide. D. The medulla is a portion of the cerebrum and primarily responds to an increase in the pH of CSF.

Answer: B Question Type: General Knowledge Page: 159

61. Relative to the adult's airway, the child's: A. tongue takes up less space in the pharynx. B. pharynx is smaller and less deeply curved. C. trachea is smaller, softer, and less flexible. D. mouth and nose are proportionately larger.

Answer: B Question Type: General Knowledge Page: 160

66. Both areas of the pons are used to: A. provide forced inspiration or expiration as needed. B. augment respirations during emotional or physical stress. C. ensure that the lungs do not overinflate during breathing. D. set the base rate and depth of breathing in a healthy person.

Answer: B Question Type: General Knowledge Page: 161

67. The Hering-Breuer reflex is stimulated when: A. excess carbon dioxide needs to be eliminated from the body. B. stretch receptors in the chest wall detect that the lungs are too full. C. the DRG stops and the process of expiration begins. D. the brain stem senses that there is a low amount of oxygen in the blood.

Answer: B Question Type: General Knowledge Page: 161

68. The amount of air that remains in the lungs simply to keep them open is called: A. tidal volume. B. residual volume. C. inspiratory reserve volume. D. expiratory reserve volume.

Answer: B Question Type: General Knowledge Page: 162

75. The heart muscle is called the: A. epicardium. B. myocardium. C. pericardium. D. endocardium.

Answer: B Question Type: General Knowledge Page: 163

81. During each heartbeat, ___________ of blood is ejected from the adult heart. This is called stroke volume (SV). A. 40 to 50 mL B. 70 to 80 mL C. 90 to 100 mL D. 100 to 120 mL

Answer: B Question Type: General Knowledge Page: 165

88. The artery that can be palpated on the anterior surface of the foot is the: A. ventral pedis. B. dorsalis pedis. C. anterior tibial. D. posterior tibial.

Answer: B Question Type: General Knowledge Page: 166

93. Worn out blood cells, foreign substances, and bacteria are filtered from the blood by the: A. liver. B. spleen. C. kidney. D. pancreas.

Answer: B Question Type: General Knowledge Page: 169

95. Hemoglobin is a molecule that attaches to ___________ and carries oxygen. A. monocytes B. erythrocytes C. leukocytes D. thrombocytes

Answer: B Question Type: General Knowledge Page: 170

98. The phase of the cardiac cycle in which the ventricles fill with blood is called: A. systole. B. diastole. C. cardiac output. D. stroke volume.

Answer: B Question Type: General Knowledge Page: 170

101. The circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called: A. respiration. B. perfusion. C. metabolism. D. cardiac output.

Answer: B Question Type: General Knowledge Page: 171

103. Key hormones of the sympathetic nervous system include: A. acetylcholine and insulin. B. epinephrine and norepinephrine. C. glucagon and noradrenaline. D. norepinephrine and acetylcholine.

Answer: B Question Type: General Knowledge Page: 172

108. Activities such as walking, talking, and writing are regulated exclusively by the: A. central nervous system. B. somatic nervous system. C. autonomic nervous system. D. involuntary nervous system.

Answer: B Question Type: General Knowledge Page: 173-174

114. Which part of the central nervous system is responsible for coordinating bodily movements such as writing or sewing? A. cerebrum B. cerebellum C. brain stem D. hypothalamus

Answer: B Question Type: General Knowledge Page: 174

120. What layer of the skin is composed of fatty tissue and serves as an insulator for the body? A. epidermis B. subcutaneous C. dermal D. sebaceous

Answer: B Question Type: General Knowledge Page: 178

125. Which of the following organs or structures lies within the retroperitoneal space? A. spleen B. kidneys C. gallbladder D. abdominal aorta

Answer: B Question Type: General Knowledge Page: 180

126. The kidneys and pancreas are called retroperitoneal organs because they: A. are protected by the anterior rib cage. B. are located behind the abdominal cavity. C. sit in front of the liver, spleen, and stomach. D. lie just anterior to the costovertebral angle.

Answer: B Question Type: General Knowledge Page: 180

132. Which of the following glands regulates the function of all other endocrine glands in the body? A. thyroid B. pituitary C. adrenal D. parathyroid

Answer: B Question Type: General Knowledge Page: 184

134. Urine is transported from the kidneys to the urinary bladder via the: A. prostate. B. ureters. C. urethra. D. renal duct.

Answer: B Question Type: General Knowledge Page: 185

138. Which of the following statements regarding anaerobic metabolism is correct? A. Anaerobic metabolism can be supported in most of the body's cells for up to 10 minutes. B. Anaerobic metabolism produces lactic acid and occurs when cellular oxygen is limited. C. The body functions optimally and produces maximum ATP during anaerobic metabolism. D. Without anaerobic metabolism, perfusion to the body would suffer and cellular death would occur.

Answer: B Question Type: General Knowledge Page: 187

140. The air you breathe is _______ oxygen, and the air you exhale is _______ oxygen. A. 16%, 25% B. 21%, 16% C. 25%, 32% D. 21%, 35%

Answer: B Question Type: General Knowledge Page: 188

3. Anaphylaxis is MOST accurately defined as a(n): A. moderate allergic reaction that primarily affects the vasculature. B. extreme allergic reaction that may affect multiple body systems. C. severe allergic reaction that typically resolves without treatment. D. allergic reaction that causes bronchodilation and vasoconstriction.

Answer: B Question Type: General Knowledge Page: 647

11. The stinger from a honeybee should be: A. left in place and covered. B. scraped away from the skin. C. squeezed with tweezers and removed. D. irrigated with copious amounts of water.

Answer: B Question Type: General Knowledge Page: 649

12. Most patients who die of anaphylaxis do so within the first __________ following exposure. A. 5 minutes B. 30 minutes C. 60 minutes D. 90 minutes

Answer: B Question Type: General Knowledge Page: 649

22. Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: A. abdominal cramps. B. drying of the eyes. C. flushing of the skin. D. persistent dry cough.

Answer: B Question Type: General Knowledge Page: 652

23. Which of the following sounds indicates swelling of the upper airway? A. rales B. stridor C. rhonchi D. wheezing

Answer: B Question Type: General Knowledge Page: 653

25. Which of the following physiologic actions does epinephrine produce when given for an allergic reaction? A. bronchodilation and vasodilation B. vasoconstriction and bronchodilation C. bronchoconstriction and vasoconstriction D. blocking of further histamine release

Answer: B Question Type: General Knowledge Page: 654

29. When administering epinephrine via auto-injector, you should hold the injector in place for: A. 5 seconds. B. 10 seconds. C. 15 seconds. D. 20 seconds.

Answer: B Question Type: General Knowledge Page: 656

33. The effects of epinephrine are typically observed within _________ following administration. A. 30 seconds B. 1 minute C. 30 minutes D. 1 hour

Answer: B Question Type: General Knowledge Page: 658

2. The EMT's primary responsibility to the patient who has been poisoned is to: A. administer the appropriate antidote. B. recognize that a poisoning occurred. C. administer 25 g of activated charcoal. D. contact poison control immediately.

Answer: B Question Type: General Knowledge Page: 669

5. Signs and symptoms of a sympathomimetic drug overdose include: A. sedation. B. tachycardia. C. hypotension. D. slurred speech.

Answer: B Question Type: General Knowledge Page: 670

4. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A. ecstasy. B. oxycodone (Percocet). C. amphetamine sulfate (Benzedrine). D. crack cocaine.

Answer: B Question Type: General Knowledge Page: 670, 681

12. Your priority in caring for a patient with a surface contact poisoning is to: A. move the patient to a safe area. B. avoid contaminating yourself. C. decontaminate the patient's skin. D. obtain and maintain a patent airway.

Answer: B Question Type: General Knowledge Page: 673

16. Activated charcoal is given to patients who have ingested certain substances because it: A. induces vomiting and empties the stomach. B. binds to the substance and prevents absorption. C. decreases absorption of poisons into the lungs. D. is a direct antidote for many toxic substances.

Answer: B Question Type: General Knowledge Page: 674

28. The major side effect associated with ingestion of activated charcoal is: A. headache. B. black stools. C. abdominal pain. D. ringing in the ears.

Answer: B Question Type: General Knowledge Page: 679

29. After administering activated charcoal to a patient, it is MOST important to: A. call medical control. B. be alert for vomiting. C. reassess the patient's blood pressure. D. document the intervention.

Answer: B Question Type: General Knowledge Page: 679

31. The MOST commonly abused drug in the United States is: A. cocaine. B. alcohol. C. codeine. D. marijuana.

Answer: B Question Type: General Knowledge Page: 680

1. ____________ is what you can see of a person's response to the environment. A. Affect B. Behavior C. Neurosis D. Psychosis

Answer: B Question Type: General Knowledge Page: 702

2. The term "behavioral crisis" is MOST accurately defined as: A. a sudden, violent outburst of an otherwise mentally stable person toward a family member. B. any reaction that interferes with activities of daily living or is deemed unacceptable by others. C. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people. D. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.

Answer: B Question Type: General Knowledge Page: 702

6. Organic brain syndrome is MOST accurately defined as: A. bizarre behavior secondary to a chemical imbalance or disturbance in the brain. B. a dysfunction of the brain caused by abnormal physical or physiological function. C. a disorder that cannot be traced to the abnormal structure or function of an organ. D. a change in behavior or mental status secondary to inadequate cerebral blood flow.

Answer: B Question Type: General Knowledge Page: 703

8. Which of the following conditions or factors would be the LEAST likely to result in a change in behavior? A. low blood glucose levels B. antihypertensive medications C. exposure to excess heat or cold D. inadequate blood flow to the brain

Answer: B Question Type: General Knowledge Page: 703

18. Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct? A. It is only appropriate to perform a physical examination on a patient with a behavioral problem if he or she is unconscious or is being physically restrained. B. A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient's state of mind and thought processes. C. The physical examination of a patient with a behavioral problem often yields crucial information and should always be performed, even if the patient is violent. D. Performing a physical examination on a patient with a behavioral problem will likely cause him or her to become violent and should be avoided in the field.

Answer: B Question Type: General Knowledge Page: 706

27. Signs of agitated delirium include: A. pallor, hypotension, and constricted pupils. B. diaphoresis, tachycardia, and hallucinations. C. slurred speech, bradycardia, and a high fever. D. subdued behavior, crying, and suicidal thoughts.

Answer: B Question Type: General Knowledge Page: 709

2. When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion. B. mechanism of injury. C. kinetic energy. D. potential energy.

Answer: B Question Type: General Knowledge Page: 747

3. When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. will most likely be thrown over the steering column. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. is thrust under the steering column onto the floorboard.

Answer: B Question Type: General Knowledge Page: 748

5. The energy of a moving object is called: A. latent energy. B. kinetic energy. C. potential energy. D. converted energy.

Answer: B Question Type: General Knowledge Page: 748

13. Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A. collapsed dashboard B. deformed steering wheel C. caved-in passenger door D. intrathoracic hemorrhage

Answer: B Question Type: General Knowledge Page: 751

14. Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. flail chest B. aortic rupture C. extremity fractures D. forehead lacerations

Answer: B Question Type: General Knowledge Page: 751

18. When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. realize that the air bag malfunctioned at the time of impact. B. remember that it could still deploy and seriously injure you. C. suspect that the patient may have experienced serious injuries. D. recognize that the force of impact was most likely not severe.

Answer: B Question Type: General Knowledge Page: 753

24. Approximately 25% of severe injuries to the aorta occur during: A. frontal collisions. B. lateral collisions. C. rollover collisions. D. rear-end collisions.

Answer: B Question Type: General Knowledge Page: 754

27. When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was propelled away from the vehicle. B. approximate the speed of the vehicle that struck the pedestrian. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle.

Answer: B Question Type: General Knowledge Page: 755

35. The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. capitation. B. cavitation. C. congruent. D. conversion.

Answer: B Question Type: General Knowledge Page: 758

2. What layer of the skin forms a watertight, protective seal for the body? A. dermis B. epidermis C. muscular layer D. subcutaneous layer

Answer: B Question Type: General Knowledge Page: 806

4. Which of the following statements regarding the dermis is correct? A. The dermis produces a substance that provides color to the skin. B. The dermis contains hair follicles, sweat glands, and nerve endings. C. The cells of the dermis are worn away and are constantly replaced. D. The dermis lies above the germinal layer and provides protection.

Answer: B Question Type: General Knowledge Page: 806

11. A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): A. abrasion. B. contusion. C. hematoma. D. crush injury.

Answer: B Question Type: General Knowledge Page: 808

12. A hematoma develops when: A. small amounts of blood leak into the epidermis. B. large blood vessels beneath the skin are damaged. C. severe swelling compromises arterial circulation. D. cells and small vessels in the dermis are damaged.

Answer: B Question Type: General Knowledge Page: 808

18. Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? A. avulsion B. abrasion C. incision D. laceration

Answer: B Question Type: General Knowledge Page: 809

20. An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): A. incision. B. avulsion. C. laceration. D. amputation.

Answer: B Question Type: General Knowledge Page: 810

42. A burn that is characterized by redness and pain is classified as a: A. third-degree burn. B. first-degree burn. C. second-degree burn D. partial-thickness burn

Answer: B Question Type: General Knowledge Page: 824

46. Common signs and symptoms of an airway burn include all of the following, EXCEPT: A. hoarseness. B. chest pressure. C. singed nasal hair. D. soot around the mouth.

Answer: B Question Type: General Knowledge Page: 825

49. Which of the following statements regarding the rule of nines is correct? A. A child's head is equal to 14% of his or her total BSA. B. The anterior trunk of an adult is equal to 18% of the BSA. C. The posterior of a child's leg is equal to 13.5% of the BSA. D. The anterior arm in the adult is equal to 9% of the total BSA.

Answer: B Question Type: General Knowledge Page: 825

53. Which of the following is a severe burn in a 2-year-old child? A. superficial burn that covers 25% of the BSA B. any full-thickness burn, regardless of its location on the body C. partial-thickness burn that covers 10% of the BSA D. any burn that involves the arms, legs, or posterior part of the body

Answer: B Question Type: General Knowledge Page: 826

55. In order for electricity to flow through the body and cause damage: A. an insulator must exist between the electrical source and the patient. B. a complete circuit must exist between the electrical source and the ground. C. the part of the body that is in contact with the electrical source must be dry. D. the person must make direct physical contact with the source of electricity.

Answer: B Question Type: General Knowledge Page: 826

7. The cricoid cartilage: A. lies superior to the thyroid cartilage in the neck. B. is the only complete circular cartilage of the trachea. C. is easier to see and palpate than the thyroid cartilage. D. lies superior to the cricothyroid membrane in the neck.

Answer: B Question Type: General Knowledge Page: 852

10. Which of the following statements regarding the vitreous humor is correct? A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost. D. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost.

Answer: B Question Type: General Knowledge Page: 853

9. The eyeball itself is referred to as the: A. orbit. B. globe. C. sclera. D. cornea.

Answer: B Question Type: General Knowledge Page: 853

15. When a light is shone into the pupil: A. the opposite pupil should dilate. B. it should become smaller in size. C. it should become larger in size. D. both pupils should dilate together.

Answer: B Question Type: General Knowledge Page: 854

18. The MOST significant complication associated with facial injuries is: A. damage to the eyes. B. airway compromise. C. cervical spine injury. D. mandibular immobility.

Answer: B Question Type: General Knowledge Page: 854

26. Frequent reassessments of the patient with face or neck injuries are MOST important because: A. they lend credibility to your documentation. B. such injuries can affect the respiratory system. C. hospital staff require frequent patient updates. D. rapid facial swelling may mask hidden injuries.

Answer: B Question Type: General Knowledge Page: 858

27. When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: A. they must make arrangements for an ICU bed. B. a specialist may need to be called. C. it saves time on repeat assessments at the hospital. D. most patients with facial trauma will need surgery.

Answer: B Question Type: General Knowledge Page: 859

49. Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8. B. 9. C. 10. D. 11.

Answer: B Question Type: Critical Thinking Page: 767

48. In contrast to a Level III trauma center, a Level I trauma center must: A. be involved in trauma prevention programs. B. have general surgeons that are in-house 24 hours a day. C. have access to an emergency physician within 30 minutes. D. be able to stabilize patients before transferring to a higher level facility.

Answer: B Question Type: General Knowledge Page: 765-766

33. When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: A. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures. B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. C. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. D. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol.

Answer: B Question Type: Critical Thinking Page: 680-681

18. During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: A. perform a rapid secondary assessment. B. assist her ventilations with a bag-mask device. C. assess her blood pressure and elevate her legs. D. perform a visual assessment of her vaginal area.

Answer: B Question Type: Critical Thinking Page: 729

43. A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of: A. cocaine. B. aspirin. C. Tylenol. D. ibuprofen.

Answer: B Question Type: General Knowledge Page: 685

2. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. thins and begins to separate. B. becomes engorged with blood. C. diverts blood flow to the vagina. D. sheds and is expelled externally.

Answer: B Question Type: General Knowledge Page: 726

3. The onset of menstruation is called menarche and usually occurs in women who are: A. between 12 and 14 years of age. B. between 11 and 16 years of age. C. between 25 and 35 years of age. D. between 45 and 50 years of age.

Answer: B Question Type: General Knowledge Page: 726

6. Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. The most severe cases of PID occur in women who are not sexually active. B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. C. PID most commonly affects women who have had an ectopic pregnancy in the past. D. The most common presenting symptom of PID is generalized upper abdominal pain.

Answer: B Question Type: General Knowledge Page: 726

13. Bacterial vaginosis is a condition that occurs when: A. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes. B. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. C. numerous bacteria enter the uterus through the cervix and cause severe tissue damage. D. abnormal bacteria enter the vagina and cause damage without causing any symptoms.

Answer: B Question Type: General Knowledge Page: 727

14. Which of the following statements regarding gonorrhea is correct? A. Most men who are infected with gonorrhea do not experience symptoms. B. Painful urination is a common symptom of gonorrhea in men and women. C. Symptoms of gonorrhea usually appear within 3 months after being infected. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

Answer: B Question Type: General Knowledge Page: 728

19. If a woman with vaginal bleeding reports syncope, the EMT must assume that she: A. is pregnant. B. is in shock. C. has an infection. D. has an ectopic pregnancy.

Answer: B Question Type: General Knowledge Page: 730

24. Which of the following statements regarding rape is correct? A. The EMT should try to determine if rape occurred. B. Rape is a legal diagnosis, not a medical diagnosis. C. Rape causes more physical harm than emotional harm. D. Only a licensed physician can make a diagnosis of rape.

Answer: B Question Type: General Knowledge Page: 732

38. If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? A. severe burns B. fractured bones C. stomach rupture D. impaled objects

Answer: C Question Type: General Knowledge Page: 760

42. When treating a patient who experienced a pulmonary blast injury, you should: A. use a demand valve to ventilate the patient. B. suspect an accompanying cardiac tamponade. C. avoid giving oxygen under positive pressure. D. administer large amounts of intravenous fluid.

Answer: C Question Type: General Knowledge Page: 761

32. You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: A. monitor her en route to the hospital and call medical control if she worsens. B. crush up an antihistamine tablet and place it in between her cheek and gum. C. request permission from medical control to give another dose of epinephrine. D. administer a nebulized bronchodilator to improve the status of her breathing.

Answer: C Question Type: Critical Thinking Page: 657

36. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: A. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.

Answer: C Question Type: Critical Thinking Page: 659

26. A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent distress. After contacting medical control, you should: A. induce vomiting with syrup of ipecac. B. transport the child for definitive care. C. administer up to 25 g of activated charcoal. D. give the child cold milk to absorb the Tylenol

Answer: C Question Type: Critical Thinking Page: 679

38. You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient: A. is a heroin abuser. B. is acutely intoxicated. C. was given flunitrazepam (Rohypnol). D. is abusing marijuana.

Answer: C Question Type: Critical Thinking Page: 682

46. A 3-year-old female ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial assessment of the child, you should: A. administer 25 g of activated charcoal. B. induce vomiting with syrup of ipecac. C. contact the regional poison control center. D. immediately transport the child to the hospital.

Answer: C Question Type: Critical Thinking Page: 689

29. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: A. try to gain the patient's trust by telling him that you see the vampires too. B. request that the police officers arrest him and take him to the hospital. C. restrain the patient with appropriate force in order to treat his injuries. D. approach the patient and calm him by placing your hand on his shoulder.

Answer: C Question Type: Critical Thinking Page: 712

21. A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. assist her ventilations with a bag-mask device, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.

Answer: C Question Type: Critical Thinking Page: 732

44. Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. spinal cord injury. B. airway compromise. C. intracranial bleeding. D. a fracture of the skull.

Answer: C Question Type: Critical Thinking Page: 763

46. While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. underlying cardiac disease. B. a lacerated coronary artery. C. bruising of the heart muscle. D. traumatic rupture of the aorta.

Answer: C Question Type: Critical Thinking Page: 763

21. A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: A. carefully probe the wound to determine if the bleeding is venous or arterial. B. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. C. replace the avulsed flap to its original position and cover it with a sterile dressing. D. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.

Answer: C Question Type: Critical Thinking Page: 810

24. A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: A. perform a neurologic exam. B. palpate his radial pulses. C. administer high-flow oxygen. D. apply ice to the hematoma.

Answer: C Question Type: Critical Thinking Page: 813

28. A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should: A. place a sterile dressing over the wound and apply direct pressure. B. control the bleeding from the wound and prepare to transport at once. C. apply an occlusive dressing to the wound and continue your assessment. D. direct your partner to assist the patient's ventilations with a bag-mask device.

Answer: C Question Type: Critical Thinking Page: 818

52. A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned? A. 18% B. 27% C. 30% D. 36%

Answer: C Question Type: Critical Thinking Page: 825

62. You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: A. remove the bandage and dressing and apply another one. B. carefully manipulate her arm until the symptoms subside. C. assess distal circulation and readjust the bandage as needed. D. remove the gauze bandage and replace it with an elastic one.

Answer: C Question Type: Critical Thinking Page: 837

24. A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: A. stabilize the impaled glass in her eye. B. administer 100% supplemental oxygen. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye.

Answer: C Question Type: Critical Thinking Page: 856

32. A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: A. scrape the splinter away with moist, sterile gauze. B. cover his right eye and flush the left eye with saline. C. cover both of his eyes and transport to the hospital. D. remove the object with a cotton-tipped applicator.

Answer: C Question Type: Critical Thinking Page: 864

44. A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: A. use tweezers to try to remove the object. B. remove the peanut with a cotton-tipped swab. C. transport her to the emergency department. D. thoroughly flush her ear with sterile saline.

Answer: C Question Type: Critical Thinking Page: 872

46. A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. quickly immobilizing her spinal column.

Answer: C Question Type: Critical Thinking Page: 873

13. A patient has fractured both femurs. Anatomically, these injuries would be described as being: A. medial. B. proximal. C. bilateral. D. unilateral.

Answer: C Question Type: General Knowledge Page: 146

14. Relative to the kidneys, the liver is: A. medial. B. dorsal. C. unilateral. D. posterior.

Answer: C Question Type: General Knowledge Page: 146

15. An intoxicated 40-year-old male is found lying face down. How would you document his body's position? A. dorsal B. supine C. prone D. recumbent

Answer: C Question Type: General Knowledge Page: 147

16. A patient in a semireclined position with the head elevated to facilitate breathing is in the ___________ position: A. prone B. supine C. Fowler's D. recovery

Answer: C Question Type: General Knowledge Page: 147

18. The axial skeleton is composed of the: A. arms, legs, and pelvis. B. lower part of the torso and the legs. C. skull, face, thorax, and vertebral column. D. bones that comprise the pelvic girdle.

Answer: C Question Type: General Knowledge Page: 147

22. The atlas is the: A. point where the ribs attach to the sternum. B. seventh cervical vertebra, which is easily palpable. C. first cervical vertebra, which articulates with the skull. D. attachment between the first and second cervical vertebrae.

Answer: C Question Type: General Knowledge Page: 148

24. Twelve pairs of ribs attach to what section of the spinal column? A. sacral B. lumbar C. thoracic D. coccyx

Answer: C Question Type: General Knowledge Page: 148

32. The large, flat, triangular bone that overlies the posterior thoracic wall is called the: A. glenoid. B. clavicle. C. scapula. D. acromion.

Answer: C Question Type: General Knowledge Page: 150

37. The femoral head forms a ball-and-socket joint with the: A. ilium. B. ischium. C. acetabulum. D. femoral condyle.

Answer: C Question Type: General Knowledge Page: 150

39. The bones that comprise the fingers and toes are called: A. carpals. B. metacarpals. C. phalanges. D. metatarsals

Answer: C Question Type: General Knowledge Page: 150-151

45. Which of the following structures does NOT contain smooth muscle? A. blood vessels B. urinary system C. skeletal system D. gastrointestinal tract

Answer: C Question Type: General Knowledge Page: 153

46. Skeletal muscle is also called: A. smooth muscle. B. autonomic muscle. C. voluntary muscle. D. involuntary muscle.

Answer: C Question Type: General Knowledge Page: 153

52. Together, the right and left lungs contain how many lobes? A. three B. four C. five D. six

Answer: C Question Type: General Knowledge Page: 157

54. The diaphragm is a unique muscle because it: A. is the exclusive muscle of breathing. B. does not receive impulses from the brain. C. is both a voluntary and involuntary muscle. D. does not have striations like skeletal muscle.

Answer: C Question Type: General Knowledge Page: 158

58. Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called: A. osmosis. B. breathing. C. diffusion. D. ventilation.

Answer: C Question Type: General Knowledge Page: 159

65. What function does the pneumotaxic center serve? A. stimulates the DRG, resulting in prolonged inspiration B. inhibits the DRG, but only affects the respiratory rate C. inhibits the DRG, resulting in shorter, faster respirations D. stimulates the DRG, resulting in longer, slower respirations

Answer: C Question Type: General Knowledge Page: 161

74. Which of the following statements regarding agonal respirations is correct? A. Agonal respirations result in excessive tidal volume. B. Agonal respirations typically occur before the heart stops. C. Agonal respirations are ineffective and need to be assisted. D. Agonal respirations are characterized by fast irregular breaths.

Answer: C Question Type: General Knowledge Page: 163

78. Contraction of the right ventricle causes: A. closure of the mitral and aortic valves. B. a return of blood from the pulmonary veins. C. blood to flow into the pulmonary circulation. D. ejection of blood into the systemic circulation.

Answer: C Question Type: General Knowledge Page: 164

82. Cardiac output (CO) is affected by: A. heart rate only. B. stroke volume only. C. stroke volume and heart rate. D. the patient's blood pressure.

Answer: C Question Type: General Knowledge Page: 165

90. The descending aorta branches into the: A. deep femoral arteries. B. internal carotid arteries. C. common iliac arteries. D. external carotid arteries.

Answer: C Question Type: General Knowledge Page: 167

92. Deoxygenated blood from the abdomen, pelvis, and lower extremities is returned to the right atrium via the: A. common iliac vein. B. coronary sinus vein. C. inferior vena cava. D. superior vena cava.

Answer: C Question Type: General Knowledge Page: 169

96. White blood cells are also called leukocytes and function by: A. producing the body's erythrocytes. B. producing blood-clotting factors. C. protecting the body from infection. D. carrying oxygen and other nutrients.

Answer: C Question Type: General Knowledge Page: 170

99. A patient has a blood pressure of 130/70 mm Hg. The "130" represents: A. atrial contraction. B. ventricular filling. C. ventricular contraction. D. ventricular relaxation.

Answer: C Question Type: General Knowledge Page: 170

107. Which of the following statements regarding nervous system control of the cardiovascular system is correct? A. When stimulated, the parasympathetic nervous system is responsible for increasing the heart rate. B. Alpha-adrenergic receptors are located exclusively in the heart and are stimulated by epinephrine. C. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure. D. The sympathetic and parasympathetic nervous systems work together to perform the same function.

Answer: C Question Type: General Knowledge Page: 173

110. The autonomic nervous system controls all of the following functions, EXCEPT: A. digestion. B. breathing. C. breath holding. D. vessel dilation.

Answer: C Question Type: General Knowledge Page: 174

121. Which of the following is NOT a function of the skin? A. sensory reception B. temperature regulation C. metabolic coordination D. pressure and pain perception

Answer: C Question Type: General Knowledge Page: 178-179

127. The exocrine gland of the pancreas secretes: A. bile. B. insulin. C. pancreatic juice. D. glucose.

Answer: C Question Type: General Knowledge Page: 181

129. The primary organ responsible for absorption of products of digestion is the: A. pancreas. B. gallbladder. C. small intestine. D. large intestine.

Answer: C Question Type: General Knowledge Page: 182

130. Which of the following systems is responsible for releasing hormones that regulate body activities? A. skeletal B. nervous C. endocrine D. reproductive

Answer: C Question Type: General Knowledge Page: 183-184

136. Large amounts of adenosine triphosphate (ATP) is generated when: A. the cells function without oxygen. B. circulating blood glucose levels fall. C. the cells function with adequate oxygen. D. carbon dioxide levels in the blood are high.

Answer: C Question Type: General Knowledge Page: 187

139. Pathophysiology is the study of the functional changes that occur when the body reacts to a particular: A. medication. B. assessment. C. disease. D. protocol.

Answer: C Question Type: General Knowledge Page: 188

7. Which of the following patients would MOST likely have a delayed onset of an allergic reaction? A. a 21-year-old female who inhaled pollen B. a 30-year-old male who was stung by a bee C. a 45-year-old male who ingested penicillin D. a 50-year-old male who was exposed to latex

Answer: C Question Type: General Knowledge Page: 648

14. Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? A. the patient's family history B. the patient's general physical appearance C. the environment in which the patient is found D. the time of season in which the exposure occurred

Answer: C Question Type: General Knowledge Page: 650

17. Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? A. diffuse urticaria B. severe hypotension C. upper airway swelling D. systemic vasodilation

Answer: C Question Type: General Knowledge Page: 651

28. When using an auto-injector to give epinephrine, the primary injection site is the: A. medial part of the buttocks. B. lateral portion of the arm. C. lateral portion of the thigh. D. medial portion of the thigh.

Answer: C Question Type: General Knowledge Page: 656

6. Which of the following drugs is NOT a sedative-hypnotic? A. secobarbital (Seconal) B. diazepam (Valium) C. cocaine D. flunitrazepam (Rohypnol)

Answer: C Question Type: General Knowledge Page: 670

10. The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center: A. knows the location of the closest hospital. B. is aware of the patient's age and gender. C. is aware of the substance that is involved. D. knows why the patient overdosed on the drug.

Answer: C Question Type: General Knowledge Page: 671

15. Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it: A. has been linked to hypotension. B. does not effectively induce vomiting. C. may result in aspiration of vomitus. D. has toxic effects on the myocardium.

Answer: C Question Type: General Knowledge Page: 674

23. Activated charcoal administration is contraindicated in patients who have ingested: A. ibuprofen. B. acetaminophen (Tylenol). C. acids or alkalis. D. steroid drugs.

Answer: C Question Type: General Knowledge Page: 679

34. DTs is a syndrome associated with withdrawal from: A. cocaine. B. opioids. C. alcohol. D. sedatives.

Answer: C Question Type: General Knowledge Page: 681

9. Which of the following is an example of a functional behavioral disorder? A. head trauma B. drug addiction C. schizophrenia D. Alzheimer's disease

Answer: C Question Type: General Knowledge Page: 703

10. The first step in assessing a patient with a behavioral emergency is to: A. take vital signs. B. restrain the patient. C. ensure your safety. D. obtain proper consent

Answer: C Question Type: General Knowledge Page: 704

26. It is MOST important for the EMT to remember that suicidal patients may: A. inject illicit drugs. B. be self-destructive. C. be homicidal as well. D. have a definitive plan.

Answer: C Question Type: General Knowledge Page: 709

1. The index of suspicion is MOST accurately defined as: A. the way in which traumatic injuries occur. B. a predictable pattern that leads to serious injuries. C. your concern for potentially serious underlying injuries. D. the detection of less obvious life-threatening injuries.

Answer: C Question Type: General Knowledge Page: 747

6. When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. triples. C. quadruples. D. is not affected.

Answer: C Question Type: General Knowledge Page: 749

11. With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A. It provides the least amount of information about the mechanism of injury. B. It has a direct effect on patient care because of the obvious vehicular damage. C. It is the most dramatic part of the collision and may make extrication difficult. D. It occurs when the unrestrained occupant collides with the interior of the vehicle.

Answer: C Question Type: General Knowledge Page: 750

17. Air bags are designed to: A. prevent a second collision inside the car. B. be used with or without a shoulder harness. C. decrease the severity of deceleration injuries. D. prevent the driver from sustaining head trauma.

Answer: C Question Type: General Knowledge Page: 752

23. Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. thoracic and sacral spine. B. lumbar and coccygeal spine. C. thoracic and lumbar spine. D. lumbar and sacral spine.

Answer: C Question Type: General Knowledge Page: 754

29. Which of the following patients has experienced the MOST significant fall? A. a 4′8″ patient who fell 13′ B. a 5′0″ patient who fell 13′ C. a 4′6″ patient who fell 13′ D. a 5′9″ patient who fell 14′

Answer: C Question Type: General Knowledge Page: 757

34. Internal injuries caused by gunshot wounds are difficult to predict because: A. the caliber of the bullet is frequently unknown. B. the area of damage is usually smaller than the bullet. C. the bullet may tumble or ricochet within the body. D. exit wounds caused by the bullet are usually small.

Answer: C Question Type: General Knowledge Page: 758

1. Which of the following areas of the body has the thinnest skin? A. scalp B. back C. ears D. soles of the feet

Answer: C Question Type: General Knowledge Page: 806

7. Functions of the skin include all of the following, EXCEPT: A. maintenance of water balance. B. regulation of body temperature. C. the production of key antibodies. D. sending information to the brain.

Answer: C Question Type: General Knowledge Page: 806

16. When assessing a patient with a closed soft-tissue injury, it is MOST important to: A. manipulate the injury site for signs of a fracture. B. assess circulation distal to the site of the injury. C. remain alert for more severe underlying injuries. D. recognize that the integrity of the skin is broken.

Answer: C Question Type: General Knowledge Page: 809

19. A laceration: A. is an injury that separates various layers of soft tissue. B. is a sharp, smooth cut that is made by a surgical scalpel. C. is a jagged cut caused by a sharp object or blunt force trauma. D. rarely penetrates through the subcutaneous tissue to the muscle.

Answer: C Question Type: General Knowledge Page: 809

31. In which of the following patients should you remove an impaled object? A. a semiconscious patient with an ice pick impaled in the chest B. an apneic patient with a shard of glass impaled in the abdomen C. a pulseless and apneic patient with a knife impaled in the back D. a conscious and alert patient with a fishhook impaled in the eye

Answer: C Question Type: General Knowledge Page: 820

36. In contrast to animal bites, the bite of a human: A. is usually less severe because the human mouth is cleaner. B. typically results in a minor infection that is slow-spreading. C. carries with it a wide variety of virulent bacteria and viruses. D. is associated with a much higher incidence of rabies infection.

Answer: C Question Type: General Knowledge Page: 822

40. Which of the following is a severe burn in a 65-year-old patient? A. superficial burn to 30% of the BSA B. full-thickness burn to 1% of the BSA C. partial-thickness burn to 20% of the BSA D. second-degree burn covering 10% of the BSA

Answer: C Question Type: General Knowledge Page: 823

44. Patients with full-thickness (third-degree) burns generally do not complain of pain because: A. blister formation protects the burn. B. he or she is generally not conscious. C. the nerve endings have been destroyed. D. subcutaneous vessels are usually clotted.

Answer: C Question Type: General Knowledge Page: 824

50. With regard to the pediatric rule of nines, the: A. head is proportionately smaller than an adult's. B. thorax is proportionately larger than an adult's. C. legs are proportionately smaller than an adult's. D. arms are proportionately larger than an adult's.

Answer: C Question Type: General Knowledge Page: 825

2. The lower jawbone is called the: A. zygoma. B. maxillae. C. mandible. D. mastoid.

Answer: C Question Type: General Knowledge Page: 851

3. The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: A. incus. B. pinna. C. tragus. D. stapes.

Answer: C Question Type: General Knowledge Page: 852

13. The white portion of the eye is called the: A. iris. B. retina. C. sclera. D. cornea.

Answer: C Question Type: General Knowledge Page: 853

20. When caring for a patient with an open facial injury, the EMT must: A. closely assess the patient's airway. B. consider the mechanism of injury. C. wear gloves and facial protection. D. manually stabilize the patient's head.

Answer: C Question Type: General Knowledge Page: 856

29. Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: A. pressure dressings and chemical ice packs. B. digital pressure to an adjacent pulse point. C. direct pressure using dry, sterile dressings. D. ice packs and elevation of the patient's head.

Answer: C Question Type: General Knowledge Page: 859

38. Which of the following findings would be LEAST suggestive of a head injury? A. one pupil larger in size than the other pupil B. failure of the eyes to move in the same direction C. briskly constricting pupils when exposed to light D. failure of the eyes to follow movement of an object

Answer: C Question Type: General Knowledge Page: 868

24. While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: A. rapid swelling of the upper airway tissues. B. a significant amount of fluid in the alveoli. C. narrowing of the bronchioles in the lungs. D. enlargement of the bronchioles in the lungs.

Answer: C Question Type: Critical Thinking Page: 653

27. You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with: A. performing a detailed secondary assessment to locate all of her injuries. B. assessing the bruises that overlie major organs in the chest and abdomen. C. the fact that her clinical signs could indicate that she is bleeding internally. D. obtaining a complete set of vital signs to rule out the possibility of shock.

Answer: C Question Type: Critical Thinking Page: 817

10. During the normal wound healing process, bleeding may occur from even a minor injury because: A. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding. B. histamines released by the immune system constrict the blood vessels, which increases the pressure within them. C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. D. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding.

Answer: C Question Type: General Knowledge Page: 807

28. Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should: A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained. B. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren. C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay.

Answer: C Question Type: Critical Thinking Page: 710

42. Atropine sulfate and pralidoxime chloride are antidotes for: A. lysergic acid diethylamide (LSD). B. diphenhydramine (Benadryl). C. nerve gas agents. D. anticholinergic drugs.

Answer: C Question Type: General Knowledge Page: 685

22. Common causes of acute psychotic behavior include all of the following, EXCEPT: A. intense stress. B. schizophrenia. C. Alzheimer's disease. D. mind-altering substance use.

Answer: C Question Type: General Knowledge Page: 708

5. It is not uncommon for young females who experience their first menstrual period to: A. have a falsely positive home pregnancy test result. B. lose up to 500 mL of blood within the first 24 hours. C. experience abdominal cramping, which may be misinterpreted. D. become so emotionally distraught that they contemplate suicide.

Answer: C Question Type: General Knowledge Page: 726

7. PID typically does NOT affect the: A. uterus. B. ovaries. C. urinary bladder. D. fallopian tubes.

Answer: C Question Type: General Knowledge Page: 726

10. Which of the following conditions does NOT typically present with vaginal discharge? A. chlamydia B. gonorrhea C. genital herpes D. PID

Answer: C Question Type: General Knowledge Page: 726-728

20. When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. determine the underlying cause of her problem. B. ask questions related to her gynecologic history. C. maintain her ABCs and transport without delay. D. keep assessment and treatment to a minimum.

Answer: C Question Type: General Knowledge Page: 731

22. General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: A. supplemental oxygen and lower extremity elevation. B. refraining from placing any dressings into the vagina. C. carefully removing any foreign bodies from the vagina. D. treating external lacerations with moist, sterile compresses.

Answer: C Question Type: General Knowledge Page: 732

40. When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious. B. primary blast injuries are typically the most obvious. C. solid organs usually rupture from the pressure wave. D. primary blast injuries are the most easily overlooked.

Answer: D Question Type: General Knowledge Page: 760

43. Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. intravenous fluid administration B. early administration of oxygen C. elevation of the lower extremities D. rapid transport to a trauma center

Answer: D Question Type: General Knowledge Page: 762

14. The hallmark sign of compartment syndrome is: A. a lack of pain despite the severity of the injury. B. extreme redness to the injury site. C. a bounding pulse distal to the injury. D. pain out of proportion to the injury.

Answer: D Question Type: General Knowledge Page: 808

31. A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to: A. reassess his breathing and blood pressure in 15 minutes. B. visualize his airway to assess for oropharyngeal swelling. C. notify medical control of the patient's response to your treatment. D. record the time and dose of the injection, and transport promptly.

Answer: D Question Type: Critical Thinking Page: 656

35. A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: A. acute hypovolemia. B. alcohol intoxication. C. acute schizophrenia. D. DTs.

Answer: D Question Type: Critical Thinking Page: 681

39. You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: A. requesting a paramedic to administer naloxone (Narcan). B. assisting his ventilations with a bag-mask device. C. asking law enforcement to place handcuffs on the patient. D. attempting to calm him and giving him oxygen if tolerated.

Answer: D Question Type: Critical Thinking Page: 684

40. In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: A. acute respiratory depression. B. a sudden outburst of violence. C. an increase in her blood pressure. D. seizures and cardiac arrhythmias.

Answer: D Question Type: Critical Thinking Page: 685

13. A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: A. approach the patient with caution. B. quickly tend to the bleeding wound. C. tell the patient that you want to help. D. calmly identify yourself to the patient.

Answer: D Question Type: Critical Thinking Page: 704

30. 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? A. his clenched fists B. the broken window C. his shouting of obscenities D. his large body

Answer: D Question Type: Critical Thinking Page: 713-714

36. A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. apply a cervical collar. B. obtain baseline vital signs. C. auscultate bowel sounds. D. assess for an exit wound.

Answer: D Question Type: Critical Thinking Page: 759

30. A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how you should care for his wound? A. Irrigate it with sterile water and cover it with a dry dressing. B. Cover the exposed bowel and keep his legs in a straight position. C. Carefully replace the exposed bowel into the abdomen and transport. D. Cover it with moist, sterile gauze and secure with an occlusive dressing.

Answer: D Question Type: Critical Thinking Page: 819

33. A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to: A. remove the kickstand in a circular motion and apply a dry, sterile dressing. B. cut the kickstand off just above the skin, and stabilize it with sterile dressings. C. leave the kickstand attached to the bike until the physician can remove it safely. D. unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

Answer: D Question Type: Critical Thinking Page: 821

35. An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: A. administer oxygen via a nonrebreathing mask. B. ask the child's father to try to locate the dog. C. advise the child that he will need rabies shots. D. report the incident to the appropriate authorities.

Answer: D Question Type: Critical Thinking Page: 822

59. You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with: A. treating him for hypothermia. B. preventing the risk of infection. C. estimating the extent of his burns. D. the potential for airway swelling.

Answer: D Question Type: Critical Thinking Page: 829

23. A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A. begin immediate ventilatory assistance. B. visualize her mouth for obvious wounds. C. apply oxygen via a nonrebreathing mask. D. suction her oropharynx for 15 seconds.

Answer: D Question Type: Critical Thinking Page: 856

47. Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. esophageal tear. B. crushed cricoid. C. collapsed trachea. D. laryngeal fracture.

Answer: D Question Type: Critical Thinking Page: 873

48. You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: A. apply direct pressure below the lacerated vessel. B. circumferentially wrap a dressing around his neck. C. apply pressure to the closest arterial pressure point. D. apply direct pressure above and below the wound.

Answer: D Question Type: Critical Thinking Page: 875

40. A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: A. leave the contact lenses in place and flush his eyes with sterile water. B. remove the contact lenses and cover his eyes with a dry, sterile dressing. C. leave the contact lenses in place and cover both eyes with a dry dressing. D. carefully remove the contact lenses and then irrigate his eyes with saline.

Answer: D Question Type: Critical Thinking Page: 869

2. The ___________ plane separates the body into left and right halves. A. sagittal B. coronal C. transverse D. midsagittal

Answer: D Question Type: General Knowledge Page: 144

3. A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the: A. proximal forearm. B. superior forearm. C. dorsal forearm. D. distal forearm.

Answer: D Question Type: General Knowledge Page: 144-145

7. In relation to the wrist, the elbow is: A. distal. B. medial. C. lateral. D. proximal.

Answer: D Question Type: General Knowledge Page: 144-145

8. In relation to the chest, the back is: A. ventral. B. inferior. C. anterior. D. posterior.

Answer: D Question Type: General Knowledge Page: 144-145

12. Movement or motion away from the body's midline is called: A. flexion. B. extension. C. adduction. D. abduction.

Answer: D Question Type: General Knowledge Page: 145

17. Trendelenburg's position is MOST accurately defined as a: A. recumbent position with the head lower than the legs. B. supine position with the legs elevated approximately 6" to 12". C. recumbent position with the head elevated at a 25° to 45° angle. D. supine position with the legs elevated 6" to 12" higher than the head.

Answer: D Question Type: General Knowledge Page: 147

19. The brain connects to the spinal cord through a large opening at the base of the skull called the: A. foramen ovale. B. vertebral foramen. C. spinous foramen. D. foramen magnum.

Answer: D Question Type: General Knowledge Page: 148

23. The cervical spine is composed of ___________ vertebrae. A. four B. five C. six D. seven

Answer: D Question Type: General Knowledge Page: 148

35. The carpal bones form the: A. foot. B. ankle. C. hand. D. wrist.

Answer: D Question Type: General Knowledge Page: 150

38. The bony prominence on the lateral/superior aspect of the thigh is called the: A. iliac crest. B. sacroiliac joint. C. sacral symphysis. D. greater trochanter.

Answer: D Question Type: General Knowledge Page: 150

48. Which of the following is a function of the upper airway? A. relaxes bronchiole smooth muscle B. exchanges oxygen and carbon dioxide C. creates sound from vocal cord vibration D. warms and humidifies inhaled air

Answer: D Question Type: General Knowledge Page: 155

57. How does respiration differ from ventilation? A. Ventilation occurs when air is forced into the lungs, whereas respiration occurs when air is drawn or sucked into the lungs. B. Respiration occurs when the diaphragm and intercostal muscles contract, whereas ventilation occurs when those same muscles relax. C. Respiration occurs when oxygen is delivered to the cells of the body, whereas ventilation occurs when carbon dioxide is removed. D. Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment.

Answer: D Question Type: General Knowledge Page: 158-159

59. Breathing occurs as the result of a(n): A. decrease in oxygen, which increases the pH of the cerebrospinal fluid (CSF). B. increase in oxygen, which decreases the pH of the CSF. C. decrease in carbon dioxide, which increases the pH of the CSF. D. increase in carbon dioxide, which decreases the pH of the CSF.

Answer: D Question Type: General Knowledge Page: 159

69. Dead space is the portion of the respiratory system that: A. includes the alveoli and capillaries surrounding the alveoli. B. must be filled with air before gas exchange can take place. C. receives oxygen but is unable to release carbon dioxide. D. contains no alveoli and does not participate in gas exchange.

Answer: D Question Type: General Knowledge Page: 162

73. Which of the following is MOST characteristic of adequate breathing in an adult? A. use of the accessory muscles in the neck and cyanosis B. respirations of 30 breaths/min and reduced tidal volume C. cool, clammy skin and retractions above the clavicles D. respirations of 20 breaths/min and bilateral chest movement

Answer: D Question Type: General Knowledge Page: 162

80. At rest, the normal adult heart rate should not exceed: A. 70 beats/min. B. 80 beats/min. C. 90 beats/min. D. 100 beats/min.

Answer: D Question Type: General Knowledge Page: 165

84. What happens when blood volume is lost from the body? A. Arterial blood is diverted to the skin and muscles. B. The veins dilate to increase systemic perfusion. C. Widespread vasodilation causes blood pressure to decrease. D. The arteries contract to increase the blood pressure.

Answer: D Question Type: General Knowledge Page: 166

87. Which of the following arteries does NOT carry highly oxygenated blood? A. aorta B. renal C. femoral D. pulmonary

Answer: D Question Type: General Knowledge Page: 166

89. The exchange of oxygen and nutrients for waste products of metabolism occurs at the cellular level in the: A. venules. B. arteries. C. arterioles. D. capillaries.

Answer: D Question Type: General Knowledge Page: 166

100. The average adult has approximately ___________ of blood in his or her body. A. 3 L B. 4 L C. 5 L D. 6 L

Answer: D Question Type: General Knowledge Page: 170

104. Stimulation of alpha-adrenergic receptors results in: A. increased heart rate. B. dilation of the blood vessels. C. increased cardiac contractility. D. constriction of the blood vessels.

Answer: D Question Type: General Knowledge Page: 173

106. Stimulation of the parasympathetic nervous system would result in: A. tachycardia. B. a strong pulse. C. vasoconstriction. D. a slow heart rate.

Answer: D Question Type: General Knowledge Page: 173

113. Trauma to the __________ lobe of the brain would likely result in visual disturbances. A. frontal B. parietal C. temporal D. occipital

Answer: D Question Type: General Knowledge Page: 174

115. All necessary life functions are coordinated in what part of the brain? A. cerebrum B. gray matter C. cerebellum D. brain stem

Answer: D Question Type: General Knowledge Page: 174

116. Your ability to remain awake is a function of the: A. cerebellum. B. limbic system. C. pons and medulla. D. reticular activating system.

Answer: D Question Type: General Knowledge Page: 174-175

118. What set of nerves is responsible for carrying information from the body to the central nervous system? A. motor B. cranial C. vertebral D. sensory

Answer: D Question Type: General Knowledge Page: 177

124. Which organ lies in the lateral and posterior portion of the left upper quadrant (LUQ) of the abdomen? A. liver B. stomach C. cecum D. spleen

Answer: D Question Type: General Knowledge Page: 180

128. Bile is produced by the liver and concentrated and stored in the: A. kidneys. B. pancreas. C. stomach. D. gallbladder.

Answer: D Question Type: General Knowledge Page: 181

135. What is the function of the fallopian tubes? A. connect both ovaries together B. supply blood to the uterine lining C. produce progesterone and estrogen D. transport a mature egg to the uterus

Answer: D Question Type: General Knowledge Page: 186

137. The waste products of aerobic metabolism include: A. ATP and glucose. B. glucose and lactic acid. C. uric acid and nitrogen. D. carbon dioxide and water.

Answer: D Question Type: General Knowledge Page: 187

2. Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: A. the bee venom itself. B. adrenaline and histamines. C. leukocytes and epinephrine. D. histamines and leukotrienes.

Answer: D Question Type: General Knowledge Page: 647

10. Because the stinger of a honeybee remains in the wound following a sting: A. the stinger can easily be removed with tweezers. B. the body's immune system deactivates the venom. C. the toxicity of the venom decreases within 10 minutes. D. it can continue to inject venom for up to 20 minutes.

Answer: D Question Type: General Knowledge Page: 649

9. A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: A. a pustule. B. purpura. C. urticaria. D. a wheal.

Answer: D Question Type: General Knowledge Page: 649

21. Which of the following medications blocks the release of histamines? A. albuterol (Ventolin) B. epinephrine C. acetaminophen (Tylenol) D. diphenhydramine (Benadryl)

Answer: D Question Type: General Knowledge Page: 652

27. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg. A. 0.1, 0.01 B. 0.01, 0.1 C. 0.03, 0.3 D. 0.3, 0.15

Answer: D Question Type: General Knowledge Page: 655

1. Substance abuse is MOST accurately defined as: A. knowingly selling illicit drugs in order to buy more drugs. B. willfully using a therapeutic drug to treat a medical illness. C. unwillingly and unknowingly consuming drugs or alcohol. D. knowingly misusing a substance to produce a desired effect.

Answer: D Question Type: General Knowledge Page: 669

7. Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? A. pupillary constriction B. excessive lacrimation C. a fall in blood pressure D. dry mucous membranes

Answer: D Question Type: General Knowledge Page: 670

8. Which of the following questions would be of LEAST pertinence during the initial questioning of a patient who ingested a substance? A. How much of the substance was taken? B. How long ago was it taken? C. What type of substance was taken? D. Why was the substance ingested?

Answer: D Question Type: General Knowledge Page: 670

13. Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because: A. water makes these chemicals impossible to remove. B. severe swelling will occur when mixed with water. C. this will eliminate the chances of you being exposed. D. these chemicals may ignite upon contact with water.

Answer: D Question Type: General Knowledge Page: 674

21. It is MOST important to determine a patient's weight when asking questions pertaining to a toxic ingestion because: A. additional help may be needed at the scene to lift the patient. B. this will allow you to predict if the exposure is lethal. C. this will determine whether or not to give syrup of ipecac. D. activated charcoal is given based on a patient's weight.

Answer: D Question Type: General Knowledge Page: 678

25. The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult patient. A. 5 g, 10 g B. 10 g, 20 g C. 12.5 g, 25 g D. 25 g, 50 g

Answer: D Question Type: General Knowledge Page: 679

30. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing a(n): A. addiction. B. dependence. C. withdrawal. D. tolerance.

Answer: D Question Type: General Knowledge Page: 679

3. From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least: A. 1 week. B. 2 weeks. C. 3 weeks. D. 1 month.

Answer: D Question Type: General Knowledge Page: 702

12. General guidelines for managing a patient with a behavioral emergency include: A. firmly identifying yourself as an EMS provider. B. placing the patient between yourself and an exit. C. allowing the patient to be alone if he or she wishes. D. being prepared to spend extra time with the patient.

Answer: D Question Type: General Knowledge Page: 704

17. A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called: A. active listening. B. passive listening. C. intuitive listening. D. reflective listening.

Answer: D Question Type: General Knowledge Page: 705-706

1. Each ovary produces an ovum in alternating months and releases it into the: A. vagina. B. uterus. C. cervix. D. fallopian tube.

Answer: D Question Type: General Knowledge Page: 725

7. Which of the following statements regarding gunshot wounds is correct? A. High-velocity bullets will cause less severe internal injuries. B. The size of a bullet has the greatest impact on producing injury. C. Low-velocity bullets will cause the greatest amount of trauma. D. The speed of a bullet has the greatest impact on producing injury.

Answer: D Question Type: General Knowledge Page: 749

8. By what mechanism is a person injured when he or she falls from a significant height? A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. B. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

Answer: D Question Type: General Knowledge Page: 749

10. What types of motor vehicle collisions present the greatest potential for multiple impacts? A. lateral and rollover B. frontal and rotational C. Rear-end and rotational D. rotational and rollover

Answer: D Question Type: General Knowledge Page: 750

12. Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. dismounted seats B. steering wheel deformity C. intrusion into the vehicle D. deployment of the air bag

Answer: D Question Type: General Knowledge Page: 750-751

21. Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact. B. assess the severity of the third collision of the crash. C. recognize if the driver hit the brakes before impact. D. identify contact points and predict potential injuries.

Answer: D Question Type: General Knowledge Page: 753

25. A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. is wearing only a lap belt. B. remains within the vehicle. C. experiences multiple impacts. D. is ejected or partially ejected.

Answer: D Question Type: General Knowledge Page: 755

33. Which of the following statements regarding low-energy penetrating injuries is correct? A. Internal injuries caused by low-velocity bullets are usually easy to predict. B. Exit wounds are typically easy to locate with low-energy penetrating injuries. C. It is usually easy to differentiate between an entrance wound and an exit wound. D. The area of injury is usually close to the path the object took through the body.

Answer: D Question Type: General Knowledge Page: 758

5. The sebaceous glands produce sebum, a material that: A. facilitates shedding of the epidermis. B. pulls the hair erect when you are cold. C. discharges sweat onto the skin's surface. D. waterproofs the skin and keeps it supple.

Answer: D Question Type: General Knowledge Page: 806

8. When a person is exposed to a cold environment: A. sweat is produced and is warmed when the vessels constrict. B. blood vessels dilate and divert blood to the core of the body. C. the skin becomes flushed secondary to peripheral vasodilation. D. peripheral vessels constrict and divert blood away from the skin.

Answer: D Question Type: General Knowledge Page: 806

29. An abdominal evisceration: A. is most commonly the result of blunt force trauma. B. should be covered with bulky dry, sterile dressings. C. often causes severe hypothermia because of heat loss. D. occurs when organs protrude through an open wound.

Answer: D Question Type: General Knowledge Page: 819

41. Which of the following is of LEAST importance when initially assessing the severity of a burn? A. area(s) burned B. age of the patient C. past medical history D. known drug allergies

Answer: D Question Type: General Knowledge Page: 823

43. A partial-thickness burn involves the outer layer of skin and a portion of the: A. epidermis. B. fatty layer. C. muscle fascia. D. dermal layer.

Answer: D Question Type: General Knowledge Page: 824

45. Which of the following statements regarding severe burns is correct? A. Severe burns involving the airway have a 100% mortality rate. B. The majority of severe burns involve full-thickness burns only. C. Patients with severe burns are especially prone to hyperthermia. D. Severe burns are typically a combination of all degrees of burn.

Answer: D Question Type: General Knowledge Page: 824

47. Burns to pediatric patients are generally considered more serious than burns to adults because: A. pediatric patients are more prone to hyperthermia. B. most burns in children are the result of child abuse. C. pediatric patients have a proportionately larger volume of blood. D. pediatric patients have more surface area relative to total body mass.

Answer: D Question Type: General Knowledge Page: 825

54. When caring for a patient whose arm is covered with a dry chemical, you should: A. deactivate the chemical with a 5% vinegar solution. B. quickly irrigate the arm with large amounts of water. C. use forceful streams of water to remove the chemical. D. brush away the chemical before flushing with water.

Answer: D Question Type: General Knowledge Page: 826

60. When treating a partial-thickness burn, you should: A. immerse the affected part in warm water. B. rupture any blisters to prevent an infection. C. cover the burn with a moist, sterile dressing. D. avoid the use of creams, lotions, or antiseptics.

Answer: D Question Type: General Knowledge Page: 836

1. The upper jawbones are called the: A. mandible. B. mastoid. C. zygoma. D. maxillae.

Answer: D Question Type: General Knowledge Page: 851

11. The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. sclera. B. cornea. C. retina. D. conjunctiva.

Answer: D Question Type: General Knowledge Page: 853

12. The conjunctiva are kept moist by fluid produced by the: A. corneal duct. B. posterior orbit. C. optic chiasma. D. lacrimal gland.

Answer: D Question Type: General Knowledge Page: 853

8. What is the function of the sternocleidomastoid muscle? A. allows flexion of the neck B. provides respiration C. connects the scapulae together D. allows movement of the head

Answer: D Question Type: General Knowledge Page: 853

16. Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with: A. retinitis. B. contact lenses. C. conjunctivitis. D. a brain injury.

Answer: D Question Type: General Knowledge Page: 854

22. Significant trauma to the face should increase the EMT's index of suspicion for a(n): A. airway obstruction. B. displaced mandible. C. basilar skull fracture. D. spinal cord injury.

Answer: D Question Type: General Knowledge Page: 856

37. A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced: A. conjunctivitis. B. acute hyphema. C. a blowout fracture. D. a detached retina.

Answer: D Question Type: General Knowledge Page: 868

41. Which of the following statements regarding anterior nosebleeds is correct? A. They cause blood to drain into the posterior pharynx. B. They are usually severe and require aggressive treatment to control. C. They are usually caused by a fracture of the basilar skull. D. They usually originate from the septum area and bleed slowly.

Answer: D Question Type: General Knowledge Page: 870

13. You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should: A. apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once. B. apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. C. assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

Answer: D Question Type: Critical Thinking Page: 649

51. According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. B. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

Answer: D Question Type: General Knowledge Page: 767

45. Which of the following statements regarding the Salmonella bacterium is correct? A. Refrigeration of food will prevent salmonellosis. B. Symptoms of salmonellosis appear within 12 hours. C. The Salmonella bacterium produces toxins that cause food poisoning. D. The Salmonella bacterium itself causes food poisoning.

Answer: D Question Type: General Knowledge Page: 687

20. Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed: A. within the first few minutes after making patient contact. B. at least every 5 minutes in order to detect signs of shock. C. only if you will be transporting the patient to the hospital. D. if doing so will not worsen his or her emotional distress.

Answer: D Question Type: General Knowledge Page: 706

8. Potentially life-threatening consequences of PID include: A. ovarian cysts and gonorrhea. B. bacterial vaginosis and chlamydia. C. uterine rupture with severe bleeding. D. ovarian abscess and ectopic pregnancy

Answer: D Question Type: General Knowledge Page: 726

9. Which of the following clinical presentations is MOST consistent with PID? A. left lower quadrant pain, referred pain to the left shoulder, and fever B. pain around the umbilicus, low-grade fever, and generalized weakness C. upper abdominal cramping, severe headache, and heavy vaginal bleeding D. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

Answer: D Question Type: General Knowledge Page: 726

25. When caring for a female patient who has been sexually assaulted, you should: A. ask the patient for a concise, detailed report of what happened to her. B. allow law enforcement to take her statement before you begin treatment. C. advise her that she will not be allowed to shower or change her clothes. D. place any bloodstained clothing or other articles in separate paper bags.

Answer: D Question Type: General Knowledge Page: 733

28. When documenting a call in which a female was sexually assaulted, you should: A. only use quotation marks when recording any statements made by witnesses. B. translate the patient's words or statements using proper medical terminology. C. record your opinion only if you have reasonable proof to justify the statement. D. keep the report concise and record only what the patient stated in her own words.

Answer: D Question Type: General Knowledge Page: 733

4. The superficial temporal artery can be palpated: A. slightly above the ear. B. at the angle of the jaw. C. over the mastoid process. D. just anterior to the tragus.

Answer: D Question Type: General Knowledge Page: 852

If gastric distention is so severe that it makes positive-pressure ventilation extremely difficult or impossible, you may have to: A. in patients who are intubated. B. if you ventilate a patient too fast. C. when you deliver minimal tidal volume. D. when the airway is completely obstructed.

Apply manual pressure to the abdomen

The body's functions that occur without conscious effort are regulated by the _________ nervous system. A. sensory B. somatic C. autonomic D. voluntary

Autonomic

1. Which of the following statements regarding an infant's vital signs is correct? A. An infant's heart rate generally ranges between 70 and 110 beats/min. B. An infant's normal body temperature is typically higher than a preschooler's. C. By 6 months of age, an infant's normal tidal volume is 2 to 4 mL/kg. D. An infant's normal heart rate increases by 10 beats/min each month.

B

10. Which of the following is the MOST rapidly acting medication administration route? A. sublingual (SL) B. intravenous (IV) C. subcutaneous (SC) D. intramuscular (IM)

B

12. At what age does separation anxiety typically peak in infants and small children? A. 6 to 8 months B. 10 to 18 months C. 18 to 24 months D. 24 to 36 months

B

13. Subcutaneous injections deliver the medication: A. directly into the muscle tissue. B. between the skin and the muscle. C. below the first layer of muscle. D. in the mucosa under the tongue.

B

14. While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to: A. give the patient nitroglycerin to increase his blood pressure. B. administer drugs via the IV route to achieve the fastest effect. C. give the patient activated charcoal to rule out a drug overdose. D. withhold drug therapy until an intraosseous catheter is in place.

B

15. The pulse rate of a child from ages 6 to 12 years is approximately: A. 60 to 100 beats/min. B. 70 to 120 beats/min. C. 90 to 140 beats/min. D. 100 to 150 beats/min.

B

18. A 16-year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should: A. obtain the majority of your information from one of her parents. B. inquire about the possibility of pregnancy in private, if possible. C. avoid asking questions that she will feel uncomfortable answering. D. recall that patients in this age group prefer not to be treated as adults.

B

18. The __________ of a medication usually dictates the route by which it will be administered. A. type B. form C. class D. name

B

20. The human body should be functioning at its optimal level between the ages of: A. 18 and 22 years. B. 19 and 25 years. C. 21 and 30 years. D. 25 and 35 years.

B

23. The average pulse rate of individuals between 19 and 60 years of age is typically: A. 60 beats/min. B. 70 beats/min. C. 80 beats/min. D. 90 beats/min.

B

23. You are dispatched to a movie theater for a 39-year-old female with signs and symptoms of an allergic reaction. As you are assessing her, she pulls an epinephrine auto-injector out of her purse and hands it to you. After administering 100% oxygen, you should: A. administer the drug. B. contact medical control. C. verify the medication name. D. check the drug's expiration date.

B

25. An EMT may administer aspirin to a patient if: A. the patient is currently experiencing hypotension. B. authorization from medical control has been obtained. C. transport time to the hospital is greater than 30 minutes. D. the patient is believed to be experiencing an acute stroke.

B

26. You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient high-flow oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should: A. notify dispatch and request that a paramedic unit respond to the scene so they can administer epinephrine to the patient. B. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital. C. elevate the patient's legs 6″ to 12″, keep her warm, begin transport to the hospital, and request a paramedic intercept en route. D. immediately load the patient into the ambulance, begin transport, and reattempt to contact medical control when you receive a cell signal.

B

3. A drug is contraindicated for a patient when it: A. is used to treat a multitude of conditions. B. may cause harm or have no positive effect. C. produces actions other than the desired ones. D. is used to treat a specific medical condition.

B

31. When assessing an 80-year-old patient in shock, it is important to remember that: A. it is common to see a more significant increase in heart rate than what would be expected in younger adults. B. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion. C. the patient's cardiac output is able to increase by nearly 200% in response to the decrease in perfusion. D. in older adults, it is especially common to observe a significant decrease in heart rate in response to shock.

B

35. Which of the following statements regarding glucose is correct? A. Glucose is a complex sugar that rapidly absorbs into the bloodstream. B. Glucose is a simple sugar that is readily absorbed by the bloodstream. C. Glucose is given to patients who are suspected of being hyperglycemic. D. Glucose is usually administered by the EMT via the intravenous route.

B

35. Why does the incidence of diabetes mellitus increase with age? A. decreased food intake, decreased weight gain, and decreased blood sugar levels B. decreased physical activity, increased weight gain, and decreased insulin production C. increased physical activity, increased food intake, and increased insulin production D. decreased physical activity, increased weight gain, and decreased blood sugar levels

B

36. Age-related changes in the renal system result in: A. a significant increase in filtration, which causes the excretion of large amounts of water from the body. B. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. C. the formation of large amounts of urine secondary to an increase in kidney mass of up to 20%. D. dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function.

B

39. A 62-year-old male presents 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 100% oxygen and contacting medical control, you should: A. begin immediate transport and request a rendezvous with a paramedic unit. B. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg. C. administer up to three doses of nitroglycerin before assessing his blood pressure. D. administer the nitroglycerin unless he has taken Viagra within the past 72 hours.

B

45. When assessing an elderly male who complains of nausea and generalized weakness, you find that he takes simvastatin (Vytorin) and clopidogrel (Plavix). This medication regimen suggests a history of: A. bacterial infection. B. cardiovascular disease. C. reactive airway disease. D. non-insulin-dependent diabetes.

B

48. What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position? A. 6 B. 8 C. 9 D. 10

B

5. Which of the following is an anatomic difference between children and adults? A. The ribcage of an infant is less flexible than an adult's. B. An infant's tongue is proportionately larger than an adult's. C. The trachea of an infant is proportionately longer than an adult's. D. An infant's head accounts for less body weight than an adult's.

B

7. Which of the following describes the Moro reflex? A. When something touches a neonate's cheek, he or she instinctively turns his or her head toward the touch. B. The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled. C. An infant's heart rate decreases secondary to hypoxia because he or she depends heavily on the heart rate to perfuse the body. D. When the sole of the foot is stroked with a blunt object, the big toe lifts upward and the other toes fan outward.

B

8. When gathering a patient's medications, you find the following: Isordil, Lasix, Motrin, and Digoxin. Which of these medications can be obtained over-the-counter (OTC)? A. Lasix B. Motrin C. Isordil D. Digoxin

B

9. Which of the following statements regarding parenteral medications is correct? A. Tylenol is an example of a parenteral medication because it is taken orally. B. Parenteral medications are absorbed more quickly than enteral medications. C. Compared to enteral medications, parenteral medications have fewer side effects. D. Parenteral medications are absorbed by the body through the digestive system.

B

9. You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she: A. is unable to track your movements with her eyes. B. responds to her name but is fearful of your presence. C. will readily allow you to separate her from her mother. D. has bulging fontanelles secondary to severe dehydration.

B

A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: A. continue to insert the airway as you suction her oropharynx. B. remove the airway and be prepared to suction her oropharynx. C. insert the airway no further but leave it in place as a bite block. D. select a smaller oropharyngeal airway and attempt to insert it.

B

A 35-year-old mildly obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is: A. acute cystitis. B. acute cholecystitis. C. appendicitis. D. pancreatitis.

B

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A. ensure that his airway is patent. B. apply direct pressure to the wound. C. elevate his legs and keep him warm. D. administer 100% supplemental oxygen

B

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: A. apply a cervical collar and suction his airway. B. open his airway with the jaw-thrust maneuver. C. apply a pressure dressing to the patient's arm. D. tilt the patient's head back and lift up on his chin

B

A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: A. acute pancreatitis. B. liver dysfunction. C. gallbladder disease. D. renal insufficiency

B

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should: A. avoid giving him nitroglycerin and transport him at once. B. ask him what he takes, how much, and when he last took it. C. recall that erectile dysfunction drugs can cause hypertension if given with nitroglycerin. D. administer his nitroglycerin and then reassess his blood pressure.

B

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of? A. unstable angina B. dissecting aortic aneurysm C. AMI D. hypertensive emergency

B

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: A. defibrillate with the AED while continuing transport to the hospital. B. stop the ambulance, begin CPR, and attach the AED as soon as possible. C. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. D. alert the receiving hospital and perform CPR for the duration of the transport.

B

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: A. insert a nasopharyngeal airway. B. perform oropharyngeal suctioning. C. apply oxygen via a nonrebreathing mask. D. assist the patient's ventilations with a bag-mask device.

B

A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a: A. nasal cannula. B. nonrebreathing mask. C. bag-mask device. D. mouth-to-mask device.

B

A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having: A. hepatitis. B. meningitis. C. hantavirus. D. tuberculosis.

B

A patient whose speech is slurred and difficult to understand is experiencing: A. aphasia. B. dysarthria. C. dysphagia. D. paraplegia.

B

A patient with atherosclerotic heart disease experiences chest pain during exertion because the: A. coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. B. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. C. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. D. ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.

B

A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding: A. time and place. B. date and event. C. event and person. D. person and place

B

A positive TB skin test indicates that: A. you have never been exposed to TB. B. you have been exposed to the disease. C. you are actively infected with the disease. D. the disease is dormant and may become active.

B

A ventilation/perfusion (V/Q ratio) mismatch occurs when: A. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange. B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen. C. ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body. D. a traumatic injury or medical condition impairs the body's ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.

B

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? A. liver B. kidney C. pancreas D. gallbladder

B

According to Occupational Safety and Health Administration (OSHA) regulations, an employer must: A. guarantee a 100% risk-free environment prior to employment. B. offer a workplace environment that reduces the risk for exposure. C. provide gloves and other personal protective equipment (PPE) to full-time paid employees only. D. screen all prospective employees for bloodborne pathogens.

B

Acting in such a way as to make another person fear immediate bodily harm is called: A. libel. B. assault. C. battery. D. negligence.

B

Acute coronary syndrome (ACS) is a term used to describe: A. the warning signs that occur shortly before a heart attack. B. a group of symptoms that are caused by myocardial ischemia. C. a severe decrease in perfusion caused by changes in heart rate. D. the exact moment that a coronary artery is completely occluded.

B

After assisting your patient with his or her nitroglycerin, you should: A. place the patient in a recumbent position in case he or she faints. B. reassess the blood pressure within 5 minutes to detect hypotension. C. avoid further dosing if the patient complains of a severe headache. D. perform a secondary assessment before administering further doses.

B

After establishing that an adult patient is unresponsive you should: A. open the airway. B. assess for breathing. C. check for a carotid pulse. D. attach an automated external defibrillator (AED).

B

After performing a primary assessment, a rapid scan of the body should be performed in order to: A. determine the need for spinal motion restriction precautions. B. identify less obvious injuries that require immediate treatment. C. look specifically for signs and symptoms of inadequate perfusion. D. find and treat injuries or conditions that do not pose a threat to life

B

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: A. contact medical control. B. take standard precautions. C. quickly access the patient. D. notify law enforcement.

B

After the AED has delivered a shock, the EMT should: A. assess for a carotid pulse. B. immediately resume CPR. C. reanalyze the cardiac rhythm. D. transport the patient at once.

B

An EMS provider who has extensive training in various aspects of advanced life support (ALS) is called a(n): A. EMT. B. paramedic. C. advanced EMT (AEMT). D. EMR.

B

An area of swelling or enlargement in a weakened arterial wall is called: A. a thrombus. B. an aneurysm. C. an embolism. D. atherosclerosis.

B

An index of suspicion is MOST accurately defined as: A. the EMT's prediction of the type of illness a patient has based on how the call is dispatched. B. your awareness and concern for potentially serious underlying and unseen injuries or illness. C. ruling out specific medical conditions based on the absence of certain signs and symptoms. D. determining the underlying cause of a patient's medical condition based on signs and symptoms.

B

An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score? A. opens eyes in response to voice, makes incomprehensible sounds, localizes pain B. opens eyes in response to pain, uses inappropriate words, withdraws from pain C. opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion D. eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

B

An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than: A. 200 psi. B. 500 psi. C. 1,000 psi. D. 1,500 psi.

B

Angina pectoris occurs when: A. a coronary artery is totally occluded by plaque. B. myocardial oxygen demand exceeds the supply. C. one or more coronary arteries suddenly spasm. D. myocardial oxygen supply exceeds the demand.

B

As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on: A. the patient's condition. B. your local EMS protocols. C. an order from a paramedic. D. the transport time to the hospital.

B

At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you: A. should transport the donor patient before critical patients. B. may have to assign the donor patient a lower triage priority. C. should use a separate ambulance to transport the donor patient. D. must assign the donor the highest priority regardless of injuries.

B

Blood that is ejected from the right ventricle: A. enters the systemic circulation. B. flows into the pulmonary arteries. C. has a high concentration of oxygen. D. was received directly from the aorta.

B

Cardiac monitoring, pharmacological interventions, and other advanced treatment skills are functions of the: A. EMT. B. paramedic. C. AEMT. D. EMR.

B

Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT: A. "Am I going to die?" B. "What hospital am I going to?" C. "What are you doing to me?" D. "Will I be permanently disabled?"

B

Common side effects of nitroglycerin include all of the following, EXCEPT: A. bradycardia. B. hypertension. C. hypotension. D. severe headache.

B

Continuing education in EMS serves to: A. prove research and statistical findings in prehospital care. B. maintain, update, and expand your knowledge and skills. C. enforce mandatory attendance to agency-specific training. D. provide an ongoing review and audit of the EMS system.

B

During the primary assessment, circulation is evaluated by assessing: A. skin quality, blood pressure, and capillary refill. B. pulse quality, external bleeding, and skin condition. C. blood pressure, pulse rate, and external bleeding. D. external bleeding, skin condition, and capillary refill

B

EMRs such as fire fighters, law enforcement officers, and park rangers, are an integral part of the EMS system because: A. they are usually trained to assist paramedics with certain procedures. B. the presence of a person trained to initiate basic life support (BLS) care cannot be ensured. C. the average response time for the EMT crew is approximately 15 minutes. D. they can initiate certain ALS procedures before EMS arrival.

B

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: A. ileus. B. an ulcer. C. appendicitis. D. cholecystitis.

B

Functions of the liver include: A. storage of bile, which is produced in the gallbladder. B. production of substances necessary for blood clotting. C. production of hormones that regulate blood sugar levels. D. release of amylase, which breaks down starches into sugar.

B

Hazards that are associated with a structural fire include all of the following, EXCEPT: A. smoke and toxic gases. B. carbon dioxide deficiency. C. high ambient temperatures. D. the risk of building collapse.

B

If a defibrillator manufacturer claims that its device terminates ventricular fibrillation on the first shock 95% of the time, you should: A. avoid purchasing the device because this claim is unrealistic. B. recognize that this does not mean it will save more lives. C. purchase the device based solely on the manufacturer's claim. D. determine which device the American Heart Association suggests.

B

If a mask cannot be placed on a coughing patient, the Centers for Disease Control and Prevention (CDC) recommend that you maintain a distance of at least ________ feet if possible. A. 2 B. 3 C. 4 D. 5

B

If it is not possible to adequately clean your ambulance at the hospital following a call, you should: A. quickly wipe down all high contact surfaces with an antibacterial solution. B. clean the ambulance at your station in a designated area that is well ventilated. C. wait until the end of your shift and then disinfect the entire patient compartment. D. thoroughly wash the back of the ambulance at a local car wash or similar facility.

B

If you cannot palpate a pulse in an unresponsive patient, you should: A. attach an automated external defibrillator (AED) at once. B. immediately begin cardiopulmonary resuscitation (CPR). C. palpate at another pulse site. D. assess for adequate breathing

B

In contrast to AMI, a dissecting aortic aneurysm: A. is more commonly associated with pressure in the chest. B. often presents with pain that is maximal from the onset. C. usually presents gradually, often over a period of hours. D. is typically preceded by other symptoms, such as nausea.

B

In contrast to inhalation, exhalation: A. requires muscular effort to effectively expel air from the lungs. B. is a passive process caused by increased intrathoracic pressure. C. occurs when the diaphragm lowers and expels air from the lungs. D. is an active process caused by decreased intrathoracic pressure.

B

In contrast to the assessment of a trauma patient, assessment of a medical patient: A. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem. B. is focused on the nature of illness, the patient's chief complaint, and his or her symptoms. C. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems. D. is not as complex for the EMT because most patients typically present with classic symptoms.

B

In infants and small children, skin color should be assessed on the: A. forehead. B. palms and soles. C. chest and abdomen. D. underside of the arms

B

In order for a do not resuscitate (DNR) order to be valid, it must: A. be dated within the previous 24 months. B. clearly state the patient's medical problem. C. be updated a minimum of every 6 months. D. be signed by the local justice of the peace.

B

In the presence of ileus, the only way the stomach can empty itself is by: A. diarrhea. B. vomiting. C. muscular contraction. D. spontaneous rupture.

B

In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway? A. a 24-year-old male who is found unconscious at the base of a tree B. a 37-year-old female who is found unconscious in her bed C. a 45-year-old male who is semiconscious after falling 20 feet D. a 50-year-old male who is unconscious following head trauma

B

In which of the following situations does the EMT NOT have a legal duty to act? A. a response to the residence of a patient who fell B. a response to a motor vehicle crash while off duty C. a response to an injured patient while off duty D. Local policy requires you to assist in any emergency.

B

Ischemic heart disease is MOST accurately defined as: A. absent myocardial blood flow due to a blocked coronary artery. B. decreased blood flow to one or more portions of the myocardium. C. death of a portion of the heart muscle due to a decrease in oxygen. D. decreased blood flow to the heart muscle due to coronary dilation.

B

It is especially important for EMS personnel to develop nonadversarial relationships with their coworkers because they: A. are highly prone to stress and burnout. B. depend on each other for their safety. C. must work together every third day. D. may have to bunk in the same room.

B

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. A. two B. three C. four D. five

B

Most prehospital cardiac arrests occur as the result of: A. severe blunt trauma. B. a cardiac arrhythmia. C. an acute ischemic stroke. D. obstruction of the airway.

B

Muscle control and body coordination are controlled by the: A. cerebrum. B. cerebellum. C. brain stem. D. cerebral cortex.

B

Nitroglycerin is contraindicated in patients: A. who have taken up to two doses. B. who have experienced a head injury. C. with a history of an ischemic stroke. D. with a systolic blood pressure less than 120 mm Hg.

B

Observations made when forming a general impression of a patient would include all of the following, EXCEPT: A. appearance. B. pulse strength. C. race and gender. D. level of distress

B

On which of the following patients would it be MOST appropriate to use the flow- restricted, oxygen-powered ventilation device? A. an 8-year-old female with respiratory failure B. a 21-year-old male with traumatic cardiac arrest C. a 38-year-old apneic female with blunt chest trauma D. a 59-year-old male with chronic obstructive pulmonary disease (COPD)

B

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of: A. acute pancreatitis. B. an aortic aneurysm. C. a kidney infection. D. acute appendicitis

B

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and anorexia are MOST indicative of: A. pancreatitis. B. appendicitis. C. cholecystitis. D. gastroenteritis.

B

Palliating factors regarding a patient's pain involve those that: A. worsen the pain. B. alleviate the pain. C. initiate the pain. D. change the pain.

B

Peritonitis may result in shock because: A. intra-abdominal hemorrhage is typically present. B. fluid shifts from the bloodstream into body tissues. C. abdominal distention impairs cardiac contractions. D. severe pain causes systemic dilation of the vasculature.

B

Poor peripheral circulation will cause the skin to appear: A. pink. B. ashen. C. flushed. D. cyanotic

B

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: A. ensure the medication is in tablet form. B. obtain authorization from medical control. C. determine who prescribed the nitroglycerin. D. wait at least 5 minutes after assessing the blood pressure.

B

Prior to attaching the AED to a cardiac arrest patient, the EMT should: A. contact medical control. B. dry the chest off if it is wet. C. perform CPR for 30 seconds. D. assess for a pulse for 20 seconds.

B

Proper technique for suctioning the oropharynx of an adult patient includes: A. continuously suctioning patients with copious oral secretions. B. suctioning while withdrawing the catheter from the oropharynx. C. removing large, solid objects with a tonsil-tip suction catheter. D. suctioning for up to 1 minute if the patient is well oxygenated.

B

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: A. a cardiac arrhythmia. B. congestive heart failure. C. significant hypotension. D. right ventricular failure.

B

Several attempts to adequately open a trams patients airway with the jaw thrust maneuver have been unsuccessful. You should: A. try opening the airway by lifting up on the chin. B. carefully perform the head tilt-chin lift maneuver. C. tilt the head back while lifting up on the patient's neck. D. suction the airway and reattempt the jaw-thrust maneuver.

B

Solid abdominal organs include the: A. stomach and small intestine. B. spleen, kidneys, and pancreas. C. gallbladder and large intestine. D. urinary bladder, colon, and ureters.

B

Syphilis is a: A. high-risk disease to the EMT, especially through a needlestick. B. bloodborne disease that can successfully be treated with penicillin. C. sexually transmitted disease that is only found in vaginal secretions. D. bacterial infection that is typically resistant to antibiotic medications.

B

The AED is MOST advantageous to the EMT because: A. it is lightweight, easy to use, and safe for the EMT who is using it. B. it delivers prompt defibrillation to patients with ventricular fibrillation. C. its use does not require the presence of ALS personnel. D. it delivers an unlimited number of shocks with the same amount of energy.

B

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: A. are elderly. B. are in denial. C. cannot afford it. D. do not trust EMTs.

B

The MOST significant complication associated with oropharyngeal suctioning is: A. oral abrasions from vigorous suctioning. B. hypoxia due to prolonged suction attempts. C. clogging of the catheter with thick secretions. D. vomiting from stimulating the anterior airway.

B

The MOST significant risk factor for a hemorrhagic stroke is: A. severe stress. B. hypertension. C. heavy exertion. D. diabetes mellitus.

B

The actual exchange of oxygen and carbon dioxide occurs in the: A. bronchioles. B. alveolar sacs. C. apex of the lung. D. pulmonary capillaries.

B

The anterior aspect of the cerebrum controls: A. touch. B. emotion. C. movement. D. vision.

B

The continuous quality improvement (CQI) process is designed to: A. provide punitive action to EMTs who do not follow local protocols. B. identify areas of improvement and provide remedial training if needed. C. ensure that all EMTs maintain licensure through the state EMS office. D. focus specifically on the quality of emergency care provided to the patient.

B

The criteria to be licensed and employed as an EMT include: A. demonstration of the ability to lift and carry at least 200 pounds. B. proof of immunization against certain communicable diseases. C. a minimum of 60 college credit hours that focus on health care. D. successful completion of a recognized bystander cardiopulmonary resuscitation (CPR) course.

B

The descending aorta divides into the two iliac arteries at the level of the: A. nipple line. B. umbilicus. C. iliac crest. D. pubic symphysis.

B

The determination of whether a medical patient is a high-priority or low-priority transport is typically made: A. once the patient's baseline vital signs are known. B. after the primary assessment has been completed. C. upon completion of a detailed secondary assessment. D. as soon as the patient voices his or her chief complaint.

B

The diastolic pressure represents the: A. average pressure against the arterial walls during a cardiac cycle. B. minimum amount of pressure that is always present in the arteries. C. increased arterial pressure that occurs during ventricular contraction. D. difference in pressure between ventricular contraction and relaxation.

B

The full-body scan of a patient that occurs following the primary assessment should take no longer than: A. 30 seconds. B. 60 to 90 seconds. C. 90 to 120 seconds. D. 120 to 180 seconds

B

The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by: A. high blood oxygen levels. B. low blood oxygen levels. C. low blood carbon dioxide levels. D. high blood carbon dioxide levels.

B

The main advantage of the Venturi mask is: A. the ability to adjust the percentage of inspired oxygen when caring for a critically ill or injured patient. B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients. C. that it does not contain an oxygen reservoir, so the same percentage of oxygen can consistently be administered. D. the ability to adjust the amount of oxygen administered to the patient by increasing the flow rate on the regulator.

B

The normal respiratory rate for an adult should range from: A. 10 to 15 breaths per minute. B. 12 to 20 breaths per minute. C. 18 to 24 breaths per minute. D. 24 to 28 breaths per minute

B

The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the: A. shift supervisor. B. medical director. C. EMS administrator. D. field training officer.

B

The physical act of moving air into and out of the lungs is called: A. diffusion. B. ventilation. C. respiration. D. oxygenation.

B

The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. blood pressure. B. systolic pressure. C. diastolic pressure. D. pulse pressure.

B

The pulse oximeter is an assessment tool used to evaluate the: A. percentage of red blood cells. B. effectiveness of oxygenation. C. saturation level of venous blood. D. amount of exhaled carbon dioxide.

B

The right coronary artery supplies blood to the: A. left ventricle and inferior wall of the right atrium. B. right ventricle and inferior wall of the left ventricle. C. right atrium and posterior wall of the right ventricle. D. left ventricle and posterior wall of the right ventricle.

B

Tidal volume is defined as the volume of air that: A. is moved through the lungs in a single minute. B. moves into or out of the lungs in a single breath. C. remains in the lungs following a complete exhalation. D. is forced into the lungs as a result of positive pressure.

B

To minimize the risk of litigation, the EMT should always: A. transport patients to the hospital of their choice. B. provide competent care that meets current standards. C. use universal precautions with every patient encounter. D. utilize at least four personnel when moving a patient.

B

Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered: A. legal and ethical. B. legal but unethical. C. illegal but ethical. D. illegal and unethical.

B

Typical methods of assessing a patient's breathing include all of the following, EXCEPT: A. listening to breath sounds with a stethoscope. B. observing for nasal flaring during inhalation. C. observing the chest for adequate rise and fall. D. quickly scanning the chest for obvious movement

B

What is the MOST common cause of airway obstruction in an unconscious patient? A. vomitus B. the tongue C. blood clots D. aspirated fluid

B

What is the function of the left atrium? A. It ejects oxygenated blood into the aorta. B. It receives oxygenated blood from the lungs. C. It receives blood from the pulmonary arteries. D. It receives oxygenated blood from the vena cava.

B

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A. tongue-jaw lift B. jaw-thrust maneuver C. head tilt-chin lift D. head tilt-neck lift

B

What occurs when a patient is breathing very rapidly and shallowly? A. Minute volume increases because of a marked increase in both tidal volume and respiratory rate. B. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange. C. Air is forcefully drawn into the lungs due to the negative pressure created by the rapid respirations. D. The majority of tidal volume reaches the lungs and diffuses across the alveolar- capillary membrane.

B

What percentage of exhaled oxygen is delivered during mouth to mask breathing without supplemental oxygen? A. 10% B. 16% C. 21% D. 32%

B

What section of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel? A. controlling insurance cost B. protecting patient privacy C. preventing insurance fraud D. ensuring access to insurance

B

What should you do before attempting to access a patient trapped in a vehicle? A. Check for other patients. B. Ensure the vehicle is stable. C. Request another ambulance. D. Contact medical control.

B

What type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years? A. acute stress reaction B. cumulative stress reaction C. posttraumatic stress reaction D. critical incident stress reaction

B

When a patient's respirations are shallow: A. chest rise will be easily noticeable. B. tidal volume is markedly reduced. C. oxygenation occurs more efficiently. D. carbon dioxide elimination is increased

B

When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. In addition to administering oxygen, you should: A. apply a cardiac monitor and observe her cardiac rhythm. B. transport at once and consider requesting a paramedic unit. C. document your findings and perform a detailed assessment. D. conclude that the irregular pulse is normal based on her age

B

When caring for a patient who takes numerous medications, it is best to: A. document the medications on your patient care report, but leave them at home so they do not get misplaced. B. take all of the patient's medications with you to the hospital and document them on your patient care report. C. send the patient's medications to the hospital with a family member or other person who will safeguard them. D. let the hospital staff retrieve the patient's medical records, which should show a list of his or her current medications.

B

When documenting a patient's description of his or her chest pain or discomfort, the EMT should: A. use medical terminology. B. use the patient's own words. C. underline the patient's quotes. D. document his or her own perception.

B

When evaluating a patient with multiple complaints, the EMT's responsibility is to: A. direct his or her attention to the most obvious signs and symptoms. B. determine which complaint poses the greatest threat to the patient's life. C. definitively rule out serious causes of each of the patient's complaints. D. assess each complaint based on the patient's perception of its seriousness.

B

When is it MOST appropriate to consider requesting additional ambulances at an accident scene? A. after you have triaged all the critical patients B. when you determine there are multiple patients C. after noncritical patients have been identified D. when all the deceased patients are accounted for

B

When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is: A. slow. B. rapid. C. irregular. D. thready

B

When performing a full-body scan on a supine patient, what part of the body is typically assessed last? A. abdomen B. posterior C. extremities D. anterior chest

B

When performing a full-body scan on a trauma patient, you note the presence of Battle's sign. This is defined as: A. unequal pupils. B. bruising behind the ear. C. swelling to the orbital area. D. fluid drainage from the nose.

B

When the myocardium requires more oxygen: A. the heart contracts with less force. B. the arteries supplying the heart dilate. C. the heart rate decreases significantly. D. the AV node conducts fewer impulses.

B

When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: A. recumbent position with the paralyzed side up. B. recumbent position with the paralyzed side down. C. sitting position with the head at a 45° to 90° angle. D. supine position with the legs elevated 6″ to 12″.

B

When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear: A. latex gloves with thick leather gloves underneath. B. puncture-proof leather gloves over your latex gloves. C. fire fighter gloves only, to preserve manual dexterity. D. thick fire fighter gloves over two pairs of latex gloves.

B

When ventilating an apneic adult with a simple barrier device, you should deliver each breath: A. over a period of about 1 to 2 seconds. B. while watching for adequate chest rise. C. with a tidal volume of about 500 mL. D. quickly to ensure adequate ventilation.

B

When you assess capillary refill time (CRT) in an infant, normal color to the tested area should return within: A. 1 second. B. 2 seconds. C. 3 seconds. D. 4 seconds

B

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. pulse pressure. B. systolic blood pressure. C. diastolic blood pressure. D. cardiac output pressure.

B

Which of the following MOST accurately defines negligence? A. transport of a mentally incompetent patient against his or her will B. deviation from the standard of care that may result in further injury C. transferring patient care to a provider with a lower level of training D. providing care that is consistent with care provided by other EMTs

B

Which of the following abnormal breath sounds indicates obstruction of the upper airway? A. rales B. stridor C. crackles D. rhonchi

B

Which of the following actions would NOT be performed during the scene size-up? A. asking a neighbor to secure the patient's dog B. rapidly assessing a patient's respiratory status C. notifying the dispatcher to send fire personnel D. noting the position of a crashed motor vehicle

B

Which of the following assessment findings is MOST indicative of a cardiovascular problem? A. unequal breath sounds B. jugular venous distention C. use of the accessory muscles D. palpable pain to the epigastrium

B

Which of the following conditions is NOT a common cause of seizures? A. poisoning or overdose B. severe hypovolemia C. acute hypoglycemia D. acute alcohol withdrawal

B

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? A. hypoglycemia B. hypovolemia C. a postictal state D. intracranial bleeding

B

Which of the following descriptions MOST accurately portrays emergency medical services (EMS)? A. a vast network of advanced life support (ALS) providers who provide definitive emergency care in the prehospital setting B. a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured C. a system composed exclusively of emergency medical responders (EMRs) and emergency medical technicians (EMTs) who are responsible for providing care to sick and injured patients D. a team of paramedics and emergency physicians who are responsible for providing emergency care to critically injured patients

B

Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? A. anxiety or severe stress B. beta-blocker medications C. internal bleeding from trauma D. lack of a regular exercise routine

B

Which of the following findings indicates that your patient has a patent airway? A. audible breathing B. forceful coughing C. inspiratory stridor D. unresponsiveness

B

Which of the following is NOT a function of the sympathetic nervous system? A. dilation of blood vessels in the muscles B. constriction of blood vessels in the muscles C. increases in the heart and respiratory rates D. constriction of blood vessels in the digestive system

B

Which of the following is a late sign of hypoxia? A. anxiety B. cyanosis C. tachycardia D. restlessness

B

Which of the following is a major difference between angina pectoris and AMI? A. AMI is caused by myocardial ischemia. B. Anginal pain typically subsides with rest. C. Nitroglycerin has no effect on angina pectoris. D. Pain from an AMI subsides within 30 minutes.

B

Which of the following is an example of a symptom? A. cyanosis B. headache C. tachycardia D. hypertension

B

Which of the following is the MOST accurate guide to palpating a pulse? A. Avoid compressing the artery against a bone or solid structure. B. Place the tips of your index and long fingers over the pulse point. C. Use your thumb to increase the surface area that you are palpating. D. Apply firm pressure to the artery with your ring and little fingers.

B

Which of the following medical history questions would be of LEAST pertinence in an acute situation? A. "Does the pain stay in your chest?" B. "Does your mother have diabetes?" C. "Has this ever happened to you before?" D. "Are there medications that you cannot take?"

B

Which of the following medications is NOT used to treat patients with a history of seizures? A. phenytoin (Dilantin) B. hydromorphone (Dilaudid) C. carbamazepine (Tegretol) D. phenobarbital

B

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? A. furosemide (Lasix) B. aspirin C. oxygen D. digoxin (Lanoxin)

B

Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder? A. vertical-position flowmeter B. Bourdon-gauge flowmeter C. ball-and-float flowmeter D. pressure-compensated flowmeter

B

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever? A. a 3-month-old female who was born prematurely B. a 17-year-old male with depression and anxiety C. a 35-year-old female in the later stages of AIDS D. an 88-year-old male with chronic renal problems

B

Which of the following patients would MOST likely require insertion of an oropharyngeal airway? A. a 33-year-old semiconscious patient with reduced tidal volume B. a 40-year-old unconscious patient with slow, shallow respirations C. a 51-year-old confused patient with severely labored respirations D. a 64-year-old conscious patient with rapid and deep respirations

B

Which of the following scenarios MOST accurately depicts informed consent? A. A patient advises an EMT of why he or she is refusing care. B. An EMT advises a patient of the risks of receiving treatment. C. An EMT initiates immediate care for an unconscious adult. D. A patient is advised by an EMT of the risks of refusing care.

B

Which of the following signs is commonly observed in patients with right-sided heart failure? A. labored breathing B. dependent edema C. pulmonary edema D. flat jugular veins

B

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure? A. hypertension and tachycardia B. hypotension and flat jugular veins C. the presence of rales in the lungs D. trouble breathing while lying down

B

Which of the following signs would indicate that your partner is experiencing significant stress? A. increased interest in daily activities B. isolation from the rest of the crew C. hyperactivity during an EMS call D. acute increase in his or her appetite

B

Which of the following situations or conditions warrants immediate transport? A. mild pain in the lower abdomen B. severe chest pain and cool, pale skin C. decreased ability to move an extremity D. responsiveness and ability to follow commands

B

Which of the following skills or interventions is included at every level of prehospital emergency training? A. oral glucose for hypoglycemia B. AED C. intranasal medication administration D. use of a manually triggered ventilator

B

Which of the following statements is MOST consistent with the bargaining phase of the grieving process? A. "It is because of our lousy health care system that I developed this brain tumor." B. "I will be compliant with all my medications if I can just see my grandson graduate." C. "I understand that my death is inevitable and I am ready to die when the time comes." D. "The doctors must be wrong in their diagnosis because I have always been healthy."

B

Which of the following statements regarding a patient with a behavioral crisis is correct? A. Depression accounts for a very small percentage of violent attacks. B. A quiet patient is not as likely to attack you as one who is screaming. C. A past history of violence is an unreliable indicator of future violence. D. People who say that they are "hearing voices" are usually bluffing you.

B

Which of the following statements regarding gastrointestinal bleeding is correct? A. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself. C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome. D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

B

Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct? A. Most cases of MRSA transmission occur following an accidental needlestick. B. MRSA is a bacterium that causes infections and is resistant to most antibiotics. C. The communicable period for MRSA is 10 days to 2 weeks after being infected. D. Studies have shown that less than 1% of health care providers are MRSA carriers.

B

Which of the following statements regarding normal gas exchange in the lungs is correct? A. The oxygen content in the alveoli is highest during the exhalation phase. B. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries. C. The actual exchange of oxygen and carbon dioxide occurs in the capillaries. D. Blood that returns to the lungs from the body has a low carbon dioxide content.

B

Which of the following statements regarding positive-pressure ventilation is correct? A. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body. B. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing. C. To prevent hypotension, the EMT should increase the rate and force of positive- pressure ventilation. D. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure.

B

Which of the following statements regarding the hepatitis B vaccine is correct? A. Vaccination against hepatitis B provides partial immunity for life. B. OSHA requires that your employer offer you the vaccine free of charge. C. The hepatitis B vaccine provides protection against the disease for 2 years. D. Vaccination with the hepatitis B vaccine confers immunity against hepatitis A.

B

Which of the following statements regarding the mechanism of injury (MOI) is correct? A. A nonsignificant MOI rules out the possibility of serious trauma. B. The MOI may allow you to predict the severity of a patient's injuries. C. The exact location of a patient's injuries can be determined by the MOI. D. A significant MOI always results in patient death or permanent disability

B

Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated? A. actual B. implied C. informed D. expressed

B

Which of the following will MOST reliably allow you to determine the nature of a patient's illness? A. trending of the patient's vital signs over time B. asking questions related to the chief complaint C. refraining from asking open-ended questions D. focusing solely on how the call is dispatched

B

Which of the following would NOT cause a decrease in tidal volume? A. shallow breathing B. deep respirations C. irregular breathing D. agonal respirations

B

While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should: A. immerse your wound in an alcohol-based solution. B. report the incident to your supervisor after the call. C. get immunized against hepatitis as soon as possible. D. discontinue patient care and seek medical attention.

B

While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should: A. ask the dispatcher if he or she knows the location of the perpetrator. B. confirm this information with law enforcement personnel at the scene. C. request law enforcement personnel if the scene is unsafe upon arrival. D. proceed to the scene as usual but exercise extreme caution upon arrival

B

While providing care to a patient, blood got onto the ambulance stretcher. Because the stretcher was not properly cleaned afterward, a virus was transmitted to another emergency medical technician (EMT) several days later. What route of transmission does this scenario describe? A. direct contact B. indirect contact C. airborne transmission D. vector-borne transmission

B

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: A. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. C. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible. D. load him into the ambulance, begin transport, and perform all treatment en route to the hospital.

B

You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to: A. notify medical control for advice. B. provide immediate patient care. C. wait for law enforcement to arrive. D. determine why the patient was injured.

B

You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. You should: A. attempt to insert an oropharyngeal airway. B. assist his ventilations with a bag-mask device. C. apply a continuous positive airway pressure (CPAP) device and monitor his breathing. D. apply high-flow oxygen via nonrebreathing mask.

B

You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the health care system caused his disease. What stage of the grieving process is this patient's behavior consistent with? A. denial B. anger C. bargaining D. depression

B

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: A. acute hypoglycemia. B. a ruptured cerebral artery. C. a complex partial seizure. D. an occluded cerebral artery.

B

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: A. repeat the arm drift test and ensure that her palms are facing downward. B. repeat the arm drift test, but move the patient's arms into position yourself. C. instruct the patient to keep her eyes open and then repeat the arm drift test. D. defer this part of the test and assess her for facial droop and slurred speech.

B

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: A. obtain baseline vital signs. B. begin ventilatory assistance. C. attach the automated external defibrillator (AED) immediately. D. apply a nonrebreathing mask.

B

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: A. assess the patient for a facial droop and hemiparesis. B. initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible. C. obtain a blood glucose sample to rule out hypoglycemia. D. perform CPR for 5 minutes before applying the AED.

B

You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to: A. palpate for the presence of a carotid pulse. B. log roll him as a unit to a supine position. C. assess the rate and quality of his breathing. D. open his airway with a jaw-thrust maneuver.

B

You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should: A. obtain permission from law enforcement before moving anything. B. quickly move the coffee table so you can access and treat the patient. C. treat the patient where he is so that you do not destroy any evidence. D. drag the patient into a larger area so that you can begin treatment.

B

You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving? A. 45% B. 55% C. 65% D. 75%

B

You are transporting an elderly woman who has possibly experienced a stroke. She is obviously scared but is unable to talk and cannot move the entire right side of her body. In addition to providing the medical care that she needs, you should: A. reassure her that after proper treatment in the hospital, she will regain her speech in time. B. acknowledge that she is scared and tell her that you are going to take good care of her. C. maintain eye contact at all times and tell her that there is no need for her to be scared. D. tell her that you understand why she is scared and that everything will likely be okay.

B

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should: A. thrust the jaw forward. B. seal the mouth and nose. C. ventilate with less pressure. D. thoroughly suction the stoma.

B

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: A. determine if the patient is a known alcohol abuser. B. obtain a description of how the seizure developed. C. determine when he was last seen by his physician. D. ask her how long the patient has been taking his medication.

B

You have been tasked by your medical director to assist in the development of your EMS agency's institutional standards. When developing these standards, it is important to: A. require personnel to transport all patients to the closest hospital. B. be reasonable and realistic to avoid overburdening your personnel. C. demand that all personnel consistently exceed the standard of care. D. expect personnel to function beyond their scope of practice if needed.

B

You have been working at the scene of a major building collapse for 8 hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is MOST effectively managed by: A. providing large amounts of caffeine to the rescue workers. B. requesting a CISM team to provide on-scene peer support. C. conducting a critical incident stress debriefing the next day. D. allowing each worker to sleep in 15- to 30-minute increments.

B

You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should: A. continue with your secondary assessment. B. prepare the patient for immediate transport. C. insert a nasal airway and assist his breathing. D. request an ALS unit to respond to the scene.

B

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: A. cover the child with wet towels and give oxygen via nasal cannula. B. transport the child to the hospital and reassure the mother en route. C. advise the mother to take her child to the doctor the following day. D. call medical control and request permission to give the child aspirin.

B

You should gently palpate a patient's pelvis only if: A. you note gross deformity to the pelvic area. B. the patient does not complain of pelvic pain. C. the MOI suggests pelvic trauma. D. the possibility of a pelvic fracture has been ruled out

B

You suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child's mother appears and refuses to allow you to continue treatment. You should: A. use your authority under the implied consent law. B. try to persuade the mother that treatment is needed. C. ask the mother to sign a refusal form and then leave. D. tell the mother that her refusal is a form of child abuse.

B

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should: A. reanalyze the patient's cardiac rhythm. B. perform CPR for 2 minutes and reassess. C. determine if a palpable pulse is present. D. immediately assess the patient's airway.

B

In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion. A. 1 B. 2 C. 3 D. 4

B. 2

Which of the following statements regarding anaphylaxis is correct? A. Patients with asthma are at lower risk of developing anaphylaxis. B. Anaphylaxis is characterized by airway swelling and hypotension. C. Most anaphylactic reactions occur within 60 minutes after exposure. D. The signs of anaphylaxis are caused by widespread vasoconstriction.

B. Anaphylaxis is characterized by airway swelling and hypotension.

Which of the following statements regarding abdominal trauma is correct? A. Most of the vital abdominal organs lie within the retroperitoneal space. B. The absence of abdominal pain does not rule out intra-abdominal bleeding. C. The liver is well protected and is rarely injured during a traumatic event. D. Hollow abdominal organs are vascular and bleed profusely when injured.

B. The absence of abdominal pain does not rule out intra-abdominal bleeding.

Which of the following statements regarding abdominal eviscerations is correct? A. Most eviscerations occur to the left upper quadrant. B. The protruding organs should be kept warm and moist. C. The organs should be replaced carefully to avoid heat loss. D. Adherent material is preferred when covering an evisceration

B. The protruding organs should be kept warm and moist.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A. normal breath sounds. B. abnormal breath sounds. C. diminished breath sounds. D. an absence of breath sounds.

B. abnormal breath sounds.

Clinical signs of compensated shock include all of the following, EXCEPT: A. cool and clammy skin. B. absent peripheral pulses. C. restlessness or anxiety. D. rapid, shallow breathing.

B. absent peripheral pulses.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: A. an obstructed airway. B. adequate air exchange. C. respiratory difficulty. D. respiratory insufficiency.

B. adequate air exchange.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. C. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. D. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma.

B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration. C. force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.

B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

You respond to a residence for a patient with a severe leg 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: A. immediately evaluate his airway. B. apply direct pressure to the wound. C. assess the rate and quality of his pulse. D. administer 100% supplemental oxygen.

B. apply direct pressure to the wound.

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: A. splint the elbow in the position of deformity and transport immediately. B. apply gentle manual traction in line with the limb and reassess for a pulse. C. carefully straighten the injured arm and secure it with padded board splints. D. make two or three attempts to restore distal circulation by manipulating the elbow.

B. apply gentle manual traction in line with the limb and reassess for a pulse.

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes: A. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B. assisted ventilation, thermal management, and elevation of the lower extremities. C. oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D. assisted ventilation, preventing hyperthermia, and elevating his lower extremities.

B. assisted ventilation, thermal management, and elevation of the lower extremities.

Bone marrow produces: A. platelets. B. blood cells. C. lymphocytes. D. electrolytes.

B. blood cells.

When assessing a patient with signs and symptoms of shock, it is MOST important to remember that: A. the patient's respirations are deep during the early stages of shock. B. blood pressure may be the last measurable factor to change in shock. C. multiple fractures are the most common cause of hypovolemic shock. D. irreversible shock often responds well to a prompt blood transfusion.

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

A fracture is MOST accurately defined as a(n): A. total loss of function in a bone. B. break in the continuity of the bone. C. disruption in the midshaft of a bone. D. abnormality in the structure of a bone.

B. break in the continuity of the bone.

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is: A. lactic acid. B. carbon dioxide. C. pyruvic acid. D. carbon monoxide.

B. carbon dioxide.

Which of the following injuries would MOST likely cause obstructive shock? A. liver laceration B. cardiac tamponade C. simple pneumothorax D. spinal cord injury Answer: B

B. cardiac tamponade

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: A. acute myocardial infarction. B. cardiogenic hypoperfusion. C. severe septic hypoperfusion. D. a ruptured aortic aneurysm.

B. cardiogenic hypoperfusion.

The respiratory distress that accompanies emphysema is caused by: A. repeated exposure to cigarette smoke. B. chronic stretching of the alveolar walls. C. massive constriction of the bronchioles. D. acute fluid accumulation in the alveoli.

B. chronic stretching of the alveolar walls.

When assessing a patient with a possible fracture of the leg, the EMT should: A. assess proximal circulation. B. compare it to the uninjured leg. C. carefully move it to elicit crepitus. D. ask the patient to move the injured leg.

B. compare it to the uninjured leg.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. slow and deep. B. deep and rapid. C. slow and shallow. D. rapid and shallow.

B. deep and rapid.

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. swelling. B. deformity. C. ecchymosis. D. point tenderness.

B. deformity.

A supracondylar or intercondylar fracture is also known as a fracture of the: A. radial head. B. distal humerus. C. proximal radius. D. olecranon process.

B. distal humerus.

A Colles fracture involves a fracture of the: A. distal ulna. B. distal radius. C. proximal radius. D. radius and ulna.

B. distal radius.

A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is: A. albuterol. B. epinephrine. C. an antihistamine. D. a beta-antagonist.

B. epinephrine.

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: A. covering him with a warm blanket. B. giving him small sips of plain water. C. promptly transporting to the hospital. D. administering supplemental oxygen.

B. giving him small sips of plain water.

During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes: A. applying and inflating the pneumatic antishock garment (PASG) and transporting. B. immobilizing her to a backboard and rapidly transporting. C. applying a traction splint to immobilize her femur. D. carefully splinting each of her deformed extremities.

B. immobilizing her to a backboard and rapidly transporting.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: A. perform a comprehensive secondary assessment to determine why his clinical status has changed. B. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device. C. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. D. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

B. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

The two processes that occur during respiration are: A. ventilation and diffusion. B. inspiration and expiration. C. diffusion and oxygenation. D. oxygenation and ventilation.

B. inspiration and expiration.

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if: A. the patient is conscious. B. law enforcement is at the scene. C. there are other patients involved. D. the severity of the injury is known.

B. law enforcement is at the scene.

When splinting a possible fracture of the foot, it is MOST important for the EMT to: A. use a pillow as a splint. B. leave the toes exposed. C. apply a pneumatic splint. D. observe for tissue swelling.

B. leave the toes exposed.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should: A. perform a head-to-toe assessment while she is in the car. B. lift the air bag and look for deformity to the steering wheel. C. carefully assess her upper chest for seatbelt-related injuries. D. extricate her immediately and transport to a trauma center.

B. lift the air bag and look for deformity to the steering wheel.

Which of the following organs would MOST likely bleed profusely when injured? A. bladder B. liver C. stomach D. intestine

B. liver

Which of the following would MOST likely result in hemorrhagic shock? A. severe vomiting B. liver laceration C. excessive sweating D. repeated diarrhea

B. liver laceration

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the: A. thoracic spine. B. lumbar spine. C. coccygeal spine. D. symphysis pubis.

B. lumbar spine.

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? A. assisted ventilation with a bag-mask device and a head-to-toe exam B. oxygen via nonrebreathing mask and a focused secondary assessment C. positive-pressure ventilations and immediate transport to the closest hospital D. oxygen via a nasal cannula, vital signs, and prompt transport to the hospital

B. oxygen via nonrebreathing mask and a focused secondary assessment

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. A. greenstick B. pathologic C. transverse D. comminuted

B. pathologic

When a hollow organ is punctured during a penetrating injury to the abdomen: A. the abdomen will become instantly distended. B. peritonitis may not develop for several hours. C. it will bleed profusely and rapidly cause shock. D. it commonly protrudes through the injury site.

B. peritonitis may not develop for several hours.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for: A. anterior hip dislocation. B. posterior hip dislocation. C. a thoracic spine fracture. D. fracture of the tibia or fibula.

B. posterior hip dislocation.

Because the depth of an open abdominal wound is often difficult to determine: A. vital signs should be monitored frequently. B. prompt transport to the hospital is essential. C. the EMT must perform a thorough exam. D. the abdomen must be vigorously palpated.

B. prompt transport to the hospital is essential.

A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: A. have her breathe into a paper or plastic bag. B. provide reassurance and give oxygen as needed. C. request a paramedic to give her a sedative drug. D. position her on her left side and transport at once.

B. provide reassurance and give oxygen as needed.

The PASG is absolutely contraindicated in patients who have: A. pelvic fractures. B. pulmonary edema. C. bilateral femur fractures. D. any trauma below the pelvis.

B. pulmonary edema.

Early bruising following abdominal trauma often manifests as: A. localized pain. B. red areas of skin. C. gross distention. D. dark purple marks.

B. red areas of skin.

37. Applying ice to and elevating an injured extremity are performed in order to: A. prevent further injury. B. reduce pain and swelling. C. enhance tissue circulation. D. maintain extremity perfusion.

B. reduce pain and swelling.

When the level of arterial carbon dioxide rises above normal: A. the brain stem inhibits respirations. B. respirations increase in rate and depth. C. exhalation lasts longer than inhalation. D. respirations decrease in rate and depth.

B. respirations increase in rate and depth.

Which of the following conditions would LEAST likely result in hypoxia? A. pleural effusion B. severe anxiety C. pulmonary edema D. prolonged seizures

B. severe anxiety

Which of the following types of muscle is under direct voluntary control of the brain? A. cardiac B. skeletal C. smooth D. autonomic

B. skeletal

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. A. strain B. sprain C. fracture D. dislocation

B. sprain

Skeletal muscle is also referred to as __________ muscle. A. smooth B. striated C. connective D. involuntary

B. striated

Harsh, high-pitched inspiratory sounds are characteristic of: A. rales. B. stridor. C. rhonchi. D. wheezing.

B. stridor.

When the body senses a state of hypoperfusion, the sympathetic nervous system releases epinephrine, the effects of which include: A. tachypnea. B. tachycardia. C. vasodilation. D. restlessness.

B. tachycardia.

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called: A. fascia. B. tendons. C. cartilage. D. ligaments.

B. tendons.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: A. distal circulation. B. the patient history. C. bruising to the shoulder. D. the presence of deformity.

B. the patient history.

In general, musculoskeletal injuries should be splinted before moving the patient unless: A. the patient is in severe pain. B. the patient is clinically unstable. C. deformity and swelling are present. D. transport time is less than 15 minutes.

B. the patient is clinically unstable.

Initial treatment to dislodge a severe foreign body airway obstruction in a responsive infant involves

Back slaps

A 60 year old male is found to be unresponsive, pulseless, and apnea. You should:

Begin CPR until an AED is available

When assessing the pulse of and unresponsive infant you should palpate the _____ artery

Brachial

1. The term "pharmacology" is MOST accurately defined as: A. the study of drugs that are produced illegally. B. the study of how medications affect the brain. C. the study of drugs and their actions on the body. D. the study of drug excretion from the human body.

C

11. In contrast to secure attachment, anxious-avoidant attachment occurs when a child: A. becomes acutely anxious at the presence of strangers or in unfamiliar surroundings. B. clings to a parent or caregiver because he or she knows that the person can be trusted. C. shows little emotional response to a parent or caregiver following repeated rejection. D. reaches out and explores because he or she knows that the parents are there as a safety net.

C

16. In preconventional reasoning, children: A. make decisions based on their conscience. B. look for approval from their peers and society. C. act almost purely to avoid punishment and to get what they want. D. blame their actions on what they have observed in older children.

C

2. A medication with antagonistic properties is one that: A. stimulates receptor sites and allows other chemicals to attach to them. B. enhances the effects of another medication when given in a higher dose. C. blocks receptor sites and prevents other chemicals from attaching to them. D. produces a cumulative effect when mixed with the same type of medication.

C

21. Which of the following statements regarding the metered-dose inhaler (MDI) is correct? A. MDIs are contraindicated for patients with asthma or emphysema. B. MDIs are most commonly used by patients with cardiovascular disease. C. An MDI delivers the same amount of medication every time it is used. D. Shaking an MDI prior to use will cause deactivation of the medication.

C

22. Physical changes that typically occur in early adults include an: A. increase in muscle strength and reflexes. B. increase in height because of spinal disc expansion. C. increase in fatty tissue, which leads to weight gain. D. increase in respiratory rate due to increased metabolism.

C

24. A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should: A. check the drug's expiration date to ensure that it is still current. B. contact medical control and apprise him or her of what you did. C. reassess the patient and document her response to the medication. D. administer another treatment in 30 seconds if she is still in distress.

C

25. Why do middle adults commonly experience financial concerns? A. They are typically receiving social security and must budget with a fixed income. B. Most people in the middle adult age group have chronic illnesses and cannot work. C. They are preparing for retirement but must still manage everyday financial demands. D. The majority of middle adults still have small children that live at home with them.

C

27. Which of the following is NOT a common factor that would affect a 75-year-old patient's vital signs? A. medications B. overall health C. increased weight D. medical conditions

C

33. Activated charcoal is frequently suspended in sorbitol, a complex sugar that: A. significantly slows the process of digestion. B. binds to any chemicals that are in the stomach. C. facilitates movement through the digestive system. D. disguises the unpleasant taste of the activated charcoal.

C

34. In late adults, the amount of air left in the lungs after expiration of the maximum amount of air: A. remains unchanged because the lungs have become accustomed to years of breathing pollution. B. decreases, resulting in widespread collapsing of the alveoli and impaired diffusion of gases. C. increases, which hampers diffusion of gases because of stagnant air that remains in the alveoli. D. decreases, which increases diffusion in the lungs and causes an accumulation of carbon dioxide.

C

38. Shortly after assisting a 65-year-old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should: A. transport her in a sitting position. B. wait 5 minutes and reassess her blood pressure. C. place her supine and elevate her legs. D. assist ventilations with a bag-mask device.

C

39. When communicating with an older patient, it is important to remember that: A. deafness and blindness are a normal part of the process of aging. B. most older patients are confused due to a decrease in brain cells. C. age-related changes diminish the effectiveness of the eyes and ears. D. the majority of older patients experience a loss of low-frequency hearing.

C

40. 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? A. Administer her epinephrine, reassess her condition, and transport her promptly. B. Begin immediate transport and request an intercept with a paramedic ambulance. C. Give her oxygen, transport her to the hospital, and monitor her condition en route. D. Give her half the dose of her epinephrine in case her allergic reaction is delayed.

C

42. Which of the following statements regarding the epinephrine auto-injector is correct? A. The adult auto-injector delivers 0.5 to 1 mg of epinephrine. B. The auto-injector delivers epinephrine via the subcutaneous route. C. The epinephrine auto-injector delivers a preset amount of the drug. D. EMTs do not need physician authorization to use the auto-injector.

C

6. Advil, Nuprin, and Motrin are brand (trade) names for the generic medication: A. aspirin. B. nitrostat. C. ibuprofen. D. acetaminophen.

C

6. An infant or small child's airway can be occluded if it is overextended or overflexed because: A. the back of the head is flat, which prevents a neutral position. B. he or she has a long neck, which makes the trachea prone to collapse. C. the occiput is proportionately large and the trachea is flexible. D. the tongue is proportionately small and can fall back into the throat.

C

A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway? A. Suction his oropharynx with a rigid catheter until all secretions are removed. B. Insert a nasopharyngeal airway and provide suction and assisted ventilations. C. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation. D. Provide continuous ventilations with a bag-mask device to minimize hypoxia.

C

A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is: A. 10. B. 12. C. 13. D. 14

C

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? A. Avoid defibrillation as this will damage the patient's AICD. B. Contact medical control and request permission to defibrillate. C. Deliver the shock followed by immediate resumption of CPR. D. Continue CPR and transport the patient to the closest appropriate hospital.

C

A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: A. wait for family members to arrive before asking any questions. B. defer SAMPLE history questions until you arrive at the hospital. C. determine if the patient has a medical alert bracelet or wallet card. D. ask law enforcement officials if they are familiar with the patient

C

A 50-year-old male presents with an altered mental status. His wife tells you that he had a "small stroke" 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should: A. repeat the primary assessment. B. inquire about his family history. C. prepare for immediate transport. D. perform a head-to-toe assessment

C

A blood pressure cuff that is too small for a patient's arm will give a: A. falsely low systolic and diastolic reading. B. falsely high systolic but low diastolic reading. C. falsely high systolic and diastolic reading. D. falsely low systolic but high diastolic reading.

C

A dissecting aortic aneurysm occurs when: A. all layers of the aorta suddenly contract. B. a weakened area develops in the aortic wall. C. the inner layers of the aorta become separated. D. the aorta ruptures, resulting in profound bleeding.

C

A low ETCO2 reading, as measured by capnography, would MOST likely be observed if: A. a patient in cardiac arrest is receiving high-quality CPR. B. an endotracheal (ET) tube is correctly placed in the trachea. C. there is an absence or decrease in the level of CO2 in the lungs. D. the cells produce large amounts of CO2 and return it to the lungs.

C

A palpable pulse is created by: A. the pressure of circulating blood against the walls of the arteries. B. the pressure that is caused when venous blood returns to the heart. C. pressure waves through the arteries caused by cardiac contraction. D. electrical conduction in the heart producing ventricular contraction

C

A patient should be placed in the recovery position when he or she: A. is semiconscious, injured, and breathing adequately. B. has experienced trauma but is breathing effectively. C. is unconscious, uninjured, and breathing adequately. D. has a pulse but is unconscious and breathing shallowly.

C

A patient who is experiencing aphasia is: A. not able to swallow without choking. B. experiencing a right hemispheric stroke. C. unable to produce or understand speech. D. usually conscious but has slurred speech.

C

A patient who was bitten by a mosquito and presents with signs and symptoms of illness should be suspected of having: A. avian flu. B. hantavirus. C. West Nile virus. D. lyme disease.

C

A patient with profuse sweating is referred to as being: A. flushed. B. plethoric. C. diaphoretic. D. edematous

C

A pulse with a consistent pattern is considered to be: A. weak. B. strong. C. regular. D. irregular

C

A transient ischemic attack (TIA) occurs when: A. medications are given to dissolve a cerebral blood clot. B. a small cerebral artery ruptures and causes minimal damage. C. the normal body processes destroy a clot in a cerebral artery. D. signs and symptoms resolve spontaneously within 48 hours

C

An EMT would MOST likely be held liable for abandonment if he or she: A. refused to care for a violent patient who is armed with a knife. B. remained at the hospital for 30 minutes to give a patient report. C. did not make provisions for continued care of an injured patient. D. terminated care of a competent adult patient at his or her request.

C

An adult at rest should have a respiratory rate that ranges between: A. 8 and 15 breaths/min. B. 10 and 18 breaths/min. C. 12 and 20 breaths/min. D. 16 and 24 breaths/min.

C

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: A. 24%. B. 35%. C. 44%. D. 52%.

C

CPAP is indicated for patients who: A. have signs of pneumonia but are breathing adequately. B. are unresponsive and have signs of inadequate ventilation. C. have pulmonary edema and can follow verbal commands. D. are hypotensive and have a marked reduction in tidal volume.

C

Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT: A. when personnel are assessed during periods of rest. B. before personnel are preparing to reenter the scene. C. when patients are actively being assessed or treated. D. before leaving the scene after the incident is resolved.

C

Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should: A. restrain her and provide ventilatory assistance. B. insert a nasopharyngeal airway and give oxygen. C. explain to her that you will assist her ventilations. D. ventilate her at the rate at which she is breathing.

C

During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that his: A. respiratory status is adequate. B. systolic blood pressure is normal. C. peripheral circulation is decreased. D. skin temperature is abnormally cold

C

During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you: A. acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others. B. adequately safeguarded the patient's PHI because the cases were discussed internally. C. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand. D. violated the patient's privacy because you should have only discussed the information with the EMTs who provided it.

C

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: A. the AED has detected asystole. B. the AED detected patient motion. C. she is not in ventricular fibrillation. D. she has a pulse and does not need CPR.

C

Each cell of the body combines nutrients and oxygen and produces energy and waste products through a process called: A. respiration. B. ventilation. C. metabolism. D. oxygenation.

C

Febrile seizures: A. often result in permanent brain damage. B. are also referred to as petit mal seizures. C. are usually benign but should be evaluated. D. occur when a child's fever progressively rises.

C

For an adult, the normal resting pulse should be between: A. 50 and 60 beats/min. B. 50 and 70 beats/min. C. 60 and 100 beats/min. D. 70 and 110 beats/min

C

Hepatitis B is more virulent than hepatitis C, which means that it: A. is less resistant to treatment. B. is a more contagious type of disease. C. has a greater ability to produce disease. D. leads to chronic infection after exposure.

C

If a patient develops difficulty breathing after your primary assessment, you should immediately: A. determine his or her respiratory rate. B. begin assisting his or her breathing. C. reevaluate his or her airway status. D. auscultate his or her breath sounds

C

If a person is partially immune to a particular disease, he or she: A. is not protected from a new infection if exposed to another individual. B. must be revaccinated at least every 18 months to avoid infection. C. may develop illness from germs that lie dormant from the initial infection. D. will not experience future illness, even if his or her immune system is stressed.

C

If you are exposed to a patient's blood or other bodily fluid, your first action should be to: A. report the incident to the infection control officer. B. abandon patient care and seek medical attention. C. transfer care of your patient to another EMS provider. D. vigorously clean the area with soap and water.

C

In contrast to the sympathetic nervous system, the parasympathetic nervous system: A. prepares the body to handle stress. B. causes an increase in the heart rate. C. slows the heart and respiratory rates. D. dilates the blood vessels in the muscles.

C

In the presence of oxygen, the mitochondria of the cells convert glucose into energy through a process called: A. perfusion. B. respiration. C. aerobic metabolism. D. anaerobic metabolism.

C

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: A. brain. B. kidneys. C. liver. D. pancreas.

C

Inhalation occurs when the: A. diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure. B. diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure. C. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure. D. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.

C

Interruption of cerebral blood flow may result from all of the following, EXCEPT: A. a thrombus. B. an embolism. C. cerebral vasodilation. D. an acute arterial rupture.

C

Intrapulmonary shunting occurs when: A. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs. B. a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. C. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state. D. any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane.

C

Law enforcement has summoned you to a nightclub, where a 22-year-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: A. place a bite block in her mouth in case she has a seizure and transport at once. B. apply oxygen via a nonrebreathing mask, place her on her left side, and transport. C. assist ventilations, perform a rapid exam, and prepare for immediate transport. D. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.

C

Laypeople are often trained to perform all of the following skills, EXCEPT: A. one- or two-rescuer CPR. B. splinting of a possible fracture. C. insertion of an oropharyngeal airway. D. control of life-threatening bleeding.

C

Physiologic manifestations of stress include: A. flushed skin, decreased muscle control, and vomiting. B. slow heart rate, low blood pressure, and severe headaches. C. perspiration, increased blood glucose levels, and dilated pupils. D. increased blood pressure, decreased blood glucose levels, and chest pain.

C

Prescription glasses do not provide adequate eye protection because they: A. have large rounded lenses. B. are not secured with a strap. C. offer little or no side protection. D. do not have shatterproof lenses.

C

Prior to applying a nonrebreathing mask on a patient, you must ensure that the: A. one-way valve is sealed. B. flow rate is set at 6 L/min. C. reservoir bag is fully inflated. D. patient has reduced tidal volume.

C

Reassessment of a patient with a medical complaint should begin by: A. reassessing the nature of illness. B. taking another set of vital signs. C. repeating the primary assessment. D. reviewing all treatment performed.

C

Risk factors for AMI that cannot be controlled include: A. excess stress. B. hyperglycemia. C. family history. D. lack of exercise.

C

Structures of the lower airway include all of the following, EXCEPT the: A. alveoli. B. trachea. C. epiglottis. D. bronchioles.

C

Sudden death following AMI is MOST often caused by: A. cardiogenic shock. B. severe bradycardia. C. ventricular fibrillation. D. congestive heart failure.

C

The EMT should use an AED on a child between 1 month and 8 years of age if: A. he or she is not breathing and has a weakly palpable pulse. B. his or her condition is rapidly progressing to cardiac arrest. C. pediatric pads and an energy-reducing device are available. D. special pads are used and the child has profound tachycardia.

C

The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to: A. wear a heavy, thick jacket or coat. B. avoid outer clothing with zippers. C. wear at least three layers of clothing. D. wear socks made of heavy-duty cotton.

C

The MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is: A. fracturing the septum. B. damaging the turbinates. C. penetrating the cranium. D. causing severe bleeding.

C

The chief complaint is MOST accurately defined as the: A. most life-threatening condition that you discover. B. condition that exacerbates an underlying problem. C. most serious thing the patient is concerned about. D. gross physical signs that you detect on assessment

C

The electrical impulse generated by the heart originates in the: A. bundle of His. B. coronary sinus. C. sinoatrial (SA) node. D. atrioventricular (AV) node.

C

The head and brain receive their supply of oxygenated blood from the: A. iliac arteries. B. brachial arteries. C. carotid arteries. D. subclavian arteries.

C

The jaw-thrust maneuver is used to open the airway of patients with suspected: A. mandibular fractures. B. upper airway swelling. C. cervical spine injuries. D. copious oral secretions.

C

The kidneys help to regulate blood pressure by: A. retaining key electrolytes, such as potassium. B. eliminating toxic waste products from the body. C. removing sodium, and thus water, from the body. D. accommodating a large amount of blood volume.

C

The left cerebral hemisphere controls: A. the right side of the face. B. heart rate and pupil reaction. C. the right side of the body. D. breathing and blood pressure.

C

The left ventricle has the thickest walls because it: A. pumps blood to the lungs to be reoxygenated. B. uses less oxygen than other chambers of the heart. C. pumps blood into the aorta and systemic circulation. D. receives blood directly from the systemic circulation.

C

The main legal risk in using the AED is: A. negligence on the part of the manufacturer. B. failure of the AED's internal computer chip. C. failing to deliver a shock when one is needed. D. not assessing for a pulse after a shock is delivered.

C

The manner in which the EMT must act or behave when caring for a patient is called the: A. EMT oath. B. code of ethics. C. standard of care. D. scope of practice.

C

The mental status of a patient who has experienced a typical seizure: A. progressively worsens over a period of a few hours. B. is easily differentiated from that of acute hypoglycemia. C. is likely to improve over a period of 5 to 30 minutes. D. typically does not improve, even after several minutes.

C

The parietal peritoneum lines the: A. retroperitoneal space. B. lungs and chest cavity. C. walls of the abdominal cavity. D. surface of the abdominal organs.

C

The primary prehospital treatment for most medical emergencies: A. typically does not require the EMT to contact medical control. B. focuses on definitive care because a diagnosis can usually be made. C. addresses the patient's symptoms more than the actual disease process. D. involves transport only until treatment can be performed at the hospital.

C

The primary waste product of aerobic metabolism is: A. lactic acid. B. pyruvic acid. C. carbon dioxide. D. adenosine triphosphate.

C

The secondary assessment of a medical patient: A. should routinely include a comprehensive examination from head to toe. B. should be performed at the scene, especially if the patient is critically ill. C. is not practical if the patient is critically ill or your transport time is short. D. is typically limited to a focused exam for patients who are unconscious.

C

The simplest yet most effective method of preventing the spread of an infectious disease is to: A. undergo an annual physical examination. B. ensure that your immunizations are up-to-date. C. wash your hands in between patient contacts. D. undergo human immunodeficiency virus (HIV) testing at least twice a year.

C

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. a physician arrives at the scene. B. the number of patients is known. C. all the patients have been triaged. D. area hospitals have been notified

C

Upon initial contact with a patient who appears to be unconscious, you should: A. assess breathing depth and determine the respiratory rate. B. squeeze the trapezius muscle to see if the patient responds. C. attempt to elicit a verbal response by talking to the patient. D. direct your partner to apply oxygen via nonrebreathing mask.

C

Vaccination against the hepatitis A virus is unnecessary if you: A. are older than 35 years of age. B. have a weak immune system. C. have been infected in the past. D. received a hepatitis B vaccination.

C

What type of medical direction do standing orders and protocols describe? A. radio B. online C. off-line D. direct

C

When a patient is dying, he or she may experience regression. This is MOST accurately defined as: A. anger projected toward the EMT or other providers. B. fear of being completely dependent upon other people. C. behavior consistent with an earlier developmental stage. D. a decreased ability to exercise age-appropriate judgment.

C

When afterload increases: A. the volume of venous blood that returns to the right atrium increases. B. the amount of resistance that the ventricle must beat against decreases. C. it becomes harder for the ventricle to push blood through the blood vessels. D. the blood pressure falls because of significant dilation of the blood vessels.

C

When assessing arm movement of a patient with a suspected stroke, you should: A. observe for approximately 5 minutes. B. expect to see one arm slowly drift down to the patient's side. C. ask the patient to close his or her eyes during the assessment. D. ask the patient to hold his or her arms up with the palms down.

C

When assessing the skin of an unconscious patient, you note that it has a bluish tint to it. This finding is called: A. pallor. B. flushing. C. cyanosis. D. mottling

C

When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of: A. assault. B. battery. C. negligence. D. abandonment.

C

When considering his or her personal life, it is important for the EMT to realize that: A. he or she should not discuss stressful issues with family members. B. shift work is the least stressful type of an EMS-related work schedule. C. family or friends may not understand the stress associated with EMS. D. it is more difficult to effectively relax at home than it is while on duty.

C

When performing a reassessment of your patient, you should first: A. obtain updated vital signs. B. reassess your interventions. C. repeat the primary assessment. D. confirm medical history findings.

C

When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than: A. 100 mm Hg. B. 200 mm Hg. C. 300 mm Hg. D. 400 mm Hg.

C

When treating a patient with chest pain, you should assume that he or she is having an AMI because: A. angina usually occurs after an AMI. B. most patients with chest pain are experiencing an AMI. C. the cause of the pain cannot be diagnosed in the field. D. angina and AMI present identically.

C

When would it be MOST appropriate for a patient to take his or her prescribed nitroglycerin? A. sharp chest pain that lasts longer than 10 to 15 minutes B. an acute onset of dizziness during a period of exertion C. chest pain that does not immediately subside with rest D. difficulty breathing that awakens the patient from sleep

C

Which of the following MOST accurately describes paradoxical movement of the chest wall? A. multiple rib fractures that cause a marked deformity of the chest wall B. a marked decrease in chest wall movement due to abdominal breathing C. only one section of the chest rises on inspiration while another area falls D. one side of the chest wall moves opposite the direction of the other

C

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? A. hyperventilation and hypersalivation B. a rapidly improving level of consciousness C. confusion and fatigue D. a gradually decreasing level of consciousness

C

Which of the following components are needed to prove negligence? A. abandonment, breach of duty, damages, and causation B. duty to act, abandonment, breach of duty, and causation C. duty to act, breach of duty, injury/damages, and causation D. breach of duty, injury/damages, abandonment, and causation

C

Which of the following conditions is NOT categorized as a psychiatric condition? A. depression B. schizophrenia C. substance abuse D. Alzheimer's disease

C

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital? A. seizures and infection B. cardiac arrest and shock C. stroke and heart attack D. diabetes and migraines

C

Which of the following conditions would MOST likely cause the pupils to remain significantly constricted? A. severe cerebral hypoxia B. intracranial hemorrhaging C. overdose of an opiate drug D. oculomotor nerve pressure

C

Which of the following conditions would be LEAST likely to cause an altered level of consciousness? A. drug overdose B. inadequate perfusion C. acute anxiety D. poisoning

C

Which of the following infectious diseases confers no protection from reinfection after exposure? A. mumps B. rubella C. syphilis D. chickenpox

C

Which of the following is NOT a possible cause of airway obstruction? A. relaxation of the tongue B. aspirated vomitus C. shallow breathing D. foreign objects

C

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? A. speech B. arm drift C. memory D. facial droop

C

Which of the following is NOT considered to be protected health information (PHI)? A. patient history B. treatment rendered C. location of the call D. assessment findings

C

Which of the following is not a BLS intervention? A. abdominal thrusts B. chest compressions C. cardiac monitoring D. automated defibrillation

C

Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A. evaluating the patient's chest for cyanosis B. applying a pulse oximeter and monitoring the SpO2 C. auscultating breath sounds with a stethoscope D. looking for the presence of accessory muscle use

C

Which of the following is the MOST reliable method of estimating a patient's cardiac output? A. Listen to heart sounds with a stethoscope. B. Connect the patient to an electrocardiogram. C. Assess the heart rate and strength of the pulse. D. Determine the average diastolic blood pressure.

C

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies? A. liver B. kidney C. spleen D. pancreas

C

Which of the following organs lies in the retroperitoneal space? A. liver B. spleen C. pancreas D. gallbladder

C

Which of the following patients should you place in the recovery position? A. a 19-year-old conscious male with a closed head injury and normal respirations B. a 24-year-old unconscious female who overdosed and has a reduced tidal volume C. a 31-year-old semiconscious male with low blood sugar and adequate breathing D. a 40-year-old conscious female with a possible neck injury and regular respirations

C

Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? A. "Have you ever had any major surgeries?" B. "How long have you had your chest pain?" C. "How much Tylenol do you take each day?" D. "When was the last time you ate a meal?"

C

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray? A. Encourage the patient to chew the tablet to increase its effectiveness. B. Place the medication under the tongue and have the patient swallow it. C. Administer the medication sublingually and allow it to dissolve or absorb. D. Wait 15 minutes and reassess the blood pressure prior to administering another dose.

C

Which of the following situations requires you to notify the appropriate authorities? A. cardiac arrest B. drug overdose C. attempted suicide D. accidental knife wound

C

Which of the following statements regarding breathing adequacy is correct? A. Patients with a grossly irregular breathing pattern usually do not require assisted ventilation. B. The single most reliable sign of breathing adequacy in the adult is his or her respiratory rate. C. Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate. D. A patient with slow respirations and adequate depth will experience an increase in minute volume.

C

Which of the following statements regarding oxygen is correct? A. Oxygen cylinders must always remain in an upright position. B. Oxygen is flammable and may explode if under high pressure. C. Oxygen supports the combustion process and may cause a fire. D. Oxygen is most safely administered in an enclosed environment.

C

Which of the following statements regarding oxygenation and ventilation is correct? A. In carbon monoxide (CO) poisoning, ventilation is impaired because CO binds to oxygen very quickly. B. Oxygenation is the movement of air into and out of the lungs, whereas ventilation is the exchange of gases. C. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation. D. Oxygenation without adequate ventilation can occur in climbers who quickly ascend to an altitude of lower atmospheric pressure.

C

Which of the following statements regarding stridor is MOST correct? A. It is a whistling sound heard in the lower airway. B. It is caused by incorrect airway positioning. C. It is a high-pitched, crowing upper airway sound. D. It suggests the presence of fluid in the lungs

C

Which of the following statements regarding the Americans With Disabilities Act (ADA) of 1990 is correct? A. The ADA only applies to individuals with a diagnosed and well-documented physical disability. B. The requirements to successfully complete an EMT program are different for those who are disabled. C. The ADA prohibits employers from failing to provide full and equal employment to the disabled. D. According to the ADA, EMT candidates with a documented disability are exempt from taking the NREMT exam.

C

Which of the following statements regarding the H1N1 virus is correct? A. H1N1 has caused more deaths worldwide than all of the other strains of influenza combined. B. Unlike other strains of the influenza virus, H1N1 is primarily transmitted via the fecal-oral route. C. It is only one type of influenza among the many other strains of influenza that exist and infect humans. D. H1N1, also known as the "swine flu," is a newly discovered strain of influenza for which no vaccine exists.

C

Which of the following statements regarding the acute abdomen is correct? A. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. C. The initial pain associated with an acute abdomen tends to be vague and poorly localized. D. An acute abdomen almost always occurs as the result of blunt trauma to solid

C

Which of the following statements regarding the different stages of the grieving process is correct? A. The grieving process typically begins with severe depression. B. It is rare that people will jump back and forth between stages. C. The stages of the grieving process may occur simultaneously. D. Bargaining is the most unpleasant stage of the grieving process.

C

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct? A. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting. B. The risk of HIV infection is high, even if an infected person's blood comes in contact with your intact skin. C. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream. D. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.

C

Which of the following statements regarding the one-person bag-mask device technique is correct? A. Bag-mask ventilations should be delivered every 2 seconds when the device is being operated by one person. B. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag-mask device. C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device. D. The bag-mask device delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.

C

Which of the following statements regarding the secondary assessment is correct? A. If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment. B. The purpose of the secondary assessment is to systematically examine every patient from head to toe, regardless of the severity of his or her injury. C. You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment. D. A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems.

C

Which of the following statements regarding the use of the AED in children is correct? A. AEDs should never be used on children younger than 8 years or less than 55 pounds. B. AEDs are only effective in pediatric patients if severe trauma is the cause of their cardiac arrest. C. AED use in children up to 8 years of age involves pediatric pads and an energy reducer. D. AEDs are not used in pediatric patients because they do not experience ventricular fibrillation.

C

Which of the following structures is NOT found in the upper airway? A. larynx B. pharynx C. bronchus D. oropharynx

C

Which of the following veins is located inferior to the trunk? A. cephalic B. axillary C. saphenous D. subclavian

C

Which of the following would the EMT most likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A. focused secondary assessment B. assessment of oxygen saturation C. systemic head-to-toe examination D. noninvasive blood pressure monitoring

C

While evaluating a patient with chest pain, your partner tells you that the patient's blood pressure is 140/94 mm Hg. The lower number represents the pressure from the: A. atria relaxing. B. atria contracting. C. ventricles relaxing. D. ventricles contracting.

C

Why are prehospital emergency care guidelines updated on a regular basis? A. Statistical data indicate that an increasing number of people are being diagnosed with a particular illness. B. EMS providers should be encouraged to actively participate in research and become familiar with data analysis. C. Additional information and evidence indicate that the effectiveness of certain interventions has changed. D. The federal government requires that changes be made to existing emergency care protocols at least every 5 years.

C

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. A. 70 B. 80 C. 90 D. 100

C

You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should: A. reassure him that he will not receive a bill for the EMS call if he cannot pay. B. tell him that he is having a heart attack and that he needs to go to the hospital. C. explain the seriousness of the situation to him, but avoid causing undue alarm. D. proceed to treat him because the stress of the situation has impaired his thinking.

C

You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should: A. tell her that he is being resuscitated by other EMTs. B. immediately tell her of his death so that she may grieve. C. let clergy or hospital staff relay the bad news if possible. D. avoid answering her questions and focus on her injuries.

C

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two bystanders performing CPR on the patient, a 58-year-old male. Your initial action should be to: A. assess the effectiveness of the bystanders' CPR. B. quickly attach the AED and push the analyze button. C. have the bystanders stop CPR and assess the patient. D. request a paramedic unit and quickly attach the AED.

C

You are dispatched to the county jail for an inmate who is "sick." When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to: A. apply a pulse oximeter. B. request a paramedic unit. C. provide assisted ventilation. D. assess his blood pressure

C

You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should: A. ask a police officer to transport the patient to the hospital. B. allow him to refuse treatment since the injury was not his fault. C. proceed with treatment and utilize law enforcement if necessary. D. have the police arrest him so that you can legally begin treatment.

C

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: A. administer one tube of oral glucose and prepare for immediate transport. B. place her in the recovery position and transport her with lights and siren. C. monitor her airway and breathing status and assess her blood glucose level. D. give her small cups of water to drink and observe for further seizure activity.

C

You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a definitive sign of death? A. absence of a pulse B. profound cyanosis C. dependent lividity D. absent breath sounds

C

You have inserted an oral airway and are ventilating an apneic woman with a bag- mask device. She suddenly begins regurgitating large amounts of vomit. You should: A. perform a finger sweep of her mouth. B. insert a nasal airway and then suction her mouth. C. roll her onto her side and remove the oral airway. D. remove the oral airway and suction her oropharynx.

C

You should suspect that a patient is experiencing respiratory failure if he or she: A. is restless and is working hard to breathe. B. has an increased heart rate and retractions. C. has bradycardia and diminished muscle tone. D. is anxious, tachycardic, and leaning forward.

C

You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. What type of consent is her agreement considered? A. implied B. informed C. expressed D. minor's

C

Your partner, a veteran EMT who you have worked with regularly for the past 4 years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do? A. Remain quiet and simply request another partner. B. Report the incident to your EMS medical director. C. Discreetly report your suspicions to your supervisor. D. Tell your partner that he must seek professional help.

C

Which of the following is MOST characteristic of adequate breathing? A. 22 breaths/min with an irregular pattern of breathing and cyanosis B. 20 breaths/min with shallow movement of the chest wall and pallor C. 24 breaths/min with bilaterally equal breath sounds and pink skin D. 30 breaths/min with supraclavicular retractions and clammy skin

C. 24 breaths/min with bilaterally equal breath sounds and pink skin

Which of the following statements regarding shoulder dislocations is MOST correct? A. Posterior dislocations are most common. B. They are caused by forced arm adduction. C. Most shoulder dislocations occur anteriorly. D. They involve the acromion process and humerus.

C. Most shoulder dislocations occur anteriorly.

Albuterol is a generic name for: A. Alupent. B. Atrovent. C. Proventil. D. Singulair.

C. Proventil.

Which of the following statements regarding pulse oximetry is correct? A. The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. B. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common. C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood. D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80%.

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

A subluxation occurs when: A. ligaments are partially severed. B. a fracture and a dislocation exist. C. a joint is incompletely dislocated. D. a bone develops a hairline fracture.

C. a joint is incompletely dislocated

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of: A. air bag deployment. B. failure to wear seatbelts. C. a poorly placed lap belt. D. rapid vehicle deceleration.

C. a poorly placed lap belt.

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with: A. acute pulmonary edema. B. right-sided heart failure. C. acute pulmonary embolism. D. spontaneous pneumothorax.

C. acute pulmonary embolism.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. The MOST appropriate method of splinting this injury involves: A. applying a traction splint to realign the deformity. B. applying and fully inflating the pneumatic antishock garment (PASG). C. applying padded board splints to both sides of the leg. D. binding the legs together and elevating them 6″ to 8″.

C. applying padded board splints to both sides of the leg.

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. area of obvious deformity over the site of impact. B. exact part of the bone or joint that was disrupted. C. area of soft-tissue damage surrounding the injury. D. part of the body that sustained secondary injury.

C. area of soft-tissue damage surrounding the injury.

While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent? A. acute asthma attack B.widespread atelectasis C. aspiration pneumonia D. early pulmonary edema

C. aspiration pneumonia

You have applied a zippered air splint to a patient's left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to: A. elevate the injured arm and reassess distal sensory function. B. inflate the splint with more air until the patient is comfortable. C. assess the amount of air in the splint and let air out as necessary. D. remove the air splint and reimmobilize with padded board splints.

C. assess the amount of air in the splint and let air out as necessary.

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should: A. transport only if signs of shock begin to develop. B. carefully probe the wound to determine its depth. C. assume that the arrow injured an internal organ. D. clean the wound and apply a dry, sterile dressing.

C. assume that the arrow injured an internal organ.

Which of the following MOST accurately describes septic shock? A. bacterial infection of the nervous system with widespread vasodilation B. widespread vasoconstriction and plasma loss due to a severe viral infection C. bacterial damage to the vessel wall, leaking blood vessels, and vasodilation D. viral infection of the blood vessels, vascular damage, and vasoconstriction

C. bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Which of the following structures is regulated by smooth muscle? A. heart B. skeleton C. blood vessels D. diaphragm

C. blood vessels

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for: A. external genitalia injury. B. a lacerated liver or spleen. C. blunt injury to the kidney. D. a ruptured urinary bladder.

C. blunt injury to the kidney.

Pulmonary edema and impaired ventilation occur during: A. septic shock. B. neurogenic shock. C. cardiogenic shock. D. anaphylactic shock.

C. cardiogenic shock.

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. A. greenstick B. diaphyseal C. epiphyseal D. metaphyseal

C. epiphyseal

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: A. assessing motor function. B. assessing sensory function. C. evaluating proximal pulses. D. determining capillary refill.

C. evaluating proximal pulses.

Traction splints are used primarily to immobilize and secure fractures of the: A. hip. B. pelvis. C. femur. D. humerus.

C. femur.

A pleural effusion is MOST accurately defined as: A. a unilaterally collapsed lung. B. diffuse collapsing of the alveoli. C. fluid accumulation outside the lung. D. a bacterial infection of the lung tissue.

C. fluid accumulation outside the lung.

A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to: A. form a general impression. B. call for an ALS ambulance. C. follow standard precautions. D. ask bystanders what happened.

C. follow standard precautions.

Contraction or tensing of the abdominal muscles in an effort to ease pain is called: A. flexing. B. referring. C. guarding. D. withdrawing.

C. guarding.

Air bags, in conjunction with properly worn seatbelts, are MOST beneficial when a person is involved in a: A. rollover crash. B. lateral collision. C. head-on crash. D. rear-end collision.

C. head-on crash.

In which of the following situations should the EMT splint an injured limb in the position of deformity? A. when distal circulation and neurological functions are absent B. if transport time to the hospital is greater than 20 to 30 minutes C. if resistance is encountered or the patient experiences severe pain D. if a traction splint will be used to immobilize the injured extremity

C. if resistance is encountered or the patient experiences severe pain

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should: A. perform a rapid secondary assessment. B. straighten his arm and apply a board splint. C. immobilize the injury with a sling and swathe. D. place a pillow under his arm and apply a sling.

C. immobilize the injury with a sling and swathe.

In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. C. increased carbon dioxide levels. D. decreased carbon dioxide levels.

C. increased carbon dioxide levels.

Cardiogenic shock may result from all of the following, EXCEPT: A. heart attack. B. increased afterload. C. increased preload. D. poor contractility.

C. increased preload.

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of: A. a ruptured spleen. B. a severe liver laceration. C. intra-abdominal bleeding. D. rupture of a hollow organ.

C. intra-abdominal bleeding.

Hypotension in a child with blunt or penetrating trauma is particularly significant because: A. it typically develops earlier in children than it does in adults. B. the most likely cause of the hypotension is respiratory failure. C. it often indicates the loss of half of his or her blood volume. D. most children with hypotension die in the prehospital setting.

C. it often indicates the loss of half of his or her blood volume.

Atrophy is a condition that occurs when: A. increased use of skeletal muscle causes an increase in its strength. B. the tendons that attach muscle to bone become stretched or injured. C. muscle decreases in size and function because of disease or trauma. D. carbon dioxide, lactic acid, and other wastes accumulate in the muscle.

C. muscle decreases in size and function because of disease or trauma.

Which of the following fractures has the greatest potential for internal blood loss and shock? A. hip B. femur C. pelvis D. humerus

C. pelvis

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: A. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. B. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg. C. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. D. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher.

C. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

Crepitus and false motion are: A. indicators of a severe sprain. B. only seen with open fractures. C. positive indicators of a fracture. D. most common with dislocations.

C. positive indicators of a fracture.

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: A. vasovagal shock. B. neurogenic shock. C. psychogenic shock. D. neurologic shock.

C. psychogenic shock.

You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: A. take his vital signs in 15 minutes. B. arrange for an ALS rendezvous. C. reassess his condition in 5 minutes. D. repeat your secondary assessment.

C. reassess his condition in 5 minutes.

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should: A. transport him immediately and provide supportive care while en route. B. consider that he may actually be experiencing an acute asthma attack. C. repeat the epinephrine injection after consulting with medical control. D. request a paramedic unit that is stationed approximately 15 miles away.

C. repeat the epinephrine injection after consulting with medical control.

15. The presence of tachycardia following a significant abdominal injury: A. is always accompanied by hypotension. B. indicates a state of decompensated shock. C. should be assumed to be a sign of shock. D. is most commonly caused by severe pain.

C. should be assumed to be a sign of shock.

During your rapid secondary assessment of a 30-year-old male who fell 25′, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should: A. defer spinal immobilization and transport to a trauma center. B. perform a focused physical exam with emphasis on the pelvis. C. stabilize the pelvis with a pelvic binder and protect the spine. D. log roll the patient onto a long backboard and transport at once.

C. stabilize the pelvis with a pelvic binder and protect the spine.

Acute pulmonary edema would MOST likely develop as the result of: A.right-sided heart failure. B. severe hyperventilation. C. toxic chemical inhalation. D. an upper airway infection.

C. toxic chemical inhalation.

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture? A. pancreas B. fallopian tubes C. urinary bladder D. liver or spleen

C. urinary bladder

Which of the following clinical signs is unique to anaphylactic shock? A. pallor B. dizziness C. wheezing D. hypotension

C. wheezing

Which of the following is not an indication to stop CPR once you have started

Care is transferred to a bystander

The _________ contain(s) about 75% of the brain's total volume. A. cerebrum B. cerebellum C. brain stem D. meninges

Cerebrum

Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is in an advanced stage of pregnancy or who is very obese

Chest thrusts

You should deliver chest compressions to an unconscious adult patient in cardiac arrest by

Compressing the sternum between the nipples

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another? A. somatic B. connecting C. peripheral D. autonomic

Connecting

14. Which of the following statements regarding toddlers and preschoolers is correct? A. The normal respiratory rate in toddlers and preschoolers is between 12 and 20 breaths/min. B. Toddlers and preschoolers have well-developed lung musculature, even though they have less lung tissue. C. Muscle mass and bone density decrease in toddlers and preschoolers because of increased physical activity. D. Toddlers and preschoolers commonly experience upper respiratory infections because of a loss of passive immunity.

D

15. How is nitroglycerin usually given by the EMT? A. orally B. inhaled C. injected D. sublingually

D

16. Which of the following medication routes delivers a drug through the skin over an extended period of time, such as a nitroglycerin or nicotine patch? A. sublingual B. intraosseous C. subcutaneous D. transcutaneous

D

19. Medications encased in a gelatin shell taken by mouth are called: A. pills. B. tablets. C. caplets. D. capsules.

D

2. An infant's blood pressure typically increases with age because: A. the infant's total blood volume decreases with age. B. his or her normal heart rate usually increases with age. C. as the infant gets older, his or her blood vessels dilate. D. blood pressure directly corresponds to body weight.

D

21. The low normal systolic blood pressure for a 30-year-old is: A. 60 mm Hg. B. 70 mm Hg. C. 80 mm Hg. D. 90 mm Hg.

D

26. At present, the average life expectancy is ________ years, while the maximum life expectancy is estimated at ________ years. A. 68, 100 B. 70, 102 C. 72, 110 D. 78, 120

D

28. The decline in cardiac function that commonly occurs in late adulthood is MOST often related to: A. hypotension. B. medication use. C. kidney failure. D. atherosclerosis.

D

29. A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should: A. give her high-flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport. B. assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions. C. transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin. D. recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs.

D

30. A 49-year-old male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (Vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering 100% oxygen, you should: A. obtain physician approval to give the nitroglycerin. B. place him in a supine position and transport at once. C. administer one nitroglycerin and call medical control. D. ask him if he took his Viagra within the past 24 hours.

D

32. You arrive at a residence approximately 20 minutes after a 7-year-old boy, who weighs 22 kg, ingested a bottle of Advil. He is conscious and alert and has stable vital signs. Medical control orders you to administer activated charcoal and oxygen and then transport the child at once. The appropriate maximum dose of activated charcoal for this child is: A. 11 g. B. 22 g. C. 36 g. D. 44 g.

D

33. Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, EXCEPT: A. a loss of respiratory muscle mass. B. increased stiffness of the thoracic cage. C. decreased residual volume. D. increased surface area available for air exchange.

D

36. Aspirin is beneficial to patients suspected of having a heart attack because it: A. reduces the associated chest pain. B. dissolves the coronary artery clot. C. causes direct coronary vasodilation. D. prevents the aggregation of platelets.

D

38. The risk of bleeding in the skull, which increases with age, is MOST directly related to: A. blood vessel dilation. B. a decrease in neurons. C. meningeal deterioration. D. shrinkage of the brain.

D

40. According to the terminal drop hypothesis: A. a person's physical health begins to decline after the age of 75 years. B. most late-stage adults retain high brain function until 1 month before death. C. most elderly patients experience depression after the death of a loved one. D. mental function is presumed to decline in the 5 years preceding death.

D

41. Which of the following is NOT a characteristic of epinephrine? A. secreted naturally by the adrenal glands B. dilates passages in the lungs C. constricts blood vessels D. decreases heart rate and blood pressure

D

43. With the flowmeter set at 6 L/min, the nasal cannula will deliver up to _______ oxygen. A. 14% B. 24% C. 34% D. 44%

D

7. Which of the following is an example of a drug's generic name? A. Bayer B. Advil C. Excedrin D. aspirin

D

8. The anterior fontanelle fuses together between the ages of: A. 3 and 4 months. B. 6 and 8 months. C. 7 and 14 months. D. 9 and 18 months.

D

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include: A. assisting him with his migraine medication and transporting without lights and siren. B. placing him in a supine position and transporting with lights and siren to a stroke center. C. applying warm compresses to the back of his neck and transporting with lights and siren. D. dimming the lights in the back of the ambulance and transporting without lights and siren

D

A 37-year-old male has an apparent foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes: A. a series of back blows and chest thrusts. B. finger sweeps to remove the obstruction. C. performing a series of abdominal thrusts. D. encouraging him to cough and transporting.

D

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to 324 mg of baby aspirin. B. administer up to three doses of nitroglycerin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations.

D

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: A. list all of the patient's current medications. B. obtain a complete set of baseline vital signs. C. administer glucose to rule out hypoglycemia. D. ask his wife when she noticed the symptoms.

D

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 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: A. nitroglycerin for her chest pain. B. ventilations with a bag-mask device. C. oxygen at 4 L/min via nasal cannula. D. placing her in an upright position.

D

A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following would NOT be appropriate for this patient? A. performing a full-body scan B. 100% supplemental oxygen C. treating her for possible shock D. gentle palpation of the pelvis

D

A crackling sound produced by air bubbles under the skin is called: A. crepitus B. rhonchi. C. Korotkoff sounds. D. subcutaneous emphysema.

D

A critical incident stress debriefing should be conducted no longer than ________ hours following the incident. A. 6 B. 12 C. 24 D. 72

D

A full-body scan should be performed on: A. stable patients who are able to tell you exactly what happened. B. all patients with traumatic injuries who will require EMS transport. C. responsive medical patients and patients without a significant MOI. D. patients with a significant MOI and unresponsive medical patients

D

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should: A. document the patient's request but continue to transport him. B. have the patient sign a refusal form and return him to his office. C. request that the police place the patient under protective custody. D. assess whether or not the patient's mental condition is impaired.

D

A patient who does not respond to your questions but moves or cries out when his or her trapezius muscle is pinched, is said to be: A. conscious and alert. B. completely unresponsive. C. responsive to verbal stimuli. D. responsive to painful stimuli

D

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: A. has had a prior heart attack. B. is older than 60 years of age. C. has a GCS score that is less than 8. D. has bleeding within the brain.

D

A patient with an altered mental status is: A. completely unresponsive to all forms of stimuli. B. typically alert but is confused as to preceding events. C. usually able to be aroused with a painful stimulus. D. not thinking clearly or is incapable of being aroused.

D

A patient with spontaneous respirations is breathing: A. at a normal rate. B. with shallow depth. C. without difficulty. D. without assistance

D

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: A. scraping fatty deposits off of the lumen of the coronary artery. B. bypassing the coronary artery with a vessel from the chest or leg. C. placing a stent inside the coronary artery to keep it from narrowing. D. dilating the affected coronary artery with a small inflatable balloon.

D

According to the CDC, recommended immunizations and tests include a: A. smallpox vaccine every 5 years. B. TB skin test every 6 months. C. two-shot hepatitis A vaccination series. D. tetanus-diphtheria booster every 10 years.

D

After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: A. place him or her in the recovery position. B. provide positive-pressure ventilatory assistance. C. assess respiratory rate, depth, and regularity. D. suction as needed and insert an airway adjunct

D

After the first 60 minutes of experiencing a significant injury: A. the patient's blood pressure elevates significantly. B. the patient's injuries will most likely be irreparable. C. most patients will die secondary to internal bleeding. D. the body's ability to compensate for shock decreases

D

After_______ Minutes without oxygen, brain damage is likely. A. 2 B. 4 C. 5 D. 6

D

All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT: A. delivering each breath over 1 second. B. ensuring the appropriate airway position. C. ventilating the patient at the appropriate rate. D. increasing the amount of delivered tidal volume.

D

An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: A. obtaining baseline vital signs. B. gathering medical history data. C. providing immediate transport. D. airway, breathing, and circulation

D

An infectious disease is MOST accurately defined as: A. any disease that enters the body via the bloodstream and renders the immune system nonfunctional. B. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs. C. a disease that can be spread from one person or species to another through a number of mechanisms. D. a medical condition caused by the growth and spread of small harmful organisms within the body.

D

As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the: A. mouth-to-mouth technique. B. one-person bag-mask device. C. manually triggered ventilation device. D. mouth-to-mask technique with a one-way valve.

D

At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should: A. proceed with normal extrication procedures. B. remove the lines with a nonconductive object. C. advise the patients to carefully get out of the car. D. mark off a danger zone around the downed lines.

D

Basic life support (BLS) is defined as: A. invasive emergency medical interventions such as intravenous therapy, manual defibrillation, and advanced airway management. B. any form of emergency medical treatment that is performed by advanced EMTs, paramedics, physicians, and emergency nurses. C. basic lifesaving treatment that is performed by bystanders while EMS providers are en route to the scene of an emergency. D. noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.

D

Cardiac output may decrease if the heart beats too rapidly because: A. a rapid heart beat causes a decrease in the strength of cardiac contractions. B. the volume of blood that returns to the heart is not sufficient with fast heart rates. C. as the heart rate increases, more blood is pumped from the ventricles than the atria. D. there is not enough time in between contractions for the heart to refill completely.

D

Common signs and symptoms of AMI include all of the following, EXCEPT: A. irregular heartbeat. B. sudden unexplained sweating. C. shortness of breath or dyspnea. D. pain exacerbated by breathing.

D

Common signs and symptoms of a hypertensive emergency include: A. pallor, cool skin, and a temporary loss of hearing. B. syncope, a weak pulse, and bleeding from the ears. C. tachycardia, pain behind the eyes, and weakness. D. a bounding pulse, a severe headache, and dizziness.

D

Cyanosis of the skin is caused by: A. increased blood oxygen. B. peripheral vasodilation. C. venous vasoconstriction. D. decreased blood oxygen

D

Defibrillator pads are placed on the patient's chest with one pad to the: A. left of the upper sternum and the other pad just to the right of the left nipple. B. right of the upper sternum and the other pad just to the right of the right nipple. C. left of the upper sternum and the other pad just to the right and below the left nipple. D. right of the upper sternum and the other pad just to the left and below the left nipple.

D

Determination of exposure is an important component of an infection control plan because it: A. determines the time of day that most exposures are likely to occur. B. determines which type of communicable disease might be present in the workplace. C. defines who is most likely to transmit communicable diseases in the workplace. D. defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure.

D

During an EMS call, you should take standard precautions: A. any time before you load the patient into the ambulance. B. after it has been determined that the patient is bleeding. C. immediately after completion of your primary assessment. D. upon exiting the ambulance, but before actual patient contact

D

During the primary assessment of a semiconscious 70-year-old female, you should: A. insert a nasopharyngeal airway and assist ventilations. B. immediately determine the patient's blood glucose level. C. ask family members if the patient has a history of stroke. D. ensure a patent airway and support ventilation as needed.

D

EMT training in nearly every state meets or exceeds the guidelines recommended by the: A. National Registry of EMTs. B. individual state's EMS protocols. C. National Association of EMTs. D. National Highway Traffic Safety Administration (NHTSA).

D

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT: A. loss of appetite and a cough. B. vomiting, fever, and fatigue. C. pain in the muscles and joints. D. jaundice and abdominal pain.

D

End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with: A. a headache. B. abdominal pain. C. high blood pressure. D. respiratory distress.

D

Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include: A. prior exposure to Mycobacterium tuberculosis. B. failure to be vaccinated against any strain of hepatitis. C. a history of a respiratory illness within the past 6 to 8 weeks. D. prolonged hospitalization, especially in an intensive care unit.

D

Gloves, a mask, eye protection, and a face shield should be used: A. any time you touch non-intact skin. B. during routine cleaning of the ambulance. C. while handling needles or other sharps. D. when performing endotracheal intubation.

D

How does positive-pressure ventilation affect cardiac output? A. There is no effect on cardiac output because positive-pressure ventilation is the act of normal breathing. B. It decreases intrathoracic pressure, which facilitates venous return to the heart and increases cardiac output. C. It causes pressure in the chest to decrease, which increases stroke volume and cardiac output. D. It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output.

D

Hypoxia is MOST accurately defined as: A. low venous oxygen levels. B. a decrease in arterial oxygen levels. C. an increase in carbon dioxide in the blood. D. inadequate oxygen to the tissues and cells.

D

If an EMT candidate has been convicted of a felony or misdemeanor, he or she should: A. wait at least 24 months before taking another state-approved EMT class. B. send an official request to the National Registry of EMT (NREMT) to seek approval to take the EMT exam. C. recognize that any such conviction will disqualify him or her from EMT licensure. D. contact the state EMS office and provide them with the required documentation.

D

If ventilation is impaired, carbon dioxide levels in the bloodstream will increase. This condition is called: A. acidosis. B. hypoxia. C. hypoxemia. D. hypercarbia.

D

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: A. palpating the carotid pulse to determine the approximate rate and checking capillary refill time. B. taking a blood pressure and determining if the patient is alert and oriented or confused. C. applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. D. checking the radial pulse and noting the color, temperature, and condition of his or her skin.

D

In contrast to the parietal peritoneum, the visceral peritoneum: A. is supplied by the same nerves from the spinal cord that supply the skin of the abdomen. B. lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract. C. is less likely to become inflamed or infected because it lines the abdominal organs themselves. D. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

D

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: A. possesses a valid driver's license. B. is mentally competent and able to refuse. C. has a poor relationship with his or her parents. D. is self-supporting and lives by him- or herself.

D

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. back of the neck. B. forehead and face. C. dorsum of the hand. D. lips or oral mucosa

D

In which of the following circumstances can the EMT legally release confidential patient information? A. a police officer requests a copy to place on file B. the family requests a copy for insurance purposes C. a media representative inquires about the patient D. the patient is competent and signs a release form

D

In which of the following situations is a pertinent negative identified? A. A 50-year-old woman states that nothing makes her chest pain better or worse. B. A 53-year-old man with dizziness also tells you that he has vomited three times. C. A 56-year-old woman states that her chest hurts every time she takes a deep breath. D. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

D

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service? A. 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs B. 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes away C. 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days' duration D. 61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes

D

Injury to a hollow abdominal organ would MOST likely result in: A. pain secondary to blood in the peritoneum. B. profound shock due to severe internal bleeding. C. impairment in the blood's clotting abilities. D. leakage of contents into the abdominal cavity.

D

Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called: A. ataxic respirations. B. agonal respirations. C. eupneic respirations. D. Cheyne-Stokes respirations.

D

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem. A. cardiac B. endocrine C. respiratory D. neurologic

D

Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A. in a supine position. B. in a prone position. C. in a recumbent position. D. sitting up at a 45° angle.

D

Maintaining the chain of evidence at the scene of a crime should include: A. quickly moving any weapons out of the patient's sight. B. placing the patient in a private area until the police arrive. C. making brief notes at the scene and then completing them later. D. not cutting through holes in clothing that were caused by weapons.

D

Narrowing of the coronary arteries due to a buildup of fatty deposits is called: A. angina pectoris. B. arteriosclerosis. C. acute ischemia. D. atherosclerosis.

D

Normal respiratory rates should not exceed _______ breaths per minute in children and _______ breaths per minute in infants. A. 18, 28 B. 20, 30 C. 24, 45 D. 30, 50

D

Palpating the carotid pulse is not recommended in infants because: A. the pulse rate is usually too fast to count. B. a decrease in cerebral perfusion may occur. C. the carotid artery is more anterior in infants. D. you may inadvertently compress the trachea

D

Patients who become dependent upon EMS personnel or other health care providers often feel: A. relieved. B. superior. C. hopeful. D. shamed.

D

Prior to defibrillating a patient with an AED, it is MOST important that you: A. properly position the defibrillation pads. B. perform up to 5 minutes of effective CPR. C. confirm that the patient is in cardiac arrest. D. ensure that no one is touching the patient.

D

Status epilepticus is characterized by: A. generalized seizures that last less than 5 minutes. B. an absence seizure that is not preceded by an aura. C. profound tachycardia and total muscle flaccidity. D. prolonged seizures without a return of consciousness.

D

Successful treatment of a stroke depends on whether: A. surgical intervention is performed to remove obstructive clots. B. medications are given to restore the function of infarcted cells. C. the stroke occurs within the left or right hemisphere of the brain. D. thrombolytic therapy is given within 3 hours after symptoms began.

D

Supplemental oxygen via nonrebreathing mask should be administered to patients: A. who are semiconscious with shallow respirations. B. with rapid respirations and a reduced tidal volume. C. who have accessory muscle use and slow breathing. D. with difficulty breathing and adequate tidal volume

D

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that: A. you are actively infected with tuberculosis and should be treated immediately. B. the disease is dormant in your body, but will probably never cause symptoms. C. you contracted the disease by casual contact instead of exposure to secretions. D. you were exposed to another infected person prior to treating the 34-year-old patient.

D

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you reanalyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to: A. obtain a blood pressure and apply the pulse oximeter. B. place him in the recovery position and apply oxygen. C. transport at once and reanalyze his rhythm en route. D. reassess airway and breathing and treat accordingly.

D

The BEST way to reduce your risk of contracting a work-related disease following exposure is to: A. vigorously wash the affected area with an antimicrobial solution. B. be evaluated by a physician within 72 hours following the exposure. C. get vaccinated against the disease you think you were exposed to. D. activate your department's infection control plan as soon as possible.

D

The MOST important consideration at the scene of a hazardous material incident is: A. identifying the material. B. calling the hazardous materials team. C. evacuating the bystanders. D. ensuring your personal safety.

D

The MOST serious consequence of drug or alcohol abuse among EMS personnel is: A. punitive action and the loss of a job. B. low morale and frequently missed shifts. C. tension among coworkers and supervisors. D. substandard or inappropriate patient care.

D

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: A. excitability. B. contractility. C. impulsivity. D. automaticity.

D

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: A. parietal lobe. B. pons and medulla. C. somatic nervous system. D. autonomic nervous system.

D

The final stage of death and dying is MOST commonly displayed as: A. anger. B. denial. C. depression. D. acceptance.

D

The goal of the full-body scan that is performed during the secondary assessment is to: A. detect and treat all non-life-threatening injuries. B. assess only the parts of the body that are injured. C. definitively rule out significant internal injuries. D. locate injuries not found in the primary assessment.

D

The goal of the primary assessment is to: A. determine if the patient's problem is medical or trauma. B. identify patients that require transport to a trauma center. C. determine the need to perform a head-to-toe assessment. D. identify and rapidly treat all life-threatening conditions

D

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. A. coronary sinus, vena cava B. aorta, inferior vena cava C. vena cava, coronary veins D. coronary arteries, aorta

D

The nasopharyngeal airway is MOST beneficial because it: A. can effectively stabilize fractured nasal bones if it is inserted properly. B. is generally well tolerated in conscious patients with an intact gag reflex. C. effectively maintains the airway of a patient in cardiopulmonary arrest. D. can maintain a patent airway in a semiconscious patient with a gag reflex.

D

The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg. A. 70, 28 B. 88, 30 C. 90, 50 D. 104, 40

D

The posterior tibial pulse can be palpated: A. on the dorsum of the foot. B. above the lateral malleolus. C. in the fossa behind the knee. D. behind the medial malleolus.

D

The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi). A. 500 B. 1,000 C. 1,500 D. 2,000

D

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: A. always take oral medications to maintain normal blood glucose levels. B. do not present with slurred speech or weakness to one side of the body. C. are typically alert and attempt to communicate with health care providers. D. usually have an altered mental status or decreased level of consciousness.

D

The three major parts of the brain are the: A. cerebellum, medulla, and occiput. B. brain stem, midbrain, and spinal cord. C. midbrain, cerebellum, and spinal cord. D. cerebrum, cerebellum, and brain stem.

D

Upon arriving at a potentially unsafe scene, you should: A. remove all bystanders. B. request another ambulance. C. move the patient to safety. D. ensure that you are safe

D

Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should: A. quickly begin the triage process. B. assist with vehicle stabilization. C. report to the incident commander. D. put on high-visibility safety vests.

D

Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in obvious distress. Your first action should be to: A. ask the patient what's wrong. B. obtain a set of baseline vital signs. C. assess the patient's airway status. D. introduce yourself to the patient

D

Ventricular tachycardia causes hypotension because: A. the volume of blood returning to the atria increases. B. the right ventricle does not adequately pump blood. C. blood backs up into the lungs and causes congestion. D. the left ventricle does not adequately fill with blood.

D

What type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital? A. formal B. implied C. informed D. expressed

D

When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery. A. radial B. apical C. femoral D. brachial

D

When caring for the parents of a child who has died of leukemia, the EMT should: A. immediately refer them to a counselor. B. tell them that their feelings are understood. C. refrain from using words such as "died" or "dead." D. acknowledge the death of their child in private.

D

When forming your general impression of a patient with a medical complaint, it is important to remember that: A. the majority of medical patients you encounter are also injured. B. it is during the general impression that assessment of the ABCs occurs. C. most serious medical conditions do not present with obvious symptoms. D. the conditions of many medical patients may not appear serious at first.

D

When palpating a patient's pulse, you note that it is grossly irregular. You should: A. count the pulse rate for at least 30 seconds to ensure accuracy. B. count the number of pulsations in 15 seconds and multiply by four. C. count the number of pulsations in 30 seconds and multiply by two. D. count the pulse rate for a full minute to obtain an accurate reading

D

When performing his or her duties, the EMT is generally expected to: A. consistently exceed the standard of care. B. contact medical control on every EMS call. C. function above his or her scope of practice. D. exercise reasonable care and act prudently.

D

When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds. B. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. C. as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient has respiratory distress. D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

D

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should: A. advise your partner that you cannot provide care to this patient. B. wait for the backup ambulance while your partner performs CPR. C. obtain permission from medical control to not attempt resuscitation. D. begin two-rescuer CPR and apply the automated external defibrillator (AED) as soon as possible.

D

When you shine a light into one pupil, the normal reaction of the other pupil should be to: A. dilate. B. not react. C. become larger. D. become smaller

D

Which of the following blood vessels transports oxygenated blood? A. superior vena cava B. pulmonary arteries C. inferior vena cava D. pulmonary veins

D

Which of the following cardiac arrhythmias has the greatest chance of deteriorating into a pulseless rhythm? A. sinus tachycardia B. sinus bradycardia C. extra ventricular beats D. ventricular tachycardia

D

Which of the following clinical signs is MOST suggestive of a ruptured cerebral artery? A. unilateral hemiparesis B. confusion and weakness C. nasal discharge of blood D. sudden, severe headache

D

Which of the following conditions would MOST likely affect the entire brain? A. blocked cerebral artery in the frontal lobe B. reduced blood supply to the left hemisphere C. ruptured cerebral artery in the occipital lobe D. respiratory failure or cardiopulmonary arrest

D

Which of the following errors is an example of a knowledge-based failure? A. An EMT gives the correct drug to a patient, although his protocols clearly state that he is not authorized to do so. B. Due to an improperly applied cervical collar, a patient's spinal injury is aggravated and he is permanently disabled. C. A patient is given nitroglycerin by an EMT who did not obtain proper authorization from medical control first. D. An EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug.

D

Which of the following factors is NOT taken into consideration when assessing a person's potential for violence? A. poor impulse control B. tattoos, such as those with gang identification C. substance abuse D. large physical size

D

Which of the following is a unique function of the emergency medical dispatcher (EMD)? A. relaying relevant information to the EMTs B. directing the ambulance to the correct address C. obtaining patient information from the caller D. providing callers with life-saving instructions

D

Which of the following is characteristic of peptic ulcer disease (PUD)? A. the passage of bright red blood in the stool or coughing up blood B. symptom relief after taking nonsteroidal anti-inflammatory drugs C. sharp pain that is typically located in both lower abdominal quadrants D. burning or pain in the stomach that subsides immediately after eating

D

Which of the following is of LEAST pertinence when obtaining medical history information from a patient complaining of chest discomfort? A. history of cigarette smoking B. history of previous heart attack C. presence of personal risk factors D. family history of hypertension

D

Which of the following is the MOST effective strategy for managing stress? A. Frequently reflect on troublesome calls. B. Avoid friends and interests outside of EMS. C. Request overtime to increase your income. D. Focus on delivering high-quality patient care.

D

Which of the following is the MOST reliable indicator of adequately performed bag- mask ventilations in an apneic adult with a pulse? A. 20 breaths/min being delivered to the adult B. decreased compliance when squeezing the bag C. an adult's heart rate that is consistently increasing D. adequate rise of the chest when squeezing the bag

D

Which of the following is the MOST significant factor in determining if a person will become ill from certain germs? A. age B. race C. gender D. immunity

D

Which of the following patient responses would establish the "E" in the SAMPLE history? A. "I was in the hospital a week ago." B. "I am not having any difficulty breathing." C. "The chest pain started about 45 minutes ago." D. "I was mowing the lawn when the pain began."

D

Which of the following pupillary changes would indicate depressed brain function? A. Both pupils dilate when a bright light is removed. B. Both pupils constrict when a bright light is introduced. C. Both pupils react briskly to light instead of sluggishly. D. Both pupils dilate with introduction of a bright light

D

Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction? A. An EMT with many years of field experience becomes irritable with her coworkers and experiences headaches and insomnia. B. A newly certified EMT becomes extremely nauseated and diaphoretic at the scene of an incident involving grotesque injuries. C. An EMT is emotionally exhausted and depressed after a school bus crash involving critical injuries and the death of several children. D. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.

D

Which of the following scenarios does NOT involve the administration of ALS? A. a 48-year-old patient whose airway is secured with a multilumen device B. a 53-year-old patient who is given glucagon for significant hypoglycemia C. a 61-year-old trauma patient whose chest is decompressed with a needle D. a 64-year-old cardiac arrest patient who is defibrillated with an automated external defibrillator (AED)

D

Which of the following scenarios does NOT involve the presence of any symptoms? A. a 44-year-old male with abdominal pain and severe dizziness B. a 49-year-old female with blurred vision and ringing in the ears C. a 55-year-old male with a severe headache and 2 days of nausea D. a 61-year-old female who is unconscious with facial cyanosis

D

Which of the following statements regarding HIV is correct? A. It is far more contagious than hepatitis B. B. It is easily transmittable in the EMS field. C. HIV is transmitted exclusively via blood. D. There is no vaccine against HIV infection.

D

Which of the following statements regarding nitroglycerin is correct? A. The potency of nitroglycerin is increased when exposed to light. B. A maximum of five nitroglycerin doses should be given to a patient. C. Nitroglycerin should be administered between the cheek and gum. D. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

D

Which of the following statements regarding the EMS medical director and an EMT's scope of practice is correct? A. The EMS medical director can expand the EMT's scope of practice but cannot limit it without state approval. B. The EMS medical director can expand or limit an individual EMT's scope of practice without state approval. C. An EMT's scope of practice is exclusively regulated by the state EMS office, not the EMS medical director. D. An EMT's scope of practice may be expanded by the medical director after proper training and state approval.

D

Which of the following statements regarding the Good Samaritan law is correct? A. It provides the EMT immunity from a lawsuit. B. It guarantees that the EMT will not be held liable if he or she is sued. C. The law does not protect EMTs who are off duty. D. It will not protect the EMT in cases of gross negligence.

D

Which of the following statements regarding the NREMT is correct? A. The NREMT is a governmental agency that certifies EMTs. B. EMS training standards are regulated by the NREMT. C. The NREMT is the exclusive certifying body for EMTs. D. The NREMT provides a national standard for EMS testing.

D

Which of the following statements regarding the blood pressure is correct? A. The systolic pressure represents ventricular relaxation. B. Blood pressure falls early in patients with hypoperfusion. C. Blood pressure is the most reliable indicator of perfusion. D. Blood pressure is usually not measured in children younger than 3 years of age.

D

Which of the following statements regarding the pain associated with AMI is correct? A. It is often described by the patient as a sharp feeling. B. It often fluctuates in intensity when the patient breathes. C. Nitroglycerin usually resolves the pain within 30 minutes. D. It can occur during exertion or when the patient is at rest.

D

Which of the following statements regarding ventricular fibrillation (V-fib) is MOST correct? A. It is an uncommon dysrhythmia in patients with sudden cardiac arrest. B. AEDs should not be used to defibrillate patients in V-fib. C. The only indication for immediate defibrillation is V-fib. D. Survival rates decrease by 7% to 10% for each minute that V-fib persists.

D

Which of the following structures is contained within the mediastinum? A. lungs B. larynx C. bronchioles D. esophagus

D

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should: A. encourage him to cough as forcefully as he can. B. deliver up to five back blows and reassess him. C. place him in a supine position and open his airway. D. stand behind him and administer abdominal thrusts.

D

While on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should: A. tell your partner to quit kidding around and focus on his or her job. B. warn your partner that you will report him or her if it happens again. C. notify law enforcement personnel and have your partner arrested. D. tell your partner to stop and report the incident to your supervisor.

D

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your MOST appropriate action should be to: A. ask a bystander to remain with your patient as you treat the crash victims. B. remain at the scene until law enforcement and another ambulance arrive. C. stop and triage the patients while your partner remains in the ambulance. D. continue transporting your patient and notify the dispatcher of the crash.

D

Without adequate oxygen, the body's cells: A. rely solely on glucose, which is completely converted into adenosine triphosphate (ATP). B. cease metabolism altogether, resulting in carbon dioxide accumulation in the blood. C. begin to metabolize fat, resulting in the production and accumulation of ketoacids. D. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

D

You and your partner are EMTs and have been dispatched to standby at the scene of a residential fire. While standing next to the ambulance observing the fire fighters, you see a woman frantically moving around in her burning house. You should: A. request permission from the fire chief to enter the structure. B. don a self-contained breathing apparatus (SCBA) and rescue the woman. C. stay where you are until fire fighters remove her from the house. D. immediately notify the incident commander or safety officer.

D

You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should: A. stop any active bleeding and advise dispatch to send a paramedic crew. B. ventilate the patient for 5 minutes and then stop if there is no response. C. request the fire department to extricate the patient so you can begin cardiopulmonary resuscitation (CPR). D. have your partner check for a pulse to confirm that the patient is deceased.

D

You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should: A. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance. B. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured. C. document the presence of the weapon, including its specific location, and continue your assessment of the patient. D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

D

You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DNR) order is presented to you. When caring for this patient, you should: A. depart the scene and allow her to die with dignity. B. start cardiopulmonary resuscitation (CPR) if she experiences cardiopulmonary arrest. C. provide no interventions and transport to the hospital. D. make her comfortable and provide emotional support.

D

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. B. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. C. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device. D. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

D

You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement "He has a gun!" Your MOST appropriate action should be to: A. continue into the apartment using extreme caution. B. proceed into the apartment and apprehend the gunman. C. get in your ambulance and leave the scene immediately. D. seek a safe place and request law enforcement assistance.

D

You receive a call to a local daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to: A. open the airway and give 2 rescue breaths. B. begin chest compressions and request backup. C. immediately transport the child to the hospital. D. assess for a brachial pulse for 5 to 10 seconds

D

You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should: A. assist her breathing with a bag-mask device. B. quickly insert an oropharyngeal airway. C. assess the rate and quality of her pulse. D. immediately suction her oropharynx

D

Your BEST protection against legal liability when a competent patient refuses EMS care and transport is to: A. advise medical control of the situation. B. err on the side of caution and transport. C. ensure that the family is aware of the risks. D. thoroughly document the entire event.

D

Your partner is performing one-rescuer CPR on a middle aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medic ovation patch over the same area where one of the AED Pads will be placed. You should: A. apply the AED pad at least 1″ away from the medication patch to avoid skin burns. B. continue CPR until you can determine the name of the medication contained in the patch. C. move the patch to another area of the patient's chest and then properly apply the AED pads. D. remove the medication patch, wipe away any medication residue, and apply the AED pads.

D

Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to: A. perform a head-to-toe secondary assessment. B. assess her oxygen saturation and blood pressure. C. retrieve the stretcher and prepare for transport. D. administer oxygen with the appropriate device.

D

Which of the following statements regarding anaphylactic shock is MOST correct? A. Anaphylactic shock occurs immediately after a person is sensitized to an allergen. B. Sensitized people will experience less severe reactions upon subsequent exposure. C. Anaphylactic shock is the result of immune system failure due to a toxic exposure. D. Each subsequent exposure following sensitization often produces a more severe reaction.

D. Each subsequent exposure following sensitization often produces a more severe reaction.

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him? A. What does your blood pressure normally run? B. Do you take any over-the-counter medications? C. Has blood soaked through your undergarments? D. Have you experienced recent abdominal trauma?

D. Have you experienced recent abdominal trauma?

Which of the following statements regarding striated muscle is correct? A. Striated muscle is involuntary because you have no conscious control over it. B. Most of the body's striated muscle is found within the walls of the blood vessels. C. Striated muscle tissue is attached directly to the bones by tough bands of cartilage. D. It forms the major muscle mass of the body and usually crosses at least one joint.

D. It forms the major muscle mass of the body and usually crosses at least one joint.

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A.Multiple bacteria have been identified as being the cause of SARS. B. SARS is most commonly transmitted by direct contact with blood. C. The onset of SARS is typically marked by acute, severe pneumonia. D. SARS is a viral infection that often begins with flulike symptoms.

D. SARS is a viral infection that often begins with flulike symptoms.

The mesentery is: A. the point of attachment between the small and large intestines. B. a layer of thick skeletal muscles that protects the abdominal organs. C. a complex network of blood vessels that supply blood to the liver. D. a membranous fold that attaches the intestines to the walls of the body.

D. a membranous fold that attaches the intestines to the walls of the body.

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: A. hyperventilate him with a bag-mask device and monitor his oxygen saturation. B. apply high-flow oxygen, perform a detailed secondary assessment, and transport. C. focus your assessment on his scapulae and clavicles and apply high-flow oxygen. D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

When documenting a call involving a female patient who was sexually assaulted, the EMT should: A. theorize as to why the sexual assault occurred. B. include the results of his or her internal vaginal exam. C. include a description of the suspected perpetrator. D. avoid speculation and document only factual data.

D. avoid speculation and document only factual data.

When treating an 80-year-old patient who is in shock, it is important to remember that: A. compensation from the respiratory system usually manifests with increased tidal volume. B. the older patient's central nervous system usually reacts more briskly to compensate for shock. C. medications older patients take for hypertension often cause an unusually fast heart rate. D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

Capillary sphincters are: A. under complete control of the voluntary portion of the nervous system. B. capable of dilating in order to increase perfusion to crucial body organs. C. responsible for constricting to compensate for decreased cell perfusion. D. circular muscular walls that regulate blood flow through the capillaries.

D. circular muscular walls that regulate blood flow through the capillaries.

Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of: A. emphysema. B. severe pneumonia. C. bronchitis or asthma. D. congestive heart failure.

D. congestive heart failure.

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should: A. visualize the vaginal area and pack the vagina with sterile dressings. B. allow her to change her clothes and take a shower before you transport. C. arrange for a rape crisis center representative to speak with the patient. D. control any external bleeding, administer oxygen, and transport at once.

D. control any external bleeding, administer oxygen, and transport at once.

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should: A. assess distal pulses as well as sensory and motor functions. B. manually stabilize the leg above and below the site of injury. C. gently manipulate the injured leg until the numbness dissipates. D. control the bleeding and cover the wound with a sterile dressing.

D. control the bleeding and cover the wound with a sterile dressing.

The MOST significant hazard associated with splinting is: A. aggravation of the injury or worsened pain. B. reduction in circulation distal to the injury site. C. compression of nerves, tissues, and vasculature. D. delaying transport of a critically injured patient.

D. delaying transport of a critically injured patient.

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 (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should: A. place her in a recumbent position to facilitate breathing. B. contact medical control and administer an antihistamine. C. call medical control and ask how to proceed with treatment. D. determine if she has been prescribed a beta-agonist inhaler.

D. determine if she has been prescribed a beta-agonist inhaler.

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured: A. aorta. B. spleen. C. stomach. D. diaphragm.

D. diaphragm.

The disruption of a joint in which the bone ends are no longer in contact is called a: A. strain. B. sprain. C. fracture. D. dislocation.

D. dislocation.

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. severe strain B. moderate sprain C. hairline fracture D. displaced fracture

D. displaced fracture

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: A. audible stridor. B. rales and rhonchi. C. profound cyanosis. D. expiratory wheezing.

D. expiratory wheezing.

Peritonitis, an intense inflammatory reaction of the abdominal cavity, usually occurs when: A. solid abdominal organs bleed secondary to penetrating trauma. B. the vessels that supply the abdominal organs become inflamed. C. bacteria or viruses invade the walls of the gastrointestinal tract. D. hollow abdominal organs are damaged and spill their contents.

D. hollow abdominal organs are damaged and spill their contents.

In an acute injury setting, neurogenic shock is commonly accompanied by: A. hypovolemia. B. tachycardia. C. diaphoresis. D. hypothermia.

D. hypothermia.

When splinting an injury of the wrist, the hand should be placed: A. into a fist. B. in a straight position. C. in an extended position. D. in a functional position.

D. in a functional position.

Bones are connected to other bones by bands of tough fibrous tissues called: A. bursa. B. tendons. C. cartilage. D. ligaments.

D. ligaments.

In order for efficient pulmonary gas exchange to occur: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. an amputated extremity B. bilateral femur fractures C. nondisplaced long bone fractures D. pelvic fracture with hypotension

D. pelvic fracture with hypotension

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: A. insert an oropharyngeal airway and perform oral suctioning. B. apply oxygen via a nonrebreathing mask and transport at once. C. insert a nasopharyngeal airway and begin assisted ventilation. D. place her in the recovery position and monitor for vomiting.

D. place her in the recovery position and monitor for vomiting.

The MOST reliable indicator of an underlying fracture is: A. guarding. B. severe swelling. C. obvious bruising. D. point tenderness.

D. point tenderness.

A 59-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 100% supplemental oxygen, you should: A. perform a head-to-toe exam. B. allow him to drink plain water. C. obtain a repeat blood pressure in 5 minutes. D. prepare for immediate transport.

D. prepare for immediate transport.

A "hip" fracture is actually a fracture of the: A. pelvic girdle. B. femoral shaft. C. pubic symphysis. D. proximal femur.

D. proximal femur.

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? A. 100% oxygen administration B. full immobilization of her spine C. application of the pneumatic antishock garment (PASG) D. rapid transport to a trauma center

D. rapid transport to a trauma center

What type of muscle contracts and relaxes to control the movement of the contents within its structures? A. cardiac B. skeletal C. striated D. smooth

D. smooth

A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? A. rupture of the diaphragm B. exacerbation of his COPD C. acute pulmonary embolism D. spontaneous pneumothorax

D. spontaneous pneumothorax

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should: A. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.

D. stabilize her head and perform a primary assessment.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. B. pay special attention to the exhalation phase since this is when you will likely hear rales or rhonchi. C. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.

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

All of the following conditions would make you suspect shock, EXCEPT: A. anaphylaxis. B. heart attack. C. severe infection. D. tachycardia.

D. tachycardia.

Common signs and symptoms of acute hyperventilation syndrome include: A. altered mental status and bradycardia. B. unilateral paralysis and slurred speech. C. anxiety, dizziness, and severe bradypnea. D. tachypnea and tingling in the extremities.

D. tachypnea and tingling in the extremities.

An open fracture is MOST accurately defined as a fracture in which: A. bone ends protrude through the skin. B. a large laceration overlies the fracture. C. a bullet shatters the underlying bone. D. the overlying skin is no longer intact.

D. the overlying skin is no longer intact.

A 22-year-old male was punched in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should: A. apply full spinal motion restriction precautions. B. keep him on his side but gently straighten his legs. C. place him supine but allow him to keep his knees bent. D. transport him in the position in which you found him.

D. transport him in the position in which you found him.

Distributive shock occurs when: A. an injury causes restriction of the heart muscle and impairs its pumping function. B. severe bleeding causes tachycardia in order to distribute blood to the organs faster. C. temporary but severe vasodilation causes a decrease in blood supply to the brain. D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

After the patients airway is intubated during two rescuer CPR you should

Deliver one rescue breath every 6 to 8 seconds

Who does Alexandra Nicole love? A. Joseph Michael B. Joey C. Babykangarooo D. Joseph Hernandez

E. All of the above

Which of the following statements regarding the cranium is correct? A. The skull is a subdivision of the cranium. B. Thirty percent of the cranium is occupied by blood. C. The cranium protects the structures of the face. D. Eighty percent of the cranium is occupied by brain tissue.

Eighty percent of the cranium is occupied by brain tissue.

Signs of a sudden sever upper airway obstruction include all of the following except

Forceful coughing

Complications associated with chest compressions include all of the following except:

Gastric distention

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. A. head B. chest C. waist D. lower extremities

Head

Which of the following statements regarding secondary brain injury is correct? A. It results from direct brain trauma following an impact to the head. B. Because cerebral edema develops quickly, it is considered to be a primary brain injury. C. Hypoxia and hypotension are the two most common causes of secondary brain injury. D. Signs are often present immediately after an impact to the head.

Hypoxia and hypotension are the two most common causes of secondary brain injury.

Gastric distention will MOST likely occur:

If you ventilate a patient too fast

The impedance threshold device may improve circulation during CPR by:

Limiting the amount of air that enters the lungs during the recoil phase between chest compressions which result in negative intrathoracic pressure and improved cardiac filling

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? A. linear B. basilar C. open D. compressed

Linear

During two-rescuer CPR, the compressor and ventilator switch positions. While rescuer one is finishing his or her cycle of 30 compressions, rescuer two should:

Move to the opposite side of the patients chest

The proper depth of chest compressions on a 9 month out infant is:

One third the diameter of the chest or about 1.5

Your initial attempt to ventilate an unresponsive patient apneic 30 year old man is met with resistance and you do not see the chest rise. Your second ventilation attempt is also unsuccessful. You should:

Perform 30 chest compressions

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. A. central B. somatic C. autonomic D. peripheral

Peripheral

CPR will not be effective if the patient is

Prone

In most cases, cardiopulmonary arrest in infants and children is caused by

Respiratory arrest

Which of the following nerves carry information from the body to the brain via the spinal cord? A. motor B. central C. somatic D. sensory

Sensory

What part of the nervous system controls the body's voluntary activities? A. central B. sensory C. somatic D. autonomic

Somatic

Which of the following statements regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. They are typically the result of local, low-energy trauma to the head.

The absence of raccoon eyes or Battle's sign does not rule it out.

Which of the following statements is NOT appropriate to document in the narrative section of a PCR? Select one: A. "General impression revealed that the patient was intoxicated." B. "The patient admits to smoking marijuana earlier in the day." C. "After oxygen was administered, the patient's breathing improved." D. "Significant damage was noted to the front end of the vehicle."

The correct answer is: A. "General impression revealed that the patient was intoxicated."

You are transporting a 54-year-old male in cardiac arrest. An EMR is driving the ambulance as you and your partner attempt to resuscitate the patient. What is the MOST logical way of notifying the hospital? Select one: A. Have the driver contact dispatch and relay the patient information to the hospital. B. Wait until you arrive at the hospital and then quickly apprise them of the situation. C. Call the receiving hospital with your cellular phone as you attempt resuscitation. D. Request that a police officer respond to the hospital to apprise them of your arrival.

The correct answer is: A. Have the driver contact dispatch and relay the patient information to the hospital.

Immediately after being dispatched to a residence for an elderly patient with diabetic complications, you should: Select one: A. confirm with dispatch that you received the call information. B. ask the dispatcher to obtain a medical history from the caller. C. request that law enforcement secure the scene before you arrive. D. ask the dispatcher if the patient is conscious or unconscious.

The correct answer is: A. confirm with dispatch that you received the call information.

When communicating with a visually impaired patient, you should: Select one: A. determine the degree of the patient's impairment. B. recall that most visually impaired patients are blind. C. expect him or her to have difficulty understanding. D. possess an in-depth knowledge of sign language.

The correct answer is: A. determine the degree of the patient's impairment.

When communicating with an older patient, it is important to remember that: Select one: A. most older people think clearly and are capable of answering questions. B. your questions should focus exclusively on the patient's obvious problem. C. speaking loudly and distinctly will ensure that the patient can hear you. D. hostility and confusion should be presumed to be due to the patient's age.

The correct answer is: A. most older people think clearly and are capable of answering questions.

After receiving online orders from medical control to perform a patient care intervention, you should: Select one: A. repeat the order to medical control word for word. B. confirm the order in your own words. C. ask the physician to repeat the order. D. perform the intervention as ordered.

The correct answer is: A. repeat the order to medical control word for word.

What type of communications equipment functions as a radio receiver and searches across several frequencies? Select one: A. scanner B. simplex station C. mobile repeater D. duplex station

The correct answer is: A. scanner

You are interviewing a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate to say? Select one: A. "I notice that you are a retired paramedic, so I'm sure you will understand all of the things that we will be doing to you." B. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow." C. "We need to take you to the ED stat. We will give you ASA and NTG en route and then reassess your vitals. Do you have any questions?" D. "This is nothing to worry about. Please try to stay calm. The physician at the hospital will probably not find any signs of a heart problem."

The correct answer is: B. "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."

Which of the following statements regarding standing orders is MOST correct? Select one: A. Standing orders only highlight the care that you may provide. B. Standing orders should be followed when physician contact is not possible. C. Standing orders require you to contact medical control first. D. Standing orders have less legal authority than orders given via radio.

The correct answer is: B. Standing orders should be followed when physician contact is not possible.

Which of the following statements regarding communication with a child is MOST correct? Select one: A. Most children are intrigued by strangers wearing uniforms. B. Standing over a child often increases his or her level of anxiety. C. Give the child minimal information to avoid scaring him or her. D. Unlike adults, children cannot see through lies or deceptions.

The correct answer is: B. Standing over a child often increases his or her level of anxiety.

Which of the following incidents does NOT require a report to be filed with local authorities? Select one: A. gunshot wounds B. cardiac arrest C. spousal abuse D. animal bites

The correct answer is: B. cardiac arrest

Ethnocentrism is defined as: Select one: A. suspecting that a person has an ulterior motive based on the tone of his or her voice when answering a question. B. considering your own cultural values as more important when interacting with people of a different culture. C. understanding that people from different cultural backgrounds respond to pain and stress differently. D. subconsciously forcing your cultural values onto a patient because you feel that yours are more acceptable.

The correct answer is: B. considering your own cultural values as more important when interacting with people of a different culture.

The patient care report (PCR) ensures: Select one: A. legal protection. B. continuity of care. C. research data. D. quality assurance.

The correct answer is: B. continuity of care.

During the alert and dispatch phase of EMS communications, the dispatcher's responsibilities include all of the following, EXCEPT: Select one: A. selecting and notifying the correct EMS response units and personnel. B. discouraging the caller from providing care until the EMS unit arrives. C. coordinating responding EMS units with other public safety personnel. D. screening and assigning a priority to each call based on local protocols.

The correct answer is: B. discouraging the caller from providing care until the EMS unit arrives.

Communicating with hearing-impaired patients can be facilitated by doing all of the following, EXCEPT: Select one: A. placing yourself in a position to ensure that the patient can see your lips. B. elevating the tone of your voice and exaggerating word pronunciation. C. providing pen and paper if the patient prefers to write his or her response. D. shining a light on your face when you are in a darkened environment.

The correct answer is: B. elevating the tone of your voice and exaggerating word pronunciation.

When obtaining patient care orders from a physician via a two-way radio, it is MOST important to remember that: Select one: A. all orders should be carried out immediately and without question. B. his or her instructions are based on the information you provide. C. the use of 10 codes is an effective method of communication. D. the physician may or may not be located within your service area.

The correct answer is: B. his or her instructions are based on the information you provide.

Calming and reassuring an anxious patient can be facilitated by: Select one: A. positioning yourself at a level that is higher than the patient. B. maintaining eye contact with the patient whenever possible. C. withholding unpleasant information until arrival at the hospital. D. using medical terminology to ensure the patient understands.

The correct answer is: B. maintaining eye contact with the patient whenever possible.

When providing a patient report via radio, you should protect the patient's privacy by: Select one: A. withholding medical history data. B. not disclosing his or her name. C. refraining from objective statements. D. using coded medical language.

The correct answer is: B. not disclosing his or her name.

As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should: Select one: A. inform the admissions clerk of the situation and then respond at once. B. respond only after giving a verbal patient report to a nurse or physician. C. place the patient in a high-visibility area and then respond to the call. D. leave a copy of the run form with a nurse and then respond to the call.

The correct answer is: B. respond only after giving a verbal patient report to a nurse or physician.

Two-way communication that requires the EMT to "push to talk" and "release to listen" describes what mode of communication? Select one: A. mediplex B. simplex C. multiplex D. duplex

The correct answer is: B. simplex

While at the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should: Select one: A. ask a police officer to call dispatch with his portable radio. B. use the mobile radio in the ambulance to contact dispatch. C. place both patients in the ambulance and transport at once. D. reattempt to contact dispatch from an area of higher terrain.

The correct answer is: B. use the mobile radio in the ambulance to contact dispatch.

When communicating information over the radio, you should: Select one: A. respond professionally by saying "please" and "thank you." B. use the words "affirmative" and "negative" instead of "yes" or "no." C. limit any single transmission to 60 seconds or less and use 10 codes. D. use the patient's name only when communicating with the hospital.

The correct answer is: B. use the words "affirmative" and "negative" instead of "yes" or "no."

General guidelines for effective radio communications include all of the following, EXCEPT: Select one: A. acknowledging a transmission as soon as possible. B. using 10 codes to ensure radio traffic confidentiality. C. holding the microphone about 2" to 3" from your mouth. D. speaking in a clear, calm, monotone voice.

The correct answer is: B. using 10 codes to ensure radio traffic confidentiality.

A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the MOST appropriate to ask him? Select one: A. "Does the pain in your chest feel like a stabbing sensation?" B. "Were you exerting yourself when the chest pain began?" C. "Do you have any heart problems or take any medications?" D. "Does the pain in your chest move to either of your arms?"

The correct answer is: C. "Do you have any heart problems or take any medications?"

Which of the following statements regarding a patient refusal is MOST correct? Select one: A. Advice given to a patient who refuses EMS treatment should not be documented. B. A patient who consumed a few beers will likely be able to refuse EMS treatment. C. A mentally competent adult has the legal right to refuse EMS care and transport. D. Documentation of proposed care is unnecessary if the patient refuses treatment.

The correct answer is: C. A mentally competent adult has the legal right to refuse EMS care and transport.

Medical control gives you an order that seems inappropriate for the patient's condition. After confirming that you heard the physician correctly, you should: Select one: A. carry out the order and then carefully document it on the run form. B. obtain consent from the patient and then carry out the order as usual. C. advise the physician that the order is unclear and ask for clarification. D. state that you will not carry out the order because it is inappropriate.

The correct answer is: C. advise the physician that the order is unclear and ask for clarification.

During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should: Select one: A. ask him if he frequently experiences severe headaches and nausea. B. tell him that you cannot help him unless he answers your questions. C. allow him time to think about the question and respond to it. D. repeat your question because he probably did not hear you.

The correct answer is: C. allow him time to think about the question and respond to it.

You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions regarding her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that: Select one: A. it is necessary to enter an older person's intimate space because the elderly are typically hearing impaired. B. a patient's personal space should not be violated, regardless of any barriers that may hamper communication. C. as you physically get closer to the patient, a greater and greater sense of trust must be established. D. placing yourself in the patient's personal space is relaying to her that you can be trusted.

The correct answer is: C. as you physically get closer to the patient, a greater and greater sense of trust must be established.

Despite numerous, sincere efforts to convince a 40-year-old man to consent to EMS treatment and transport, he refuses. After explaining the potential consequences of his refusal and determining that he has decision-making capacity, you ask him to sign an EMS refusal form, but he refuses to do that as well. You should: Select one: A. document the patient's refusal, but leave the refusal form blank because only the patient can legally sign it. B. advise the patient that unless he signs the refusal form, he cannot legally refuse EMS treatment or transport. C. ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign. D. sign the refusal form, include the date and time, and have your partner witness it with his or her signature.

The correct answer is: C. ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign.

In what manner should you act and speak with a patient? Select one: A. loud and official B. passive C. calm and confident D. authoritative

The correct answer is: C. calm and confident

A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should: Select one: A. attempt to calm the child's mother, but avoid separating her from her child because this will increase her anxiety. B. give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability. C. consider asking the father to hold the child so you can assess him while your partner tries to calm the mother. D. reassure the child's mother that seizures in children are very common and that there is nothing to worry about.

The correct answer is: C. consider asking the father to hold the child so you can assess him while your partner tries to calm the mother.

After delivering your patient to the hospital, you sit down to complete the PCR. When documenting the patient's last blood pressure reading, you inadvertently write 120/60 instead of 130/70. To correct this mistake, you should: Select one: A. leave the error on your PCR but inform the staff of the patient's actual blood pressure. B. attempt to erase the error, initial it, and then write the correct data on a separate addendum. C. draw a single horizontal line through the error, initial it, and write the correct data next to it. D. cover the error with correction fluid and simply write the patient's actual blood pressure over it.

The correct answer is: C. draw a single horizontal line through the error, initial it, and write the correct data next to it.

Which of the following is NOT a function of the Federal Communications Commission (FCC)? Select one: A. licensing base stations and assigning appropriate radio call signs B. monitoring all radio traffic and conducting field spot checks C. maintaining communications equipment on the ambulance D. allocating specific radio frequencies for use by EMS providers

The correct answer is: C. maintaining communications equipment on the ambulance

You could be sued for ___________ if your radio report to the hospital describes the patient in a manner that injures his or her reputation. Select one: A. assault B. negligence C. slander D. libel

The correct answer is: C. slander

Typical components of an oral patient report include all of the following, EXCEPT: Select one: A. the chief complaint or mechanism of injury. B. the patient's response to treatment you provided. C. the set of baseline vital signs taken at the scene. D. important medical history not previously given.

The correct answer is: C. the set of baseline vital signs taken at the scene.

You and your partner are attempting to resuscitate a middle-aged female in cardiac arrest. Because of the remote location you are in, you are unable to contact medical control. What should you do? Select one: A. Make continuous attempts to contact medical control. B. Perform CPR only and initiate immediate transport. C. Ask the husband if he wants to continue resuscitation. D. Follow locally established protocols or standing orders.

The correct answer is: D. Follow locally established protocols or standing orders.

Which of the following statements regarding a "dedicated line" is MOST correct? Select one: A. It is a constantly open line of communication that is under exclusive control of a single user. B. It is a designated frequency on a portable radio that provides direct access to medical control. C. It is an exclusive frequency that is used by EMTs to communicate with each other in the field. D. It is a constantly open line of communication that cannot be accessed by outside users.

The correct answer is: D. It is a constantly open line of communication that cannot be accessed by outside users.

Information included in a radio report to the receiving hospital should include all of the following, EXCEPT: Select one: A. a brief summary of the care you provided. B. a brief history of the patient's current problem. C. your perception of the severity of the problem. D. a preliminary diagnosis of the patient's problem.

The correct answer is: D. a preliminary diagnosis of the patient's problem.

A patient's refusal for EMS treatment and/or transport must be: Select one: A. authorized by a judge. B. witnessed by a notary. C. reported to the police. D. an informed refusal.

The correct answer is: D. an informed refusal.

Any radio hardware containing a transmitter and receiver that is located in a fixed location is called a: Select one: A. mobile radio. B. repeater. C. multiplex. D. base station.

The correct answer is: D. base station.

When relaying patient information via radio, communications should be: Select one: A. spoken in a loud voice. B. coded and scripted. C. lengthy and complete. D. brief and easily understood.

The correct answer is: D. brief and easily understood.

When you begin an oral report, you should state the patient's age, sex, and: Select one: A. the emergency care given. B. any known allergies. C. past medical history. D. chief complaint.

The correct answer is: D. chief complaint.

Your EMS system uses a computerized PCR in which you fill in the information electronically and then send it to the emergency department via a secure Internet server. The PCR has a comprehensive series of drop-down boxes, which are used to identify your assessment findings and specify the treatment that you provided; it also has a section for your narrative. When completing your PCR after a call, you should: Select one: A. defer the narrative only if the information in the drop-down boxes accurately reflects the assessment and treatment that you performed. B. avoid documenting personally identifiable information, such as the patient's name, because the PCR could be intercepted during transmission. C. enter all of the pertinent information of the electronic PCR, but then print it out and provide a copy to the emergency department staff. D. complete a thorough and accurate narrative because drop-down boxes cannot provide all of the information that needs to be documented.

The correct answer is: D. complete a thorough and accurate narrative because drop-down boxes cannot provide all of the information that needs to be documented.

All information recorded on the PCR must be: Select one: A. typewritten or printed. B. reflective of your opinion. C. a matter of public record. D. considered confidential.

The correct answer is: D. considered confidential.

You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should: Select one: A. advise the emergency department physician that you feel as though the child was intentionally abused by his parents. B. acknowledge and respect this practice as a cultural belief, but advise the child's parents that it has no healing power. C. advise the child's parents that this is a harmful practice and is considered a form of child abuse in the United States. D. document this on your patient care report and advise the emergency department staff of what the child's parents told you.

The correct answer is: D. document this on your patient care report and advise the emergency department staff of what the child's parents told you.

The official transfer of patient care does not occur until the EMT: Select one: A. notifies the admitting clerk of their arrival at the hospital. B. gives a radio report to the receiving medical facility. C. informs dispatch of their arrival at the emergency department. D. gives an oral report to the emergency room physician or nurse.

The correct answer is: D. gives an oral report to the emergency room physician or nurse.

A ___________ receives messages and signals on one frequency and then automatically retransmits them on a second frequency. Select one: A. scanner B. duplex C. decoder D. repeater

The correct answer is: D. repeater

After being dispatched on an emergency call, you should expect the dispatcher to provide you with all of the following information, EXCEPT: Select one: A. the number of patients involved in the incident. B. the time at which your unit was dispatched. C. other agencies that are responding to the scene. D. the general geographic location of the incident.

The correct answer is: D. the general geographic location of the incident.

You and your partner are dispatched to a residence for an "ill person." When you arrive, you find that the patient, a 44-year-old man, does not speak English. There are no relatives or bystanders present who can act as an interpreter. You should: Select one: A. speak to the patient with a moderately louder voice to facilitate his ability to understand what you are saying. B. refrain from performing any assessment or treatment until you can contact someone who can function as an interpreter. C. give the patient oxygen, assess his vital signs, and transport him to the hospital in a position of comfort. D. use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint.

The correct answer is: D. use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint.

Which of the following has the weakest transmission signal and, as a result, is LEAST likely to be heard by the party being called? Select one: A. multiplex base station B. hand-held portable radio C. mobile repeater station D. land-base repeater station

The correct answer is: b. hand-held portable radio

The main benefit of using. Mechanical piston or load-distributing band device for chest compressions is

The elimination of rescuer fatigue that results from manual compressions

Which of the following statements regarding motor nerves is correct? A. They carry information from the CNS to the muscles. B. They perform special functions such as sight, smell, and hearing. C. They transmit information from the body to the brain via the spinal cord. D. They are part of the CNS and control reflexes.

They carry information from the CNS to the muscles.

Abdominal thrusts in a conscious child or adult with a severe upper airway obstruction are performed

Until he or she loses consciousness

When performing CPR on a child, you should compress the chest

With one or two hands

. A 30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that: A. her spleen is enlarged because of red blood cell engorgement. B. the pain in her abdomen is referred pain from an enlarged liver. C. she has gastrointestinal bleeding due to large blood vessel rupture. D. she is experiencing an aplastic crisis and needs a blood transfusion.

a

. Esophageal varices MOST commonly occur in patients who: A. drink a lot of alcohol. B. have severe diabetes. C. have a history of esophagitis. D. have weak immune systems.

a

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 also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. In addition to administering oxygen, you should: A. contact medical control and administer oral glucose. B. assist him with his insulin injection and reassess him. C. request a paramedic ambulance to administer IV glucose. D. transport only with close, continuous monitoring en route.

a

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: A. is significantly hyperglycemic. B. has a low blood glucose level. C. has a urinary tract infection. D. has overdosed on her insulin.

a

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: A. protect her airway from aspiration. B. keep her supine and elevate her legs. C. rapidly transport her to the hospital. D. give her high-flow supplemental oxygen.

a

An important aspect in the treatment of a patient with severe abdominal pain is to: A. provide emotional support en route to the hospital. B. administer analgesic medications to alleviate pain. C. encourage the patient to remain in a supine position. D. give 100% oxygen only if signs of shock are present.

a

Diabetes is MOST accurately defined as a(n): A. disorder of carbohydrate metabolism. B. abnormally high blood glucose level. C. mass excretion of glucose by the kidneys. D. lack of insulin production in the pancreas.

a

Excessive eating caused by cellular "hunger" is called: A. polyphagia. B. polydipsia. C. dysphasia. D. dyspepsia.

a

Insulin shock will MOST likely develop if a patient: A. takes too much of his or her prescribed insulin. B. markedly overeats and misses an insulin dose. C. eats a regular meal followed by mild exertion. D. misses one or two prescribed insulin injections.

a

Kussmaul respirations are an indication that the body is: A. attempting to eliminate acids from the blood. B. trying to generate energy by breathing deeply. C. severely hypoxic and is eliminating excess CO2. D. compensating for decreased blood glucose levels.

a

Most patients with abdominal pain prefer to: A. lie on their side with their knees drawn into the abdomen. B. sit in a semi-Fowler position with their knees slightly bent. C. lie in a supine position with their knees in a flexed position. D. sit fully upright because it helps relax the abdominal muscles.

a

When assessing a patient with abdominal pain, you should: A. palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

a

When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: A. if he or she has had any recent illnesses or excessive stress. B. approximately how much water the patient drank that day. C. if there is a family history of diabetes or related conditions. D. the name of the physician who prescribed his or her insulin.

a

Which of the following conditions is more common in women than in men? A. cystitis B. hepatitis C. pancreatitis D. cholecystitis

a

Which of the following conditions is the diabetic patient at an increased risk of developing? A. blindness B. depression C. alcoholism D. hepatitis B

a

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 high-flow 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 breaths/min and labored. You should: A. leave him in a sitting position, keep him warm, and prepare for immediate transport. B. place him in a supine position, elevate his lower extremities, and transport at once. C. treat for shock and request a paramedic unit to respond to the scene and assist you. D. perform a detailed secondary assessment and then transport him to a dialysis center.

a

The MOST reliable sign of a head injury is: A. a pulse that is rapid and thready. B. a decreased level of consciousness. C. an abnormally low blood pressure. D. decreased sensation in the extremities.

a decreased level of consciousness.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: A. a rapid deterioration of neurologic signs. B. a progressively lowering blood pressure. C. an acute increase in the patient's pulse rate. D. acute unilateral paralysis following the injury.

a rapid deterioration of neurologic signs.

A reflex arc occurs when: A. the motor nerves function automatically without receiving a message from the CNS. B. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body. C. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: A. regenerating brain cells after they have been damaged. B. acting as a shock absorber for the brain and spinal cord. C. delivering oxygen directly to the CNS. D. producing leukocytes that protect the brain from infection.

acting as a shock absorber for the brain and spinal cord.

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar: A. after the torso has been adequately secured. B. after moving the patient to a long backboard. C. after assessing distal neurovascular functions. D. before manually stabilizing the patient's head.

after assessing distal neurovascular functions.

Any unresponsive trauma patient should be assumed to have: A. a history of diabetes mellitus. B. an accompanying spinal injury. C. a severe intracranial hemorrhage. D. internal bleeding in the abdomen.

an accompanying spinal injury.

A short backboard or vest-style immobilization device is indicated for patients who: A. are found supine and have stable vital signs. B. are in a sitting position and are clinically stable. C. require prompt extrication from an automobile. D. are sitting in their car and are clinically unstable.

are in a sitting position and are clinically stable.

After your partner assumes manual in-line stabilization of the patient's head, you should: A. apply an appropriately sized rigid cervical collar. B. assess distal neurovascular status in the extremities. C. thoroughly palpate the patient's head for deformities. D. use four people to log roll the patient onto a backboard.

assess distal neurovascular status in the extremities.

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes: A. hyperventilating her at 30 breaths/min. B. administering oxygen via a nonrebreathing mask. C. ventilation assistance to maintain an oxygen saturation of 90%. D. assisting ventilations at an age-appropriate rate.

assisting ventilations at an age-appropriate rate.

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: A. elevate the patient's head and apply an ice pack. B. apply manual pressure and avoid applying a bandage. C. avoid excessive pressure when applying the bandage. D. apply firm compression for no longer than 5 minutes.

avoid excessive pressure when applying the bandage.

. Diabetic coma is a life-threatening condition that results from: A. hypoglycemia, excess insulin, and dehydration. B. hyperglycemia, ketoacidosis, and dehydration. C. hypoglycemia, dehydration, and ketoacidosis. D. hyperglycemia, excess insulin, and ketoacidosis.

b

A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop: A. severe insulin shock. B. acidosis and dehydration. C. complete renal failure. D. hypoxia and overhydration

b

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: A. transport him in a supine position. B. be alert for signs and symptoms of shock. C. assess his blood pressure to determine perfusion adequacy. D. determine the exact location and cause of his pain.

b

A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. vigorously palpate the abdomen to establish pain severity. B. administer oxygen and prepare for immediate transport. C. place the patient in a sitting position and transport at once. D. request a paramedic unit to give the patient pain medication.

b

An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis. A. aplastic B. hemolytic C. vaso-occlusive D. splenic sequestration

b

Classic signs and symptoms of hypoglycemia include: A. warm, dry skin; irritability; bradycardia; and rapid respirations. B. cool, clammy skin; weakness; tachycardia; and rapid respirations. C. warm, dry skin; hunger; abdominal pain; and deep, slow respirations. C. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.

b

Common signs and symptoms of diabetic coma include all of the following, EXCEPT: A. warm, dry skin. B. cool, clammy skin. C. rapid, thready pulse. D. acetone breath odor.

b

Glipizide, a non-insulin-type medication, is another name for: A. Glucophage. B. Glucotrol. C. Micronase. D. Diabinese

b

Glutose is a trade name for: A. glucotrol. B. oral glucose. C. micronase. D. glucophage.

b

Hypoglycemic crisis tends to develop more often and more severely in children because: A. they have larger glucose stores than adults do. B. they do not always eat correctly and on schedule. C. their cells do not uptake glucose as fast as adults' do. D. their low activity levels cause rapid glucose depletion.

b

Insulin functions in the body by: A. producing new glucose as needed. B. enabling glucose to enter the cells. C. increasing circulating blood glucose. D. metabolizing glucose to make energy.

b

Patients with uncontrolled diabetes experience polyuria because: A. they drink excess amounts of water due to dehydration. B. excess glucose in the blood is excreted by the kidneys. C. low blood glucose levels result in cellular dehydration. D. high blood sugar levels cause permanent kidney damage.

b

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: A. assessing the patient's mental status. B. ensuring the absence of a gag reflex. C. checking the medication's expiration date. D. requesting permission from medical control.

b

The normal blood glucose level, as measured by a glucometer, is between: A. 60 and 80 mg/dL. B. 80 and 120 mg/dL. C. 130 and 150 mg/dL. D. 160 and 200 mg/dL.

b

Type 1 diabetes: A. is typically treated with medications such as metformin (Glucophage). B. is a condition in which no insulin is produced by the body. C. typically occurs in patients between 50 and 70 years of age. D. is defined as a blood sugar level that is less than 120 mg/dL.

b

Which of the following statements regarding diabetic coma is correct? A. Diabetic coma can be prevented by taking smaller insulin doses. B. Diabetic coma typically develops over a period of hours or days. C. Patients with low blood glucose levels are prone to diabetic coma. D. Diabetic coma rapidly progresses once hyperglycemia develops.

b

Which of the following statements regarding sickle cell disease is correct? A. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin A. D. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

b

You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include: A. administering one to two tubes of oral glucose. B. applying a nonrebreathing mask at 15 L/min. C. assisting the patient with his diabetic medication. D. performing a rapid exam and obtaining vital signs.

b

An epidural hematoma is MOST accurately defined as: A. bleeding between the skull and dura mater. B. bleeding between the dura mater and brain. C. venous lacerations that occur within the brain. D. an injury caused by a damaged cerebral artery.

bleeding between the skull and dura mater.

Which of the following sets of vital signs depicts Cushing's triad? A. blood pressure, 190/110 mm Hg pulse, 55 beats/min respirations, 30 breaths/min B. blood pressure, 90/50 mm Hg pulse, 120 beats/min respirations, 10 breaths/min C. blood pressure, 200/100 mm Hg pulse, 140 beats/min respirations, 28 breaths/min D. blood pressure, 80/40 mm Hg pulse, 30 beats/min respirations, 32 breaths/min

blood pressure, 190/110 mm Hg pulse, 55 beats/min respirations, 30 breaths/min

The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. brain and spinal cord. C. cerebrum and meninges. D. meninges and spinal cord.

brain and spinal cord.

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. A. brain stem B. cerebellum C. spinal cord D. cerebral cortex

brain stem

. In contrast to insulin shock, diabetic coma: A. is rapidly reversible if oral glucose is given. B. commonly results in excess water retention. C. can only be corrected in the hospital setting. D. is a rapidly developing metabolic disturbance.

c

. You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: A. oxygen. B. glucagon. C. insulin. D. dextrose.

c

A 29-year-old female 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: A. transport immediately. B. administer oral glucose. C. provide ventilatory support. D. treat her for hyperglycemia

c

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: A. quickly assess for the presence of a medical identification tag. B. administer 100% oxygen via a nonrebreathing mask. C. open and maintain her airway and assess breathing. D. administer oral glucose between her cheek and gum.

c

Chronic renal failure is a condition that: A. can be reversed with prompt treatment. B. occurs from conditions such as dehydration. C. is often caused by hypertension or diabetes. D. causes dehy

c

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that: A. he has a thrombosis. B. he has hemophilia B. C. he has hemophilia A. D. his blood clots too quickly.

c

Hemoglobin is: A. the fluid portion of the blood that transports cells throughout the body. B. essential for the formation of clots, such as when vessel damage occurs. C. found within the red blood cells and is responsible for carrying oxygen. D.

c

Ketone production is the result of: A. acidosis when blood glucose levels are low. B. blood glucose levels higher than 120 mg/dL. C. fat metabolization when glucose is unavailable. D. rapid entry of glucose across the cell membrane.

c

Patients with acute abdominal pain should not be given anything to eat or drink because: A. it will create referred pain and obscure the diagnosis. B. food will rapidly travel through the digestive system. C. substances in the stomach increase the risk of aspiration. D. digestion prevents accurate auscultation of bowel sounds.

c

The MOST important treatment for a patient with severe abdominal pain and signs of shock includes: A. administering high-flow oxygen. B. giving oral fluids to maintain perfusion. C. transporting the patient without delay. D. positioning the patient on his or her side.

c

The signs and symptoms of insulin shock are the result of: A. increased blood glucose levels. B. fat metabolism within the cells. C. decreased blood glucose levels. D. prolonged and severe dehydration.

c

Which of the following statements regarding dialysis is correct? A. Acute hypertension is a common adverse effect of dialysis. B. Hemodialysis is effective but carries a high risk of peritonitis. C. Patients who miss a dialysis treatment often present with weakness. D. The purpose of dialysis is to help the kidneys retain salt and water.

c

Which of the following statements regarding glucose is correct? A. Most cells will function normally without glucose. B. Blood glucose levels decrease in the absence of insulin. C. The brain requires glucose as much as it requires oxygen. D. The brain requires insulin to allow glucose to enter the cells.

c

While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: A. document the error and report it to your supervisor. B. notify law enforcement so they can file an incident report. C. contact medical control and notify him or her of the error. D. exclude this from the PCR since it did not harm the patient. While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: A. document the error and report it to your supervisor. B. notify law enforcement so they can file an incident report. C. contact medical control and notify him or her of the error. D. exclude this from the PCR since it did not harm the patient.

c

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to: A. quickly gain access to the patient. B. notify the dispatcher of your arrival. C. assess the scene for potential hazards. D. place a paramedic ambulance on standby.

c

Coordination of balance and body movement is controlled by the: A. medulla. B. cerebrum. C. cerebellum. D. brain stem.

cerebellum.

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n): A. cerebral contusion. B. cerebral concussion. C. intracranial hemorrhage. D. intracerebral hematoma.

cerebral concussion.

The MOST common and serious complication of a significant head injury is: A. a skull fracture. B. cerebral edema. C. a hypoxic seizure. D. acute hypotension.

cerebral edema.

The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, thoracic, lumbar, sacral, and coccygeal. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, coccygeal, thoracic, sacral, and lumbar.

cervical, thoracic, lumbar, sacral, and coccygeal.

The frontal and parietal bones of the skull are especially susceptible to: A. basilar skull fractures. B. compressed skull fractures. C. linear skull fractures. D. nondisplaced skull fractures.

compressed skull fractures.

Rapid deceleration of the head, such as when it impacts the windshield, causes: A. compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain. B. primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels. C. stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain. D. compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function.

constricted pupils.

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

d

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: A. hypoglycemia. B. an acute stroke. C. hyperglycemia. D. a heart attack.

d

A strangulated hernia is one that: A. spontaneously reduces without any surgical intervention. B. can be pushed back into the body cavity to which it belongs. C. is reducible if surgical intervention occurs within 2 hours. D. loses its blood supply due to compression by local tissues.

d

Assessment of a patient with hypoglycemia will MOST likely reveal: A. sunken eyes. B. hyperactivity. C. warm, dry skin. D. combativeness.

d

Diabetic ketoacidosis occurs when: A. blood glucose levels rapidly fall. B. the cells rapidly metabolize glucose. C. the pancreas produces excess insulin. D. insulin is not available in the body.

d

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of: A. chronic dementia, which inhibits communication. B. interactions of the numerous medications they take. C. progressive deterioration of abdominal organ function. D. age-related deterioration of their sensory systems.

d

Patients with thrombophilia are at an increased risk for: A. various cancers. B. hemorrhagic stroke. C. acute arterial rupture. D. pulmonary embolism.

d

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT: A. diet and exercise. B. tolbutamide (Orinase). C. glyburide (Micronase). D. supplemental insulin.

d

To which of the following diabetic patients should you administer oral glucose? A. an unconscious 33-year-old male with cool, clammy skin B. a conscious 37-year-old female with nausea and vomiting C. a semiconscious 40-year-old female without a gag reflex D. a confused 55-year-old male with tachycardia and pallor

d

When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: A. patient's mental status. B. rate of the patient's pulse. C. presence of a medical identification tag. D. rate and depth of breathing.

d

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should: A. assist his ventilations with a bag-mask device. B. immediately perform a rapid physical examination. C. continue transporting and alert the receiving hospital. D. consider requesting a rendezvous with an ALS unit.

d

You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: A. calm him down so you can assess him. B. be assertive and talk the patient down. C. contact medical control for instructions. D. retreat at once and call law enforcement.

d

When assessing a conscious patient with an MOI that suggests spinal injury, you should: A. determine if the strength in all extremities is equal. B. rule out a spinal injury if the patient denies neck pain. C. defer spinal immobilization if the patient is ambulatory. D. ask the patient to move his or her head to assess for pain.

determine if the strength in all extremities is equal.

The tough, fibrous outer meningeal layer is called the: A. pia mater. B. arachnoid. C. gray mater. D. dura mater.

dura mater.

When immobilizing a patient on a long backboard, you should: A. have the patient exhale before fastening the torso straps. B. secure the torso and then center the patient on the board. C. follow the commands of the person at the patient's torso. D. ensure that you secure the torso before securing the head.

ensure that you secure the torso before securing the head.

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly? A. cerebral contusion B. subdural hematoma C. cerebral concussion D. epidural hematoma

epidural hematoma

The hormone responsible for the actions of the sympathetic nervous system is: A. insulin. B. thyroxine. C. epinephrine. D. aldosterone.

epinephrine.

The MOST important treatment for patients with a head injury, regardless of severity, is to: A. immobilize the spine. B. administer 100% oxygen. C. establish an adequate airway. D. transport to a trauma center.

establish an adequate airway.

The Glasgow Coma Scale (GCS) is used to assess: A. mental status, eye opening, and respiratory rate. B. sensory response, pupil reaction, and heart rate. C. verbal response, eye opening, and mental status. D. eye opening, verbal response, and motor response.

eye opening, verbal response, and motor response.

It would be MOST appropriate to perform a focused secondary assessment on a patient who: A. fainted and fell to the ground from a standing position. B. was restrained during a high-speed motor vehicle crash. C. has blood draining from the ears following a head injury. D. struck his or her head and is experiencing nausea or vomiting.

fainted and fell to the ground from a standing position.

Distraction injuries of the spine are MOST commonly the result of: A. falls. B. diving. C. hangings. D. compression.

hangings.

The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by: A. immediate reassessment following the intervention. B. a neurosurgeon or emergency department physician. C. reassessing the patient's blood pressure after at least 10 minutes. D. noting a decrease in the heart rate during ventilations.

immediate reassessment following the intervention.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should: A. obtain a Glasgow Coma Score value and give him oxygen. B. immobilize his spine and perform a focused secondary exam. C. allow him to refuse transport if his vital signs remain stable. D. perform a rapid head-to-toe exam and immobilize his spine.

immobilize his spine and perform a focused secondary exam.

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should: A. perform a focused secondary assessment of the patient's head and neck. B. instruct him to assist her ventilations while you perform a rapid assessment. C. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. D. immediately place her on a long backboard and prepare for rapid transport.

instruct him to assist her ventilations while you perform a rapid assessment.

Bleeding within the brain tissue itself is called a(n): A. epidural hematoma. B. intracerebral hematoma. C. subdural hematoma. D. intracranial hematoma.

intracerebral hematoma.

In contrast to a cerebral concussion, a cerebral contusion: A. does not cause pressure within the skull. B. results from a laceration to the brain tissue. C. involves physical injury to the brain tissue. D. usually does not cause a loss of consciousness.

involves physical injury to the brain tissue.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: A. the patient adamantly denies neck pain. B. lateral immobilization has been applied. C. it causes a problem managing the ABCs. D. sensory and motor functions remain intact.

it causes a problem managing the ABCs.

A tight-fitting motorcycle helmet should be left in place unless: A. it interferes with your assessment of the airway. B. the patient must be placed onto a long backboard. C. the patient complains of severe neck or back pain. D. the helmet is equipped with a full face shield or visor.

it interferes with your assessment of the airway.

When opening the airway of a patient with a suspected spinal injury, you should use the: A. tongue-jaw lift maneuver. B. head tilt-neck lift maneuver. C. head tilt-chin lift maneuver. D. jaw-thrust maneuver.

jaw-thrust maneuver.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's: A. pupil size. B. blood pressure. C. pulse regularity. D. level of consciousness.

level of consciousness.

Lacerations to the scalp: A. bleed minimally because the scalp has few vessels. B. uncommonly cause hypovolemic shock in children. C. may be an indicator of deeper, more serious injuries. D. are most commonly associated with skull fractures.

may be an indicator of deeper, more serious injuries.

When a patient experiences a severe spinal injury, he or she: A. will likely be paralyzed from the neck down. B. may lose sensation below the level of the injury. C. most commonly has a palpable spinal deformity. D. often loses motor function on one side of the body.

may lose sensation below the level of the injury.

When immobilizing a child on a long backboard, you should: A. secure the head prior to securing the torso and legs. B. defer cervical collar placement to avoid discomfort. C. place the child's head in a slightly extended position. D. place padding under the child's shoulders as needed.

place padding under the child's shoulders as needed.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: A. pupillary constriction. B. increase in heart rate. C. shunting of blood to vital organs. D. dilation of the bronchiole smooth muscle.

pupillary constriction.

A patient who cannot remember the events that preceded his or her head injury is experiencing: A. retrograde amnesia. B. anterograde amnesia. C. perigrade amnesia. D. posttraumatic amnesia.

retrograde amnesia.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: A. fractures to the internal structures of the ear following direct trauma. B. a linear skull fracture and a significant increase in intracranial pressure. C. significant pressure and bleeding in between the skull and dura mater. D. rupture of the tympanic membrane following diffuse impact to the head.

rupture of the tympanic membrane following diffuse impact to the head.

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: A. slow. B. weak. C. rapid. D. irregular.

slow.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by: A. increased blood pressure, bradycardia, reactive pupils, and rapid respirations. B. sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing. C. ataxic respirations, unequal pupils, no response to pain, and an irregular pulse. D. fixed and dilated pupils, decreased blood pressure, and irregular respirations.

sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

The spinal cord is encased in and protected by the: A. spinal canal. B. vertebral body. C. vertebral arch. D. intervertebral disc.

spinal canal.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: A. assist his ventilations with a bag-mask device. B. suction his oropharynx for up to 15 seconds. C. immobilize his spine and transport immediately. D. pack his nostrils to stop the drainage of blood.

suction his oropharynx for up to 15 seconds.

Common signs of a skull fracture include all of the following, EXCEPT: A. mastoid process bruising. B. ecchymosis around the eyes. C. noted deformity to the skull. D. superficial scalp lacerations.

superficial scalp lacerations.

The ideal procedure for moving an injured patient from the ground to a backboard is: A. the clothes drag. B. the four-person log roll. C. to use a scoop stretcher. D. the direct patient carry.

the four-person log roll.

When the parasympathetic nervous system is activated: A. blood is shunted away from the digestive organs. B. the heart rate decreases and the blood vessels dilate. C. hormones are released that prepare the body for stress. D. heart rate and blood pressure increase.

the heart rate decreases and the blood vessels dilate.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: A. an appropriately sized cervical collar has been applied. B. the patient has been secured to the ambulance stretcher. C. the head has been stabilized with lateral immobilization. D. the patient has been completely secured to the backboard.

the patient has been completely secured to the backboard.

If you do not have the appropriate size cervical collar, you should: A. use rolled towels to immobilize the patient's head. B. place sandbags on either side of the patient's head. C. ask the patient to keep his or her head in a neutral position. D. defer cervical immobilization and apply lateral head blocks.

use rolled towels to immobilize the patient's head.