EMT Quiz 15

While using the AED to treat a patient in cardiac​ arrest, your partner informs you that he can feel a carotid pulse. Which of the following should you do​ immediately?

A.* Assess the​ patient's breathing. This is the correct answer. B. Reanalyze the​ patient's heart rhythm. C. Insert an oropharyngeal airway. D. Obtain a blood pressure.

As you approach a​ patient, you observe a 1 dash -inch circle of dark blood on his shirt. He appears​ confused, pale, and diaphoretic. Which one of the following should you do​ first?

. Apply oxygen. B. Treat for shock. C.* Assess his airway. This is the correct answer. D. Cut his shirt.

You have been called for an elderly male patient who suddenly collapsed. On scene you find an 82 dash -year dash -old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. Which one of the following should you do​ immediately?

. Apply the AED. B. Start cardiopulmonary resuscitation. C.* Check for a carotid pulse. This is the correct answer. D. Determine the​ "down time."

As you arrive at a metal scrap yard for an unknown medical​ emergency, you observe a male supine on the ground with AED electrodes on his chest. The AED operator has just ordered coworkers to clear the patient because the AED is going to shock. Within​ seconds, the AED delivers a shock without the operator pressing a​ "shock" button. The EMT should recognize what type of​ AED?

. Biphasic B.* Fully automated This is the correct answer. C. Manual D. Semi dash -automated

How does the body prolong the effects of the sympathetic nervous system during​ shock?

. By promoting fluid reabsorption in the kidneys B.* By releasing hormones from the adrenal glands This is the correct answer. C. By constantly providing nervous stimuli to the heart and adrenal glands D. By increasing the intravascular volume by creating more blood During the initial stages of a shock​ syndrome, the sympathetic nervous system initially stimulates the heart and blood vessels to react through direct nerve stimulation to cause an immediate effect. To prolong this​ effect, the body also stimulates the adrenal medulla to release epinephrine and norepinephrine into the bloodstream. The release of the hormones is what causes the ongoing sustained effects of the sympathetic nervous system. While the kidneys will reabsorb volume during​ shock, this is not the mechanism by which the body propagates the sympathetic effect​ (it is actually an effect of​ it).

You have been assigned to a football game to provide standby coverage. While taking a​ break, you decide to walk to a nearby concession stand for a soft drink. On the​ way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be​ unresponsive, not​ breathing, and pulseless. A bystander states that the patient collapsed less than a minute earlier. An AED is located less than a minute from your location. The nearest EMT is 5 minutes from your location. Which one of the following should you do​ immediately?

. Call for assistance and start CPR. B. Start CPR and wait for the AED. C.* Run to retrieve the nearby AED. This is the correct answer. D. Take manual in dash -line spinal stabilization.

What two care interventions are MOST likely to contribute to the successful resuscitation of a patient who is in ventricular​ fibrillation?

. Compressions and rapid transport B. Airway maintenance and ventilatory support C. Early ALS care and endotracheal intubation D.* CPR and defibrillation Research by the American Heart Association reinforces the necessity of early defibrillation in the management of sudden cardiac arrest due to ventricular fibrillation.​ However, high-quality CPR focusing on immediate chest compressions with minimal interruption was found to be even more important. Additional research has shown that​ high-quality chest compressions with minimal interruption and early defibrillation are the best determinants of successful cardiac arrest management.

During what phase of cardiac arrest is successful resuscitation LEAST​ likely, owing to widespread death of heart​ tissue?

. Electrical phase B. Terminal phase C. Circulatory phase D.* Metabolic phase

Which one of the following is a benefit of the automated external​ defibrillator?

. Elimination of the need for a primary assessment B. The need for little dash -to dash -no training C. Its ability to identify and confirm cardiac arrest D.* The ease and speed by which it can be used

In which of the following interventions may the EMT participate with ALS providers for a patient who has a return of spontaneous​ circulation?

. Facilitated oxygenation B. ​High-frequency ventilation C. Hyperbaric therapy D.* Therapeutic hypothermia

You have applied the​ AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze​ button, the AED gives you a​ "check electrode" message. In looking at the​ patient, which one of the following would most likely be responsible for this​ message?

. History of asthma B. AED pads placed too far to the left C. Obese chest and abdomen D.* Hairy chest This is the correct answer.

When managing the patient whom you suspect is in​ shock, why is it important NOT to hyperventilate this​ patient?

. It will increase the blood pressure too dramatically. B. It will promote increased bleeding into the nervous tissue. C. It will increase the body temperature. D.* It makes the blood alkalotic and reduces​ off-loading of oxygen from the hemoglobin.

What is the overall goal for the EMT in managing a shock​ patient?

. Keep the pulse ox reading greater than​ 94%. B.* Maintain adequate perfusion to the core and peripheral tissues. This is the correct answer. C. Provide adequate ventilations. D. Keep the heart rate less than​ 100/min.

Which one of the following unresponsive patients would the EMT recognize as in cardiac​ arrest?

. Male with an absent radial pulse but breathing 20 times a minute B.* Female who has an occasional gasp for a breath but no palpable carotid pulse This is the correct answer. C. Male patient with a heart rate of 16 beats per minute and agonal respirations D. Female who is not breathing and has a heart rate of 24 beats per minute

You are assessing a patient that has a heart rate of​ 110/min, a blood pressure of​ 108/88, and respirations of about​ 14/min. If this patient also has lost blood from a traumatic​ event, what stage of shock would this be categorized​ as?

. Progressive B. Decompensated C.* Compensated This is the correct answer. D. Irreversible

During transport to the hospital of a patient who was successfully resuscitated from cardiac​ arrest, which of the following should the EMT​ do?

. Provide ventilations at​ 20/minute. B. Maintain a​ compression/ventilation ratio of​ 30:2. C. Do not transport the patient unless an ALS provider is in the ambulance with the EMT. D.* Leave the AED attached to the patient. Patients who have been brought out of ventricular fibrillation through use of the AED have a high likelihood of deteriorating back into that state. Monitor these patients​ closely, and leave the AED attached so that it is ready to be used immediately if needed. Ventilating at​ 20/minute is too​ fast, and there is no need for compressions if the patient has a pulse.​ Finally, having ALS available is​ favorable, but if that will delay delivery of the patient to the​ hospital, transport should be initiated immediately.

Which of the following findings generally indicates that the patient has transitioned from compensated shock to decompensated​ shock?

. Tachycardia B.* Hypotension This is the correct answer. C. Pale skin D. Tachypnea Although all the findings could be present in decompensated​ shock, the specific finding that often delineates when that has occurred is systolic hypotension.​ Tachycardia, tachypnea, and pale skin are present in compensated shock as​ well, but hypotension is not.

The EMT realizes that the best means of preventing failure of the AED is​ to:

. always make sure that the AED is kept clean and free of damage. B.* check the AED and its supplies at the beginning of each shift. This is the correct answer. C. obtain a second set of batteries when the original set is no longer functional. D. check the electrodes monthly and replace when expired.

An unrestrained 37 dash -year dash -old female is in cardiac arrest after striking a tree head dash -on at a high rate of speed. Assessment reveals her to have suffered massive blunt trauma to the chest and abdomen. The patient is quickly extricated from the vehicle and placed on a long board for immobilization. It is estimated that the patient has been in cardiac arrest for approximately 10​ minutes, during which CPR was not performed. At this​ time, the EMT​ would:

. apply electrodes to the​ patient's chest and follow the​ AED's instructions. B.* perform CPR and contact medical command for permission to use the AED. This is the correct answer. C. administer CPR for 2 minutes prior to applying the AED. D. withhold CPR and perform a focused trauma assessment.

The EMT understands that when paramedics administer IV fluids as treatment for hemorrhagic​ shock, the fluids​ will:

. enable the lungs to better oxygenate the blood. B. stabilize the shock by restoring needed electrolytes. C.* do nothing to enable the blood to carry more oxygen to the cells. This is the correct answer. D. reverse the shock by increasing the blood pressure.

A 47 dash -year dash -old patient has been in cardiac arrest for 6 minutes. While you set up the​ AED, you would direct your partner​ to:

. perform CPR at a ratio of 30 ventilations to two compressions. B.* start cardiopulmonary resuscitation until the AED is ready. This is the correct answer. C. assist you in making sure that the AED is ready for application. D. perform a primary and secondary assessment.

Your service has a new AED. During the in dash -service on the new​ device, the instructor informs you that it is a semi dash -automated AED and uses a biphasic wave​ form, as opposed to the monophasic form used by the previous AED. As a knowledgeable​ EMT, you should recognize​ that:

. the EMT will not need to press a​ "shock" button to shock the patient. B. less energy but more shocks will be needed to treat cardiac arrest. C.* the new AED will defibrillate with lower amounts of electrical energy. This is the correct answer. D. the new AED will defibrillate with higher amounts of electrical energy.

Within two minutes of going into cardiac​ arrest, an AED is​ applied, the patient is​ shocked, and a pulse is restored. The EMT should recognize that the heart was​ in:

. ventricular fibrillation and now is in cardiac arrest. B. ventricular fibrillation and now is in asystole. C.* ventricular fibrillation and now is in an organized rhythm. This is the correct answer. D. asystole and now is in an organized rhythm.

The AED should never be applied to a patient who is not in cardiac arrest because some patients​ in:

. ventricular fibrillation may be conscious and alert. B.* ventricular tachycardia may have a pulse. This is the correct answer. C. ventricular fibrillation may have a pulse. D. asystole may still have a pulse.

Because of a shortage of paramedics at your ambulance​ service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of the following statements indicates an understanding of how this will affect the​ EMTs?

. ​"EMTs will now be able to shock all patients in cardiac​ arrest." B.* ​"The AED will let us know whether or not to shock the​ patient." This is the correct answer. C. ​"EMTs will have to learn how to interpret ECG​ tracings." D. ​"Cardiopulmonary resuscitation will no longer be​ needed."

You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67 dash -year dash -old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be​ unresponsive, apneic, and pulseless. Which one of the following is your first​ response

. ​"Let's start ventilation with a bag dash -valve mask and​ oxygen." B. ​"We need to quickly dry him from head to toe before applying the​ AED." C.* ​"Let's take a towel and dry off his​ chest." This is the correct answer. D. ​"Stop CPR and​ let's apply the​ AED."

After two cardiac​ arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional​ session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should​ be:

. ​"You will need to reanalyze the heart​ rhythm." B.* ​"The AED will automatically shock the​ patient." This is the correct answer. C. ​"You will need to press the shock​ button." D. ​"The AED will prompt you to recheck the​ pulse."

The major categories of shock​ include:

. ​burn, hypovolemic,​ distributive, and hypoxic. B.* ​hypovolemic, cardiogenic,​ obstructive, and distributive. This is the correct answer. C. ​hemorrhagic, distributive,​ hypoxic, and obstructive. D. ​hypoglycemic, obstructive,​ distributive, and hypovolemic

During management of a patient who is in​ shock, what abnormal metabolic process is the EMT attempting to​ prevent?

.* Anaerobic metabolism This is the correct answer. B. Hyponatremia C. Hypokalemia D. Aerobic metabolism A lack of oxygen in the cell from a shock syndrome causes a shift from aerobic to anaerobic metabolism. Aerobic metabolism is the creation of ATP in the presence of oxygen. When there is a lack of available​ oxygen, anaerobic metabolism takes​ place, resulting in a drastically lower production of ATP and the creation of lactic acid as a​ by-product. This is the initiating event that causes cellular death and eventual organ failure and system failure. Both hyponatremia​ (low sodium​ levels) and hyperkalemia​ (low potassium​ levels) are​ conditions, not abnormal metabolic processes.

You believe that a young male​ patient, who has been shot in the lower​ abdomen, is bleeding internally and is in the early stage of shock. Which item indicates the appropriate prehospital care of this​ patient?

.* Oxygen therapy and rapid transport to the hospital This is the correct answer. B. ​"Shock" position and administration of water by mouth C. Oxygen therapy and warm packs to the abdomen D. Semi dash -​Fowler's position and direct pressure over the injury site

The patient has been in cardiac arrest for 15 minutes​ now, and you are still 10 more minutes away from the hospital. ALS intercept did not occur due to the ALS units all being assigned to another call. During​ transport, the AED analyzed the patient and gave a​ "No Shock​ Advised" message. What should the EMT​ do?

.* Resume compressions This is the correct answer. B. Contact medical direction to ask if a defibrillatory shock can be administered anyway. C. Decrease the oxygen flow rate in case the patient is becoming hyperoxic. D. Attempt defibrillation anyway to​ "start" the heart.

You are treating a patient with severe chest pain and believe she is in cardiogenic shock. As​ such, which of the following is most​ appropriate?

.* Supplemental oxygen This is the correct answer. B. Rapid transport with the patient supine C. Application of the AED D. Administration of nitroglycerin

You have arrived at a residence where a 4 dash -month dash -old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the​ patient's side. You have an AED with adult pads with​ you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac​ arrest, you​ would:

.* place the AED on the patient and follow all prompts. This is the correct answer. B. continue CPR for 2 more minutes before placing the AED. C. continue CPR and transfer to the stretcher for transport. D. discuss with the parents if they want to proceed with use of the AED.

Not only should the EMT provide a​ 30:2 ratio of compressions to ventilations to an adult patient in cardiac​ arrest, the EMT should​ also:

.* push hard and push fast. This is the correct answer. B. remain on scene with the arrested patient until ALS arrives. C. provide a large ventilation with each squeeze of the​ bag-valve-mask device. D. pause compressions for 30 seconds while assessing for a pulse. The American Heart Association advocates​ "push hard and push​ fast" to provide effective chest compressions. Doing this helps to ensure that the compressions are delivered at a rate of at least​ 100/minute, which has been shown to provide suitable blood flow to essential organs during cardiac arrest. Delivering large ventilations using a​ bag-valve-mask device can be​ detrimental, as can delaying compressions for 30 seconds while assessing for a pulse.​ Finally, do not wait on scene with an arrested patient if arrival of ALS is delayed.​ Instead, consider allowing them to intercept with you en route to the hospital.

What assessment parameter is the EMT interpreting if the​ patient's pulse pressure is determined to be​ narrowing?

A.* Blood pressure This is the correct answer. B. Pulse oximeter C. Heart rate D. Respiratory rate

It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock​ could:

A.* cause the beating heart to go into cardiac arrest. This is the correct answer. B. cause the patient to lose his eyesight. C. produce full thickness burns and lead to a deadly infection. D. cause the patient extreme pain.

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the​ shock, what should you​ do?

A. ***Ensure that no rescuer is touching the stretcher. This is the correct answer. B. Withhold all shocks because metal will conduct the shock into the ambulance. C. Move the patient from the metal stretcher to a nonmetal surface. D. Stop the ambulance and have all rescuers exit prior to shocking with the AED

Proper care of cardiac arrest for a 6 dash -year dash -old pediatric patient when there are no available pediatric AED pads would​ include

A. 2 EMTs providing a​ 30:2 ratio of compressions to ventilations. B. CPR with no AED placement due to lack of pediatric pads. C.* placement and use of the adult pads with adult energy levels. This is the correct answer. D. compressing the chest to a maximum of​ 1½ inches in depth.

You have been asked to describe the American Heart​ Association's Chain of Survival to a group of Emergency Medical Responder students. What description is​ best?

A. A treatment​ plan, that if​ followed, guarantees the survival of cardiac arrest B. A sequence of care that provides instructions on how to use an AED C.* A sequence of events​ that, if enacted​ quickly, gives the best chance for surviving cardiac arrest Your answer is correct. D. A treatment plan that helps to prevent and treat cardiac arrest in the general population

A 7 dash -year dash -old boy choked on a grape at school. By the time the obstruction was​ removed, assessment revealed him to be in cardiac arrest. When you​ arrive, teachers are performing CPR. The school nurse informs you that CPR has been in progress for 6 minutes. You have an​ AED, but do not have a pediatric conversion device that reduces the energy of defibrillation from that of an adult to that of a child. Which one of the following should you do​ immediately?

A. A.* Place the electrodes on the​ boy's chest and follow the​ AED's prompts. This is the correct answer. B. Instruct the teachers to continue CPR for 2 additional minutes before applying the AED. C. Perform five abdominal thrusts and then 1 minute of CPR before using the AED. D. Continue CPR and transfer the boy to the stretcher for immediate transport.

You get a call for cardiac arrest. Upon your​ arrival, you find out that the family did CPR for about 3 minutes before the pulse returned and the patient awoke. The patient is now conscious and has a chief complaint of heart palpitations and dyspnea. She has a very fast pulse and feels dizzy. What should you​ do?

A. Analyze the rhythm with the AED. B. Administer one​ shock, and start chest compressions. C.* Administer​ oxygen, and call for ALS. This is the correct answer. D. Lay her down in Trendelenburg position.

You have been called for a 57 year old female who is choking on a large pill. On arrival you find the patient collapsed and unresponsive on the floor with family by her side attempting to remove the obstruction. After you quickly verify the airway is still occluded and confirming the pulse is still​ present, you should​ immediately?

A. Apply the AED and hit​ the? "analyze" button. B.* Start chest compressions. This is the correct answer. C. Perform five abdominal thrusts. D. Open the airway and attempt ventilation.

What cardiac arrest rhythm is the AED designed to​ shock?

A. Asystole B.* Ventricular fibrillation This is the correct answer. C. Bradycardia D. Pulseless electrical activity

Which of the following mechanisms have been found to cause distributive shock in a​ patient?

A. Cardiac valve failure B.* Blood infection This is the correct answer. C. Pulmonary embolism D. Blood loss

A confused and anxious patient fell 20 feet from a ladder. What sign suggests that the patient is in​ shock?

A. Constricted pupils Your answer is not correct. B. Contusion to his head C. Deformity to the left arm D.* Heart rate of 110

Which type of shock results from cardiac​ insufficiency, that​ is, the inability of the heart to pump an adequate amount of​ blood?

A. Distributive B. Circulatory C.* Cardiogenic This is the correct answer. D. Obstructive

Upon arrival for a patient who was found unresponsive by​ neighbors, you note that the skin is cool with​ mottling, the smaller joints of the hands are​ stiff, and the jaw seems to be locked into position. There are no environmental extremes in the ambient environment. What should you infer from this​ presentation?

A. The patient has arthritis. B. The patient is hyperthermic. C.* The patient has rigor. This is the correct answer. D. The patient just went into arrest. Rigor is a condition in which the joints of the body start to stiffen from changes due to prolonged cardiac arrest. This is a finding that occurs hours after​ arrest, so this serves as a condition to not start resuscitation on the patient. Hyperthermia is caused by an increased core temperature and is not consistent with stiff joints. Arthritis can cause stiff joints but not cold and mottled skin.

You are treating a patient whom you suspect has a tension pneumothorax. The patient has no external hemorrhage or suspected internal​ hemorrhage, yet he is hypotensive. What type of shock is most likely causing the drop in blood​ pressure?

A. Distributive shock B.* Obstructive shock This is the correct answer. C. Cardiogenic shock D. Hypovolemic shock Obstructive shock results from a condition that obstructs forward blood flow. The volume is​ adequate, the heart is not​ damaged, and the vessels are of a normal size with adequate resistance.​ However, an obstruction is not allowing the blood to move forward. For​ example, a large clot that obstructs blood flow in the lungs​ (pulmonary embolism) will prevent an adequate amount of blood from getting to the left atrium​ and, subsequently, the left ventricle. Two other conditions that are often associated with injury and can lead to obstructive shock are tension pneumothorax and pericardial tamponade.

What is the first link in the American Heart​ Association's Chain of​ Survival?

A. Early CPR B. Early ALS C. Early defibrillation D.* Recognition and activation

You arrive on the scene of an unconscious​ middle-aged male patient. On​ assessment, you find that the patient is in cardiac arrest. The witness states that she saw him fall and called for help. She did NOT initiate chest compressions. What should you do​ NEXT?

A. Give the patient two full breaths and then begin chest compressions. B. Immediately apply the AED and shock the patient. C.* Begin chest compressions at the rate of at least 100 per minute. This is the correct answer. D. Compress the chest 1.5 to 2 inches for two minutes.

Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac​ arrest?

A. He applies one electrode over the top of the power source for a pacemaker located on the​ patient's chest. B. He intentionally withholds a shock on a patient in cardiac arrest who has an implantable defibrillator. C. He places the AED pads two inches away from a transdermal medication patch on the​ patient's chest. D.* He​ places, then quickly​ removes, a set of electrodes in an attempt to remove hair from a​ patient's chest.

A 52 dash -year dash -old male has collapsed on his front porch and his family dialed 911. When you​ arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. Which one of the following should you do​ immediately?

A. Hold CPR so that the AED can be checked and applied for use. B.* Start CPR while the AED is being prepared for use. This is the correct answer. C. Contact medical direction for permission to use the AED given the downtime. D. Perform five cycles of CPR at a ratio of 15 compressions to two ventilations​ (single rescuer​ CPR).

If the​ body's cells exist too long with insufficient oxygen during a shock​ syndrome, what metabolic process will start to​ prevail?

A. Hypoxic drive B.* Anaerobic metabolism This is the correct answer. C. Hypercapnic drive D. Aerobic metabolism

What is the BEST reason for the EMT to have extra batteries available for the AED on each​ shift?

A. In case the medical director is on scene and wants to ensure that you are following protocol B.* In case the batteries in the machine fail This is the correct answer. C. In case you have two patients at one scene D. Because it is mandated by federal law Scheduled maintenance of the AED is crucial for ensuring that the machine functions properly. Follow your local protocols and the​ manufacturer's directions when maintaining the AED. AED failure is most commonly attributed to improper​ maintenance, especially battery failure.​ Typically, if two arrested patients are on​ scene, you will have two ambulances and two AEDs. State​ law, not federal​ law, dictates equipment types.

In what locations are cardiac pacemakers MOST often implanted that may interfere with AED pad​ placement?

A. In the upper left quadrant of the abdomen B. In the upper right quadrant of the abdomen C. Directly in front of the heart on the anterior chest D.* Beneath the clavicles Cardiac pacemakers are usually positioned beneath one of the clavicles. They form a visible lump and can be palpated. If you detect a pacemaker in a cardiac arrest​ patient, you can still use the AED.​ However, be sure not to place an adhesive pad directly over the pacemaker.

Which one of the following statements about the heart rhythm of ventricular fibrillation is​ true?

A. ​"The AED is designed to identify ventricular fibrillation and give a​ 'No Shock​ Advised' message when it is​ present." B. ​"Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be​ felt." C.* ​"When a​ patient's heart is in ventricular​ fibrillation, it is unable to pump blood throughout the​ body." This is the correct answer. D. ​"The most effective treatment for converting ventricular fibrillation to a healthy heart rhythm is​ CPR."

The EMT knows that the cause underlying distributive shock​ is:

A.* dilation of the blood vessels. This is the correct answer. B. poor fluid intake. C. loss of blood volume. D. damaged heart with poor contractility.

The change in which body process is the primary reason that the patient will progress through the stages of shock and eventually​ die?

A. Increasing heart rate B.* Lack of adequate perfusion This is the correct answer. C. Diminishing respirations D. Decreasing alveolar ventilation The primary change of the body that causes death in a shock syndrome is a lack in organ perfusion. With a lack of​ perfusion, cells,​ tissues, and organs become ischemic and start failing. A drop in perfusion to the heart results in its​ failure, and a drop in perfusion to the lungs results in ongoing hypoxia and hypercapnia. An increasing heart rate is a compensatory mechanism​ initially, and the changes to the respiratory rate and alveolar ventilation are the result of a failing pulmonary​ system, not the cause of the failing pulmonary system.​ Eventually, everyone dies when the heart rate​ stops, but the stopping of the heart is a consequence of the failing perfusion pressure.

Why does the American Heart Association advocate​ "push hard and push​ fast" in performing​ CPR?

A. It ensures that the EMT will stop to give ventilations. B. It decreases the likelihood of causing a rib fracture from the compressions. C.* It provides more effective blood flow. This is the correct answer. D. It increases the amount of oxygen in the alveoli for the body

You have been dispatched to a residence for a male patient with a cardiac history who is complaining of chest pain. On scene you find a 52 dash -year dash -old male patient sitting in a chair. He is alert and oriented and states that his chest pain feels like the last time he had a heart attack. He also states that in the hospital his heart stopped and they had to shock him twice before it restarted. He is breathing adequately and has a strong radial pulse. Which one of the following would be appropriate in the care of this​ patient?

A. Open the airway using the head dash -​tilt, chin dash -lift maneuver. B. Provide positive pressure ventilation with high dash -concentration oxygen. C.* Obtain the heart​ rate, respiratory​ rate, and blood pressure. This is the correct answer. D. Apply the AED to the patient but do not turn it on.

You are teaching your local police department how to use an​ AED, as they just recently equipped each of their police cruisers with one. Beyond teaching them when and how to use the​ device, what other point would you emphasize about the most common cause of AED​ failure?

A. Outdated electrodes B. Electrode cable breakage or separation C.* Battery failure This is the correct answer. D. Complex instructions for operation

You are transporting a 57 dash -year dash -old male who went into cardiac arrest at home. After two shocks and​ CPR, he regained a​ pulse, but remains unresponsive and in respiratory arrest. During​ transport, your reassessment reveals the absence of a carotid pulse. Which one of the following should you do​ first?

A. Provide five cycles of CPR prior to using the AED. B.* Stop the ambulance and analyze the heart rhythm with the AED. This is the correct answer. C. Start CPR and continue emergency transport. D. Reapply the AED and analyze the heart rhythm

A patient has just gone into cardiac arrest. His heart is most likely in what​ rhythm?

A. Pulseless electrical activity B. Ventricular tachycardia C. Asystole D.* Ventricular fibrillation

What structures within the​ cell, after becoming released as a result of failure of the​ sodium/potassium pump, start to autodigest the​ cell?

A. Sodium molecules B. ATP C.* Lysozymes This is the correct answer. D. Carbon dioxide

You are caring for an​ 8-year-old male patient who was thrown from a car during a collision. The child has a blood pressure of​ 90/systolic, a heart rate of​ 98/min, and respirations of​ 20/min. How would you characterize the​ patient's shock​ state?

A. The child is in irreversible shock. B. The child is hypotensive. C. The child is tachycardic. D.* The​ child's blood pressure is acceptable Normal vital sign findings vary with age for pediatric patients. For children younger than 10 years of​ age, a systolic blood pressure of 70 mmHg plus two times the age in years is a lower limit of normal. A systolic blood pressure less than the lower limit would be considered hypotensive. Hypotension is a late finding in pediatric patients and often leads to cardiac arrest. In this​ patient, the low systolic value calculates to 86 mmHg. This means that the blood pressure is above the minimally acceptable value that would represent hypotension.

A​ "No Shock​ Advised" message is provided by the AED. The EMT understands that this could​ mean:

A.* the patient has regained a pulse. This is the correct answer. B. the electrodes may be loose. C. the patient is in ventricular fibrillation. D. CPR is no longer needed.

While you are caring for a patient with a heart​ attack, the patient is becoming tachycardic and hypotensive. Your partner asks you why this might be happening. What would be a logical​ explanation?

A. The patient is suffering from massive vasodilation secondary to the heart attack. B. The use of oxygen causes​ vasodilation, which will drop the blood pressure and cause the heart rate to increase. C. The​ patient's lungs are no longer able to oxygenate the blood because of alveolar damage. D.* The​ patient's stroke volume is probably diminished. The heart is the pump that is responsible for generating the force necessary to move the blood throughout the body. If the pump​ fails, regardless of the blood​ volume, the delivery of oxygen and glucose to cells will be decreased. Pump function failure may result from an injury to the heart that reduces its ability to generate contractions strong enough to push the blood forward throughout the body. For​ example, a heart attack​ (myocardial infarction) deadens a portion of the heart muscle. Like any other​ muscle, a portion that is dead​ doesn't contribute to the force of contraction. If the heart attack has affected a large enough area of heart​ muscle, the pump will fail and lead to a shock state.

A driver was ejected from his vehicle in a rollover dash -type collision. Assessment findings reveal the patient to be unresponsive with bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing 32 times per minute. His skin is cool and clammy and the radial pulses weak. Manual in dash -line spinal stabilization is being maintained. The​ EMT's next intervention would be​ to:

A. examine the fracture site. B.* assist respirations. This is the correct answer. C. apply a cervical collar. D. obtain a blood pressure.

An EMT has just received a​ "Shock Advised" message from the AED. Just before delivering the​ shock, the EMT​ must:

A. hold the​ patient's head to avoid injury when shocking. B. press the analyze button once more. C. remove the oral airway to prevent possible choking. D.* ensure that all rescuers are clear of the patient.

A patient has fallen down a flight of stairs and has suffered a scalp laceration with minimal venous bleeding. You find him to be restless and confused. The airway is​ open, and he is adequately breathing 22 times per minute. He has a radial pulse of 92 beats per minute and is moderate in strength. Emergency Medical Responders are maintaining manual​ in-line spinal stabilization. Your next priority action would be​ to:

A. immobilize the patient with a cervical collar and long spine board. B.* apply oxygen at 15 liters per minute via nonrebreather face mask. This is the correct answer. C. check the blood pressure and assess for injuries causing blood loss. D. insert an oral airway and start positive pressure ventilation with oxygen.

When a​ patient's heart​ stops, the patient goes into cardiac arrest. There are three phases after cardiac arrest that lead to biological death. The phases include each of the following​ EXCEPT:

A. metabolic phase. B. circulatory phase. C. electrical phase. D.* sudden death.

After analyzing a cardiac arrest​ patient's heart​ rhythm, the AED provides a​ "Deliver Shock" message. After clearing the​ patient, the​ EMT's next step should be​ to:

A. press the shock​ button, and then allow the AED to analyze the heart rhythm. B.* press the shock​ button, and then perform CPR for 2 minutes. This is the correct answer. C. check for a​ pulse, and then press the shock button if a pulse is not present. D. press the shock​ button, and then check for the return of a pulse.

The AED has just been applied to a female cardiac arrest patient. After analyzing the heart​ rhythm, it provides a​ "No Shock​ Advised" message. The EMT should​ immediately:

A. reanalyze the​ patient's heart rhythm. B. check the patient for a pulse and blood pressure. C.* resume cardiopulmonary resuscitation. This is the correct answer. D. check the electrodes for proper placement.

Your unresponsive trauma patient has a rapidly dropping blood pressure. This indicates the​ patient:

A. will not survive his injuries. B. is compensating adequately. C. has internal bleeding. D.* is in a state of decompensation

A 28 dash -year dash -old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and​ thready, and his skin is cool to the touch. Emergency Medical Responders​ (EMRs) have placed him on a nonrebreather face mask and are holding manual in dash -line cervical spine stabilization. His respirations are snoring. Based on these assessment​ findings, which one of the following instructions would you provide to the​ EMRs?

A. ​"He has snoring​ respirations, so​ let's go ahead and open the airway with the head dash -​tilt, chin dash -​lift." B. ​"Do not cover him with a blanket because that will cause his blood vessels to dilate and drop his​ BP." C.* ​"Let's take off the oxygen mask and start positive pressure ventilation to assist his​ breathing." This is the correct answer. D. ​"Let's go ahead and elevate his legs 8 to 12 inches so more blood gets to his vital​ organs."

Which one of the following statements best indicates an understanding of the prehospital role in caring for the patient in​ shock?

A. ​"If shock is in the compensatory or early​ stage, it is not yet life dash -threatening and the EMT can take his time in assessing and treating the​ patient." B. ​"Because shock is a life dash -threatening ​condition, it is important that the EMT identify the exact cause so the proper care can be​ given." C. ​"The job of the EMT is to recognize that a person is in shock and get him or her to the hospital so treatment can be​ started." D.* ​"Since shock is best treated in the​ hospital, the EMT should provide care to maintain perfusion to the vital organs and​ transport." This is the correct answer.

You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of the following instructions is appropriate at this​ time?

A. ​"Stop CPR but continue to check for a​ pulse." B. ​"Stop chest compressions but continue​ ventilation." C.* ​"Stop CPR and clear the​ patient." This is the correct answer. D. ​"Continue CPR until we see if a shock is​ advised."

When should the EMT transport the cardiac arrest​ patient?

A.* After three​ "No Shock​ Advised" messages are received This is the correct answer. B. After one shock has been delivered and the patient remains in cardiac arrest C. Immediately upon determining that the patient is in cardiac arrest D. Before delivering the first shock when a​ "Shock Advised" message is received

Which one of the following statements about the AED and its use in the treatment of cardiac arrest is​ true?

A. ​"To use an​ AED, the EMT must be able to identify some basic cardiac arrest heart rhythms so that he or she can tell the AED to shock or not shock the​ patient." B.* ​"Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual​ defibrillator." This is the correct answer. C. ​"The AED is advantageous in that it will determine if a patient is in cardiac arrest and whether or not to​ shock." D. ​"AEDs have simplified the treatment of cardiac arrest to the point where the EMT does not have to be worried about inappropriately shocking a​ patient."

Which one of the following statements made by a​ patient's family member would cause the EMT to suspect that a patient is suffering from hypovolemic​ shock?

A. ​A.* "He cannot stop throwing​ up." This is the correct answer. B. ​"He has had a rash for the past three​ days." C. ​"He got up this morning and was having a hard time​ breathing." D. ​"He has been taking an antibiotic for a chest​ cold."

The cardiac arrest rhythms for which defibrillation is appropriate​ include:

A.* ventricular tachycardia. This is the correct answer. B. pulseless electrical activity. C. asystole. D. bradycardia.

Your patient has a blood pressure of​ 88/46, shallow respirations of​ 38/min, a heart rate of​ 68/min, and a pulse ox reading of 96 percent on​ high-flow oxygen. Given these vital​ signs, what type of shock is this patient most likely​ experiencing?

A.* Distributive shock from a spinal cord injury This is the correct answer. B. Cardiogenic shock from a heart attack C. Obstructive shock from a thoracic injury D. Hypovolemic shock from blood loss With a spinal cord​ injury, the blood vessels may dilate from a lack of sympathetic tone causing hypotension.​ Additionally, because of the lack of sympathetic​ tone, the heart rate will be in the slow to normal range and not tachycardic. Hypovolemic​ shock, obstructive​ shock, and cardiogenic shock all result in narrowing pulse pressure and tachycardia.

During the initial stages of​ shock, the skin becomes pale and the heart rate increases. These findings are due to what​ hormone(s)?

A.* Epinephrine and norepinephrine This is the correct answer. B. Epinephrine and glucagon C. ​Norepinephrine, epinephrine, and glycogen D. Norepinephrine

You are treating a patient who is hypotensive and unresponsive. The ALS partner with whom you are working states that the patient is having a massive heart attack according to the​ 12-lead ECG findings. Why might this cause a hypotensive​ patient?

A.* Inadequate pump function This is the correct answer. B. Inadequate vessel tone C. Inadequate oxygen levels D. Inadequate blood volume

What is an advantage of a​ load-distributing band CPR device or vest CPR​ device?

A.* It improves coronary and cerebral blood flow in comparison to traditional CPR. This is the correct answer. B. It allows for a​ 100% successful resuscitation rate. C. It eliminates the need to ventilate the patient. D. It eliminates the need to intubate the patient or place any other advanced airway. Although some research shows that the devices are better at providing cerebral and coronary perfusion than is traditional​ CPR, the available evidence still cannot support routine use of these devices.

The EMT would recognize which of the following as the most probable case of cardiogenic​ shock?

A.* Myocardial infarction This is the correct answer. B. Systemic infection C. Gastrointestinal bleed D. Severe vomiting and diarrhea

To prevent a shift to anaerobic​ metabolism, the body needs to ensure adequate perfusion to the tissues of glucose as well as what other​ substance?

A.* Oxygen This is the correct answer. B. Platelets C. White blood cells D. Carbon dioxide To prevent the development of anaerobic​ metabolism, the body needs not only to have good perfusion to deliver glucose to the cells and remove carbon dioxide and other wastes from the​ cells, but also to deliver adequate amounts of oxygen so that aerobic metabolism can occur. White blood cells are part of the immune system and do not play a role in adenosine triphosphate​ (ATP) development, nor do platelets.

What is an important difference between the pediatric Chain of Survival and the adult Chain of​ Survival?

A.* Prevention of arrest This is the correct answer. B. Bystander CPR C. Rapid transport to the hospital D. ​Post-arrest care The American Heart Association pediatric Chain of Survival also has five​ links; however, the first three links emphasize slightly different elements of emergency cardiac care from those recommended for adults. This is based on the difference in the physiology and typical etiology of cardiac arrest in the pediatric patient. The steps of the pediatric Chain of Survival are prevention of​ arrest, early​ high-quality CPR, rapid activation of​ EMS, effective ALS care and​ transport, and integrated​ post-cardiac-arrest care.

After you apply the AED to a cardiac arrest​ patient, it delivered a shock. Immediately after the​ shock, the EMT should do which one of the​ following?

A.* Provide 2 minutes of​ CPR, and then check the patient for a pulse. This is the correct answer. B. Check the patient for a pulse and start CPR if no pulse can be located. C. Provide five cycles of single dash -rescuer CPR with a ratio of 15 compressions to two ventilations. D. Check the patient for a pulse and reanalyze the rhythm if no pulse is present.

What is one reason the EMT should summon ALS to the scene of a cardiac arrest patient who experienced return of spontaneous circulation​ (ROSC)?

A.* The ALS interventions may prevent arrest from recurring. This is the correct answer. B. Only ALS providers can adequately ventilate a patient once an advanced airway is in place. C. State law requires ALS on every cardiac arrest. D. After one shock by the​ EMT, any additional shocks must be performed by the ALS provider.

What is the relationship between AED use and the conversion of ventricular​ fibrillation?

A.* The earlier the shock is​ applied, the higher the conversion rate. This is the correct answer. B. The higher the energy level that is used to​ shock, the lower the conversion rate. C. The lower the energy level that is used to​ shock, the higher the conversion rate. D. The later the shock is​ applied, the higher the conversion rate.

Which of the following scenarios would be MOST unsafe for the EMT who is about to deliver a shock with an​ AED?

A.* The patient is lying on a metal surface. This is the correct answer. B. The patient has an implanted defibrillator. C. The patient is lying outside in the yard. D. The patient is lying on a hotel room floor. When you are using an​ AED, you are operating a device that delivers an electric shock. That shock can save the life of a cardiac arrest​ patient, but it can injure others who come into contact with it. Such shocks are unlikely to be​ lethal, but they should be avoided. Metal is a good conductor of electricity. Be careful with patients who are in contact with metal​ flooring, catwalks,​ stretchers, and other items with metal components. Before you administer a​ shock, either remove the patient from this surface or ensure that no one else is directly in contact with metal that is touching the patient.

What is the likelihood of successful resuscitation and survival of a patient who has been in cardiac arrest for 10 minutes before the onset of resuscitation​ efforts?

A.* Unlikely This is the correct answer. B. Certain C. Very good D. Impossible

How are AEDs designed to help prevent malfunction from dead​ batteries?

A.* With a system​ self-check indicator This is the correct answer. B. With batteries that cannot be replaced C. With batteries that never expire D. With batteries that will never discharge

What statement regarding care for the adult patient in cardiac arrest is NOT​ true?

A.* ​"It is important to always check for a pulse immediately after the AED has delivered a​ shock." This is the correct answer. B. ​"When using an​ AED, the machine should be turned on before applying the​ electrodes." C. ​"If two EMTs are performing​ CPR, a ratio of 30 compressions to two ventilations can be​ used." D. ​"The sternum should be compressed about 2​ ½ inches with each​ compression."

You have arrived at a residence for a 66 dash -year dash -old female who is in cardiac arrest. In the living​ room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which one of the following statements should you make at this​ time?

A.* ​"Let's stop CPR so I can check the​ airway, breathing, and​ circulation." This is the correct answer. B. ​"Let's stop CPR so I can put the electrodes of the AED on her​ chest." C. ​"Let's continue CPR while I talk with the family to see if they want us to​ continue." D. ​"Let's continue CPR for another 2​ minutes, and then I will put the AED​ on."

You are instructing a first dash -aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED​ failure?

A.* ​"The batteries must be checked​ regularly." This is the correct answer. B. ​"An extra set of electrodes should be kept in the​ AED." C. ​"The AED should be kept clean and​ undamaged." D. ​"Always check the electrode wires for​ cracks."

When assessing the patient whom you suspect has​ hypoperfusion, the early effects of norepinephrine can be seen​ as:

A.* ​pale, cool skin. This is the correct answer. B. pupillary constriction. C. tachycardia. D. increased urine output.

If a patient is found to be hypotensive after a stabbing to the​ thigh, what is the most likely type of​ shock?

Obstructive shock B.* Hypovolemic shock This is the correct answer. C. Cardiogenic shock D. Respiratory shock