EMT review FINAL, EMT Final extra

A 55-year-old male with poorly controlled hypertension presents with respiratory distress and difficulty speaking in complete sentences. He is conscious and alert with a blood pressure of 150/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 28 breaths/min and labored. Auscultation of his lungs reveals diffuse coarse crackles. After placing the position in a comfortable position, you should:

Apply the CPAP device

When treating an anxious and uncooperative patient with chest pain, you state, "If you don't settle down, I am going to put a large IV in your arm." What is this an example of?

Assualt

Shortly after administering a second nitroglycerin dose to a 44-year-old male with chest pain, he becomes lightheaded. You take his blood pressure and is reads 80/50 mm Hg. You have already established IV access and are administering oxygen. You should:

place him supine and elevate his legs

You are dispatched to an office complex for a middle-aged male with acute abdominal pain. Your assessment reveals that he is conscious, restless, and in severe pain. His airway is patent, his breathing is adequate, and his vital signs are stable. Treatment for this patient should include all of the following, EXCEPT:

placing him supine and elevating his legs

A 67-year-old male who smokes three packs of cigarettes per day complains of a productive cough, chills, and generalized weakness. He is in mild respiratory distress; auscultation of his lungs reveals rhonchi to the lower left lobe. This patient's clinical presentation is MOST consistent with:

pneumonia

A 66-year-old female is in cardiac arrest and requires advanced airway management. Prior to inserting a Combitube, you should take standard precautions and then:

preoxygenate the patient with a bag-mask device and 100% oxygen

Your general impression of a 50-year-old man with acute abdominal pain reveals that he is confused and has pale, diaphoretic skin. After correcting any problems with airway, breathing, and circulation, your main focus should be on:

prompt transport to the hospital

You and your partner are the first to arrive at a potential crime scene involving a critically injured patient. The scene is safe. Your FIRST priority is to:

provide emergency care to the patient

While treating a man with severe chest pain and difficulty breathing, you are presented with a valid do not resuscitate (DNR) order by the patient's wife. She tells you that her husband does not want any "heroics." How should you manage this situation?

provide supportive care and transport the patient.

While ventilating an apneic 33-year-old man, you note that his stomach is becoming slightly distended. You should:

recheck and reposition his airway

After inserting the CobraPLA into your patient, you note that her tongue is protruding from her mouth. You should:

recognize that the device is not inserted far enough

An apneic 2-year-old child with a heart rate of 110 beats/min is being ventilated with a bag-mask device at a rate of 20 breaths/min. After 2 minutes of ventilations, you note that the child's heart rate is 80 beats/min. You should:

recognize that your ventilations are not adequate

A 56-year-old male complains of pain to the right upper quadrant of his abdomen and pain to his right shoulder; however, he denies pain in between his abdomen and shoulder. This is characteristic of:

referred pain

A 29-year-old male with a history of type 1 diabetes presents with excessive urination and marked thirst. These signs indicate that the:

renal system is excreting excess glucose

You have just established an IV on a critically injured patient. As you prepare to dispose of the needle in the appropriate container, you get stuck with the needle. You should:

report the incident to your supervisor as soon as possible

A patient who is developing early stages of hypoxia may exhibit: A: cyanosis. B: restlessness. C: a weak pulse. D: a pulse oximetry reading below 80%.

B: restlessness Restlessness is an early sign of hypoxia and should lead to immediate oxygen therapy. The others are all late signs of hypoxia.

The T in "DCAP-BTLS" stands for: A: tingling. B: tenderness. C: tightness. D: turgor.

B: tenderness Tenderness is associated with musculoskelatal injuries and is an important finding during the rapid physical exam.

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. insertion of an oropharyngeal airway.

What type of medical direction do standing orders and protocols describe? A. radio B. online C. off-line D. direct

C. off-line

What is meant by BVM. A: A device for measuring minute volume. B: Bilateral (lungs) Ventilation Machine C: Bag Valve Mask D: Breathing and Ventilation Maneuvers

C: Bag Valve Mask

When inserting a nasopharyngeal airway, it is important to do all the following except: A: Measure the size from the tip of the nose to the earlobe. B: Ensure that the bevel faces the septum when inserting into the right nare. C: Insert with a constant rotating motion. D: Lubricate the airway with a water-based lubricant.

C: Insert with a constant rotating motion. The device should be rotated 180 degrees if placed in the left nare, and not at all in the right nare.

An inflammation of the layers of tissue around the brain and spinal cord is known as: A: neoplasm. B: infarction. C: meningitis. D: epilepsy.

C: Meningitis Meningitis can lead to permanent brain damage or death, making recognition by the EMT very important. Neoplasm is an abnormal growth (cancer), infarction is the hypoxic injury to tissue, and epilepsy is an illness that manifests in seizures.

A 43-year-old female is unconscious following an overdose of heroin. Her respirations are slow and shallow. Which of the following conditions will she initially develop if not treated?

Respiratory acidosis

A 50-year-old female with nausea, vomiting, and diarrhea complains of intense thirst and generalized weakness. Her blood pressure is 86/50 mm Hg and her pulse rate is 130 beats/min and thready. Which of the following interventions would NOT be appropriate for her?

Salt-containing solutions by mouth

You are caring for an infant who is having mild respiratory distress. You notice that he is having difficulty breathing through his nose. What is the most appropriate step to take next.

Suction the nose with a bulb syringe.

What might lead you most to suspect a that baby may be dehydrated.

The fontanelle appears sunken and there is a recent history of diarrhea.

A 22-year-old male, who was trapped in a confined space during a structural fire, is conscious and alert and refuses EMS treatment and transport. He is breathing without difficulty, but has singed nasal hair and facial redness. Which of the following statements regarding this patient is correct?

The patient may die several hours later due to pulmonary complications

You encounter a child after a bicycle accident. You note an open fracture of the forearm with copious blood loss. The child is alert and oriented and all vitals are normal. You have successfully controlled the bleeding using pressure points, splinted the arm and packaged the child for transport. Which of the following statements best reflects the situation:

The risk of rapid decompensation into hypovolemic shock is something to be considered.

PEDIATRIC EMERGENCIES: 171-190 This age group does not like to be separated from parents, and can often frighten easily. They often need simple explanations and need to establish some sense of trust before assessment can begin.

Toddler - 1 to 3 years old.

A 21-year-old male has lost approximately 35% of his blood volume following a penetrating injury to the chest. Which of the following signs or symptoms would you NOT expect to see?

Widened pulse pressure

A 39-year-old male with a history of type 1 diabetes is found unresponsive by his wife. When obtaining initial information from the wife, which of the following questions would be LEAST pertinent?

"Was your husband hospitalized for this problem in the past?"

With regard to potential treatment in the hospital, which of the following questions is MOST important to ask the spouse of a 66-year-old female who presents with signs and symptoms of an acute ischemic stroke?

"When did you first notice the symptoms?"

A 60-year-old male has sustained partial- and full-thickness burns to his anterior chest, head, and both anterior arms. On the basis of the "Rule of Nines," what percentage of his body surface area (BSA) has been burned?

36%

The determination that prompt surgical care in the hospital is more important than performing timeconsuming 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. EMS research.

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. assist a patient with certain prescribed medications.

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. community awareness programs that emphasize the dangers of drinking and driving

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. continue to be nonjudgmental, compassionate, and respectful.

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. human resources department

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. individual EMT.

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. perform blood glucose monitoring.

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. state office of EMS.

The path air takes during exhalation goes through the following route: A: Alveoli, bronchioles, bronchi, trachea, epiglottis, oropharynx B: Oropharynx, larynx, trachea, carina, bronchi, alveoli C: Bronchioles, carina, larynx, oropharynx, epiglottis D: Alveoli, trachea, carina, epiglottis, pharynx, mouth

A: Alveoli, bronchioles, bronchi, trachea, epiglottis, oropharynx This sequence accurately describes the structures air passes through during exhalation.

AIRWAY MANAGEMENT: 41-50 What is meant by respiratory distress? A: An increase in breathing effort, accompanying a feeling of being short of breath. B: When breathing, for whatever reason, decreases to a point of where the body can not get enough oxygen. C: When breathing completely stops. D: When the body gets too much oxygen, which creates a hypoxic drive.

A: An increase in breathing effort, accompanying a feeling of being short of breath. Answer B describes respiratory failure. Answer C describes respiratory arrest. Answer C relates more to COPD (chronic obstructive pulmonary disease)

INTRO TO EMERGENCY MED CARE: 1-10 The organization in the United States government that is responsible for establishing the National Standard Curriculum for each EMT level is the: A: Department of Transportation. B: Department of Health and Human Services. C: Department of Homeland Security. D: Department of Defense.

A: Department of Transportation. The Department of Transportation establishes the National Standard Curriculum. The DOT relationship to EMS standards goes back nearly 40 years to the publication Accidental Death and Disability. The curricula for different levels are published on the National Highway Traffic Safety Administration website

Fever in children is a common reason for parents to call for an ambulance. A fever can result from: A: infection. B: lack of oxygen. C: blood loss. D: cold environments.

A: Infection. Body temperature of 100.4 degrees F (38 degrees C) or higher are considered abnormal and may be caused by infection, cancer, drug ingestion, arthritis, lupus, or a high environmental temperature

A patient who to takes an occasional gasping breath after their heart has stopped has: A: agonal respirations. B: ataxic respirations. C: apneic respirations. D: hypoxic respirations.

A: agonal respirations. Agonal respirations are shallow, inadequate respirations that occur after the heart has stopped.

An oropharyngeal airway or OPA is used: A: as a convenient way to maintain an open airway in an unconscious patient. B: as a one size fits all piece of curved plastic inserted into the throat and designed to maintain an open airway. C: as a small rubber device inserted into a patients nose and down into the throat in order to maintain an open airway. D: as a simple way to provide oxygen to the body via oxygen tubing and a non rebreather mask.

A: as a convenient way to maintain an open airway in an unconscious patient. OPAs come in different sizes and must be fit to the patient. Answer C describes a nasopharyngeal airway. Answer D does not describe what an OPA does.

At the scene of an unexplained infant death, or SIDS call, the EMT-B should: A: carefully inspect the scene for signs of illness, the general condition of the house, and family interaction. B: attempt to calm the parents by telling them, "I know exactly how you must feel." C: treat the house as a crime scene because SIDS results from child abuse or neglect. D: withhold attempting CPR as SIDS is not reversible.

A: carefully inspect the scene for signs of illness, the general condition of the house, and family interaction. Careful inspection of the house and infant is essential to provide important diagnostic information, including toys and other items in the infant's crib. The EMT-B should never say that he or she knows how the patient or family feels. SIDS is more likely a result of a medical condition than abuse. Some SIDS cases may revive with stimulation and are then known as "apparent life-threatening events" or "near-miss SIDS."

Abnormal skin characteristics such as paleness, coolness, or moistness may indicate: A: hypoperfusion. B: hypertension. C: jaundice. D: coagulation

A: hypoperfusion Hypoperfusion or shock can often be detected in the skin because the body shunts blood to more important body tissues. This finding during the initial assessment is important because treatment for shock needs to begin quickly

To relieve choking in a conscious child, the EMT-B should: A: kneel behind the child, encircle the child with both arms, and apply five rapid abdominal thrusts. B: place the child on a chair, table, or countertop and apply six to ten abdominal thrusts. C: lie the child on his or her back, straddle the child, and deliver five abdominal thrusts. D: deliver five deliberate back blows and encouraged the child to cough.

A: kneel behind the child, encircle the child with both arms, and apply five rapid abdominal thrusts. To relieve a foreign obstruction from the airway of a standing or sitting child, kneel behind the child and encircle the body with both arms to deliver five rapid, distinct abdominal thrusts, repeating until the object is cleared or the child becomes unconscious. The child should not be placed on a chair, table, or counter to reduce risk of injury if they become unconscious. Lying the child down and delivery of abdominal thrusts is done once the patient becomes unconscious. Back blows alternating with chest thrusts are recommended only for infants less than 1 year old.

A significant difference between adults and children in shock is: A: loss of even a small volume of blood can lead to shock in the child. B: children require greater amounts of blood loss to develop shock. C: capillary refill is the most reliable indicator of shock in adults. D: adults can compensate for blood loss better than children.

A: loss of even a small volume of blood can lead to shock in the child. Infants and children have less circulating blood than adults, so small losses can result in shock developing. Blood volume loss of 25% or more significantly increases childhood risk of shock, compared with 30% to 40% in the adult. Capillary refill is more reliable in children than adults. Hypotension in adults, although a late sign, is a more reliable indicator of shock than capillary refill. Children are able to compensate longer for shock than adults.

The carrier of an infectious organism: A: may never know that they have the disease. B: will always tell an EMT-B that they are contagious. C: can only transmit the disease by exposure to blood. D: can be traced through an investigation.

A: may never know that they have the disease. Carriers of an infectious organism may never know that they are contagious and may have no symptoms of the disease.

Signs of respiratory distress in children include: A: nasal flaring, grunting, wheezing or stridor, retractions, and tripod positioning. B: loud crying, effective coughing, ability to speak, and flushed color. C: cyanosis in the beds of the fingernails with shivering. D: respiration rates between 20 to 30 breaths/min.

A: nasal flaring, grunting, wheezing or stridor, retractions, and tripod positioning. As the body attempts to maximize air exchange, the work of breathing increases, resulting in retractions, nasal flaring, accessory muscle usage, and decrease in chest rise and fall. The ability to speak, cough, or cry indicates freely moving air. Shivering and bluish nails is associated with local cold exposure. Respiration rates of 12 to 50 breaths/min are normal depending on the child's age.

The roles and responsibilities of the EMT-B do not include: A: placing yourself or your partner at risk to save a patient's life. B: providing essential immediate intervention. C: advising the patient of any procedures you will perform. D: documenting all findings and care on the patient care report.

A: placing yourself or your partner at risk to save a patient's life. Ensuring safety of yourself and your crew are more important than any risk for a patient. Most EMT-Bs lack the special training and equipment for rescue situations.

Suctioning is used to: A: remove small debris and liquid from a patient's airway. B: provide the negative pressure necessary to deflate the lungs after ventilation. C: to vacuum the periphery of the airway in order to eliminate possible future lung infections. D: remove any debris that may have gotten into the patient's lungs and which may interfere with artificial ventilation.

A: remove small debris and liquid from a patient's airway.

Head injuries are common in children because: A: the size of the head is larger in relation to the body than an adult. B: helmets designed for children offer less protection than expected. C: they are more likely to suffer whiplash in auto accidents. D: infants haven't fully developed balance for walking.

A: the size of the head is larger in relation to the body than an adult. In proportion to the body, a child's head is larger than an adult. Helmets for children have been designed to offer maximum protection, whiplash is more likely to occur in the adult, and infants have not yet begun to walk.

A man is experiencing significant anxiety and depression regarding the impending death of his wife. However, the wife is trying to comfort her husband by telling him that she loves him and is prepared to die. What stage of the grieving process is the patient experiencing?

Acceptance

You are assessing a 45-year-old male who experienced a syncopal episode. He is conscious and alert, and complains only of slight weakness. He denies any medical problems or drug allergies. His blood pressure is 140/90 mm Hg, pulse is 40 beats/min, and respirations are 22 breaths/min. What is the MOST likely cause of this patient's syncopal episode?

Acute bradycardia

INITIAL ASSESSMENT: 151-160 The 'A' in AVPU stands for:

Alert

You are a member of the time travelling EMT force, enabling you to meet yourself in the past and correct your mistakes. What would you correct?

All of the above: Visualizing the cherry red epiglottis during assessment of a child with epiglottitis. Using the rule of eights to assess a burn patient. Not studying enough to pass the NREMT the first time.

An 8 child has been struck by a bull. Witnesses say he was thrown into the air, over a fence and onto pavement. When you arrive on scene, the child has no obvious signs of trauma and is sitting on the ground with multiple bystanders comforting him. What should you suspect before you even begin your assessment.

All of the above: internal injuries. head injury. limb fractures.

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. AED

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. a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured

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. identify areas of improvement and provide remedial training if needed.

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. maintain, update, and expand your knowledge and skills.

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. medical director.

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. paramedic.

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

B. paramedic.

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. proof of immunization against certain communicable diseases.

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. recognize that this does not mean it will save more lives.

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. the presence of a person trained to initiate basic life support (BLS) care cannot be ensured.

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. your local EMS protocols.

What is the rate of breaths per minute for an adult? A: 10-18 B: 12-20 C: 15-25 D: 8-16

B: 12-20

If a D-sized oxygen cylinder contains 300 L of oxygen and is at 2,000 PSI at the start of call, the best estimate for the amount of time a patient can receive 15 L/min with a nonrebreathing mask is: A: 10 minutes. B: 20 minutes. C: 30 minutes. D: 40 minutes.

B: 20 minutes. 20 minutes. This can be calculated either by dividing 15 L/min into 300 L, for a result of 20 minutes, or by using the psi constant for a D cylinder, which is 0.16. The calculation would then be (2,000 -200) x 0.16 /15 L/min = 19.2, which is approximately 20 minutes.

Your decision regarding whether the patient is high priority should be made at which step in the assessment? A: When receiving dispatch information B: After the initial assessment is performed C: After vital signs are taken D: After the focused physical exam is performed

B: After the initial assessment is performed Although a patient can be upgraded to priority at anytime based on additional information, the first point where you should make that decision is after the initial assessment.

To which of the following patients is appropriate to administer the head tilt chin lift maneuver? A: An unconscious teenage male who fell off his skateboard. B: An unresponsive 70 year old male who has is in cardiac arrest at a restaurant. C: A 25 year old female complaining of difficulty breathing after falling an hitting her head. D: A 35 year old man who loses consciousness in you presence after being extricated from a car accident.

B: An unresponsive 70 year old male who has is in cardiac arrest at a restaurant. The head tilt chin lift maneuver is contraindicated for suspected c-spine and head trauma.

PATIENT ASSESSMENT: 161-170 You are working on a night shift on an ambulance and arrive on the scene of an assault at a residence. The house is dark and the front screen door has been knocked off its hinges. No law enforcement is on scene yet and the street is quiet. Which of the following is your best course of action? A: Get out of the ambulance and approach the house, calling out, "EMS—we're here to help." B: Park your ambulance several houses away and wait for the police. C: Take your equipment and quietly head up to the house. D: Pull the ambulance onto the front lawn to get it as close as possible to use for shelter.

B: Park your ambulance several houses away and wait for the police. The safest course of action in approaching an unknown dark scene is to wait for law enforcement to arrive to make certain that the scene is safe. Regardless of how badly injured a patient may be, your safety comes first.

A common source of confusion, vomiting, or even unconsciousness, especially in toddlers, is: A: infection. B: poisoning. C: near drowning. D: sport injury.

B: Poisoning Toddlers frequently ingest improperly stored household chemicals as they explore their surroundings. Infections, near drowning, and sport injury are infrequent among toddlers by comparison.

What is the difference between the head-tilt-chin-lift maneuver and the jaw thrust maneuver? A: The head tilt is for trauma patients and the jaw thrust is for medical patients. B: The mechanism of injury or nature of illness determines which technique is used in opening the airway. C: The jaw thrust requires two EMTs, whereas the head tilt requires only one. D: The head tilt opens the airway more than the jaw thrust, allowing for more effective artificial respirations.

B: The mechanism of injury or nature of illness determines which technique is used in opening the airway. The head tilt chin lift is contraindicated for a suspected head, neck or spine injury patient. In these cases the jaw thrust must be used. This is determined by the mechanism of injury.

Children between the age of one and three years of age are considered to be: A: infants. B: todlers. C: preschoolers. D: adolescents.

B: Toddlers Infants are children up to age 1, toddlers are age 1 to 3, preschoolers are age 3 to 6, school-age children are age 6 to 12, and adolescents are between age 12 and 18

The three stages of the body's reaction to stress (general adaptation syndrome) do not include: A: the alarm response. B: burnout. C: reaction and resistance. D: recovery or exhaustion.

B: burnout. Burnout can be a result of poorly managed stress, but it is not a part of the body's physiological reaction to stress.

he second most common cause of death in children is: A: child abuse. B: drowning. C: sport injuries. D: poisoning.

B: drowning Children under 5 years of age are particularly at risk for submersion injury. After toddlers, adolescents account for the most drownings.

PEDIATRIC ASSESSMENT AND MANAGEMENT: 191-200 Problems leading to cardiopulmonary arrest in children include: A: coronary artery disease, heart attack, and elevated cholesterol. B: foreign body obstruction, respiratory infection, and electrocution. C: congestive heart failure, diseased heart valves, and dysrhythmia. D: acute myocardial infarction, stroke, and kidney failure.

B: foreign body obstruction, respiratory infection, and electrocution. Because most children have healthy hearts, cardiopulmonary arrest is more commonly a result of infections of the respiratory tract, foreign body obstruction, electrocution, drowning, poisoning, and drug overdose, injury, and SIDS. In adults, cardiac arrest is usually the result of an underlying heart disease or ailment.

AIRWAY: 21-40 The aspect of natural ventilation that involves the diaphragm contracting and the chest wall expanding is: A: metabolism. B: inhalation. C: exhalation. D: airway expansion.

B: inhalation. Inhalation is the active phase of breathing or ventilation. The body must work to bring air in.

Hypoxia is best defined as: A: cyanosis, altered mental status, shortness of breath, grayish skin tone B: insufficient oxygen supply to the tissues of the body. C: respiratory arrest D: Chronic Obstructive Pulmonary Disease

B: insufficient oxygen supply to the tissues of the body. This one was a little tricky. Answer A describes the symptoms of hypoxia, not what it is. Prolonged hypoxia can turn into respiratory arrest. COPD can cause hypoxia.

If you arrive at the scene of a motor vehicle crash involving a truck with a black and white diamond-shaped label stating "corrosive" that is leaking a fluid, you should: A: slowly walk around the vehicles, looking for more leaks. B: keep a safe distance from the scene and notify dispatch of a hazardous material. C: quickly but carefully run to the cab of the truck to check for patients. D: begin treating any patients.

B: keep a safe distance from the scene and notify dispatch of a hazardous material. Never go into a known hazardous material scene unless you are properly trained and protected. Notify dispatch with as much information as possible to update incoming units.

Emergency management of the child in seizure includes: A: physically restraining the arms and legs until the seizure ends. B: preventing injury by clearing away close objects and focusing on the ABC's. C: placing several taped tongue blades between the teeth to prevent biting. D: placing ice packs at the nape of the neck and armpits to rapidly cool the patient.

B: preventing injury by clearing away close objects and focusing on the ABC's. Initial assessment begins with scene safety, protecting the seizure patient from further harm, and ensuring an open airway, breathing, and circulation. In addition, the EMT-B should be prepared to suction and apply oxygen as necessary. Physical restraint of the arms and legs may cause further harm and should not be done. Bite blocks of any kind, including your fingers, should never be placed in the mouth as they may break teeth or force the tongue into the airway. Although children between 6 months and 6 years of age commonly experience seizure caused by fever, you should never use ice packs to cool the seizure patient.

What is meant by artificial ventilation? A: the insertion of an oropharyngeal bag valve mask to provide negative air flow and proper suction. B: the forcing of air or oxygen into the lungs when a patient cannot breathe for themselves at all. C: when a machine does the breathing for a patient that can still breathe on normally their own. D: breathing assistance for a patient that has a slow heart rate.

B: the forcing of air or oxygen into the lungs when a patient cannot breathe for themselves at all.

What is respiration? A: the way the body uses carbon dioxide to maintain metabolism. B: the process by which the body uses oxygen and expels carbon dioxide. C: when oxygen is perfused with the blood and carbon monoxide is removed. D: the process by which the body removes excess moisture and cools the body through evaporation.

B: the process by which the body uses oxygen and expels carbon dioxide.

Properly performed suctioning of a patient may still cause: A: hypoxia. B: vomiting. C: gastric distention. D: aspiration.

B: vomiting. Vomiting maybe caused even when the skill is performed correctly. Hypoxia can be prevented if the EMT-B only uses the machine for 15 seconds or less on adult patients. Aspiration and gastric distention are not caused by suctioning.

You respond to the home of a 75-year-old man who is in cardiac arrest. The family states that the patient is terminally ill and has an advance directive; however, they are unable to locate it. How should you manage this situation?

Begin CPR and contact medical control

You encounter a baby in it's crib who is not breathing, has no pulse and is cool to the touch. The parents are very distraught and are looking to you for help. What would you do next?

Begin CPR and initiate rapid transport to hospital.

A 67-year-old male complains of burning sensation in his abdomen and hematemesis. During your assessment, you note pain to palpation of his left upper quadrant; his vital signs are suggestive of shock. Which of the following conditions should you suspect?

Bleeding peptic ulcer

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. Additional information and evidence indicate that the effectiveness of certain interventions has changed.

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. The ADA prohibits employers from failing to provide full and equal employment to the disabled.

Why is the year 1966 usually referred to as the beginning of the modern era of EMS? A: It was the year the first EMT textbook was published. B: It was the year the term "paramedic" was first used. C: The report "Accidental Death and Disability: The Neglected Disease of Modern Society" was published. D: The first "van ambulance" was manufactured.

C: The report "Accidental Death and Disability: The Neglected Disease of Modern Society" was published. The paper "Accidental Death and Disability" highlighted the serious inadequacy of prehospital care and transportation in many areas. The other events all occurred later in the 1960s or in the early 1970s.

When would an EMT use the jaw thrust maneuver to open an airway? A: When the patient has no suspected cervical injury. B: When the patient is bleeding profusely, necessitating a more rapid way to open the airway. C: When the patient has a suspected neck injury. D: When there is a high suspicion of an airway obstruction.

C: When the patient has a suspected neck injury. When there is a suspected c-spine injury the jaw thrust maneuver is used in order to minimize damage that could be caused by opening the airway.

Respiratory failure is distinguished from respiratory distress by: A: the patient refusing to sit upright, preferring to lie flat. B: the heart rate returning to normal and skin color improving. C: a decreased level of consciousness and developing cyanosis. D: respiration rates between 20 to 30 breaths/min indicating an increase in hypoxia.

C: a decreased level of consciousness and developing cyanosis. Although a definitive diagnosis of respiratory failure is made in the hospital, progression to failure includes decreased effort to breathe, less chest rise with inspiration, changes in behavior, developing cyanosis, and apnea. Patients experiencing respiratory distress prefer to sit upright, or in a tripod position. In respiratory distress the heart rate returns to normal when the condition is reversed. Abnormal respiratory rates in the child are above 60 breaths/min.

When dealing with the death of a child, the EMT-B should: A: attempt to joke with the family regarding the circumstances. B: tell the family that child is going to "make it." C: acknowledge to the family that the child is dead. D: not tell the family anything until a clergy member is present.

C: acknowledge to the family that the child is dead. Acknowledging the death to the family can help them begin the grieving process. It is not appropriate to joke, deceive, or unnecessarily delay the notification to the family.

Emergency Medical Dispatch has been developed to: A: provide an exact location of the caller using GPS. B: see what is going on at the scene. C: allow dispatchers to provide instructions to the caller until EMS arrives. D: all of the above.

C: allow dispatchers to provide instructions to the caller until EMS arrives. EMD allows a dispatcher to provide instructions for a caller using a script and to categorize a call so appropriate assistance can be sent to the scene. Enhanced 9-1-1 for certain cellular phones can provide the exact location. Technology doesn't yet exist to allow us to see the scene.

During your assessment of the patient's breath sounds, you should: A: tap the chest wall to hear an echo. B: auscultate the chest the ventral wall. C: auscultate the chest from the dorsal wall. D: ask them to exhale forcefully so you can listen.

C: auscultate the chest from the dorsal wall. The preferred place to listen is the dorsal (back) wall of the chest because there is usually less tissue.

Considerations in immobilization of a small child with a suspected head and neck injury include: A: children are less likely to experience cervical trauma than adults. B: children should always be removed from child restraint seats for transport. C: children should be secured to a backboard with padding under the shoulders. D: children should be secured to a backboard, head before torso, to minimize panic.

C: children should be secured to a backboard with padding under the shoulders. Childrens' heads are proportionately larger than adults'. To maintain a neutral airway position, padding is necessary under the child's shoulders. Because children have weaker muscles in the neck, they are more prone than adults to experience neck injury. If the child is unstable or the seat is visibly damaged, the child must be removed to another spinal restraint device. When securing a patient of any age to a backboard, the torso must always be secured before the head to prevent accidental neck injury.

Common signs and symptoms of patients suffering from cardiac compromise include: A: crushing pain, tremulousness, lacrimation, dyspnea and alopecia B: dyspnea, complaints of dull chest pain, diarrhea, diaphoresis, cardiomyopathy C: dyspnea, chest pain that is described a squeezing dull or crushing, mild chest discomfort, sweating, nausea and vomiting D: dull aching chest pain, numbness in the extremities, cyanosis, decreased blood pressure, diminished bowel sounds

C: dyspnea, chest pain that is described a squeezing dull or crushing, mild chest discomfort, sweating, nausea and vomiting

Of the following, what is the most likely place an EMT would look for cyanosis in her patient? A: the superior aspect of the scalp. B: the palms. C: earlobes D: both the palms and the superior aspect of the scalp.

C: earlobes.

When using a bag-valve-mask device, the key finding to observe to assure adequate ventilation is: A: three seconds between squeezing the bag and lifting the mask off the face. B: the patient's weight in kilograms. C: good chest rise and fall. D: the location of the patient's cricoid cartilage.

C: good chest rise and fall. Good chest rise and fall is the most important method to measure the patient's ventilations.

Oxygen cylinders are what color? A: red B: blue C: green D: magenta

C: green

The goal of universal precautions is to: A: protect you from all infectious diseases. B: protect you from all hazardous materials. C: interrupt the transmission of germs. D: prevent exposure to stressful situations.

C: interrupt the transmission of germs. The goal is to interrupt the transmission of germs by decreasing the chance that you will come in contact with them.

As you approach the scene of a motor vehicle crash, you observe that the vehicle appears to have struck a telephone pole on a rural road at high speed. The windshield is cracked near the driver's seat and the hood has been bent up significantly. You have observed the: A: nature of illness. B: scene safety. C: mechanism of injury. D: history of the accident.

C: mechanism of injury. The mechanism of injury is observed by looking at the patient and his or her surroundings to determine how much force they might have received.

The party responsible for ensuring that an EMT-B maintains his or her ability to provide high-quality EMS care and updates his or her knowledge of EMS care is the: A: state regulatory authority. B: EMT-B. C: medical director. D: EMS agency chief.

C: medical director. After EMT-Bs become certified; they become responsible for continuing their education. The state regulatory authority or EMS agency chief may require certain hours or types of training, and the medical director may identify areas that need training, but it is up to the EMT-B to remain committed to learning new things and remaining comfortable with the core knowledge of an EMT-B.

The type of medical control where a physician may either confirm or modify a proposed treatment plan over the radio or telephone is referred to as: A: offline or indirect medical control. B: retrospective Medical control. C: online or direct medical control. D: implied medical control.

C: online or direct medical control. Online medical control involves direct communication between an EMS provider and medical control physician. Offline medical control are usually found in protocols and quality assurance activities.

When encountering a patient who is not breathing the first thing you should do is: A: stabilize C-spine in case the patient is suffering from syncope. B: administer high flow oxygen at 15 lpm via non-rebreather mask. C: open the airway. D: check the patient's pulse.

C: open the airway

If you suspect that a patient has a communicable disease, you may: A: refuse to treat them. B: delay treating them while you wait to learn the seriousness of the condition. C: pause to don appropriate personal protective equipment. D: none of the above.

C: pause to don appropriate personal protective equipment. The only acceptable delay in care for a person with a communicable disease is to reduce your risk by donning PPE. Refusal to care for them or a lengthy delay may be considered a breach of duty.

Dehydration can present a serious problem to the infant or small child and should be suspected if: A: the child has produced frequent wet diapers. B: the child has unexplained, tearful crying. C: the skin is loose and has no elasticity. D: the child has excessive saliva or drooling.

C: the skin is loose and has no elasticity. Signs of dehydration include dry lips and gums, decreased saliva, fewer or dryer diapers, sunken dry eyes, crying without producing tears, poor skin turgor or elasticity, and infants may also have a sunken anterior fontanel. Unexplained, tearful crying may be an indication of abuse. Excessive drooling may indicate epiglottitis.

One of the simplest and most effective ways to control disease transmission is to: A: wear latex gloves on all EMS calls. B: wear a HEPA mask during long transports. C: wash your hands after every call. D: recap a dirty needle after it is used.

C: wash your hands after every call. Washing hands properly is the best answer. Gloves should be used anytime there is possibility of blood or body fluid exposure. HEPA masks should be worn when transporting a patient requiring airborne precautions. Needles should never be recapped

The general impression of the patient should be formed: A: after the vital signs are taken. B: during the SAMPLE history. C: while observing the patient during your approach and initial conversation. D: based on the dispatch information.

C: while observing the patient during your approach and initial conversation. The general impression is formed as soon as you reach the patient and begin speaking with them.

You are dispatched to the home of a 64-year-old male patient with lung cancer. The patient complains of acute dyspnea; however, as long as he is sitting upright, his breathing is easier. He denies fever and his breath sounds are decreased over the base of the left lung. What is the MOST likely cause of this patient's symptoms?

Collection of fluid outside of the lung

You respond to a call for an 16-year-old boy who injured his arm. As you are assessing the child, he tells you that he does not want you to touch him. His mother tells you to begin treatment and transport the child to the hospital if necessary. What should you do?

Continue your assessment and transport if necessary

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. An EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug.

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. An EMT's scope of practice may be expanded by the medical director after proper training and state approval.

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. National Highway Traffic Safety Administration (NHTSA).

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. The NREMT provides a national standard for EMS testing.

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. a 64-year-old cardiac arrest patient who is defibrillated with an automated external defibrillator (AED)

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. contact the state EMS office and provide them with the required documentation.

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. providing callers with life-saving instructions

A nasal canula is meant to deliver oxygen concentrations of: A: 2-6% B: 4-8% C: 8-15% D: 24-44%

D: 24-44%

EMS providers who can perform advanced cardiac life support skills, may use a manual defibrillator, and are trained for 800 to 1,500 hours are called: A: first responders. B: EMT-Basics. C: EMT-Intermediates. D: EMT-Paramedics.

D: EMT-Paramedics. EMT Paramedics are recognized as the highest level of pre-hospital care in the national curriculum. They can perform a wide range of advanced life support skills.

Strategies that EMT-Bs may use to positively manage the stress of the job include the following except: A: sustaining friends and interests outside of EMS. B: regular physical activity. C: eating a balanced diet of carbohydrates, protein, and limited fats. D: learning how to hold your stress reaction inside.

D: learning how to hold your stress reaction inside. The other three choices are among the many that are strategies recognized to help EMT-Bs manage stress.

Differences in anatomy between adults and children that influence treatment decisions, include: A: The proportionately larger diameter airway of the child is less easily obstructed by secretions. B: The proportionately larger tongue of the child is less likely to cause obstruction. C: The epiglottis is larger in the child than adult and is more likely to prevent aspiration. D: The child's occiput is larger and rounder than an adult, requiring careful positioning.

D: The child's occiput is larger and rounder than an adult, requiring careful positioning. The proportionately larger head makes it easier to close the child's airway if it is not carefully positioned to maintain a neutral position, a larger tongue can easily block the airway, a floppy epiglottis is less likely to prevent aspiration, less well-developed rings of cartilage may easily collapse if the neck is flexed or hyperextended, and the lower airway is much narrower, allowing for more problems.

Describe a patent airway. A: an airway that is blocked and must be cleared with a series of abdominal thrusts. B: an airway that is mostly clear, but contains a small yet irremovable obstruction that does not interfere with ventilation. C: an airway that requires either the jaw thrust or the head tilt chin lift maneuver. D: an airway that is open and clear, and that will remain so, so that air may freely pass in and out of the lungs.

D: an airway that is open and clear, and that will remain so, so that air may freely pass in and out of the lungs.

The PAT or pediatric assessment triangle is a structured assessment tool to rapidly determine the child's condition using: A: muscle tone, facial grimace, and activity. B: respiratory rate, pulse, and capillary refill. C: patient weight, height or body length, and age. D: appearance, work of breathing, and circulation to the skin.

D: appearance, work of breathing, and circulation to the skin. The three components of the Pediatric Assessment Triangle include the appearance, work of breathing, and circulation to the skin. Muscle tone, facial grimace, and activity are components to the APGAR newborn assessment. Respiratory rate, pulse, and capillary refill are among the vital signs assessed during the physical exam. Patient weight, height, and age are helpful to determine proper medication and other devices.

Inadequate breathing is best described as: A: no chest rise, no air moving in and out of lungs, no sounds B: the patient complains of shortness of breath and is cyanotic around the lips. C: the rate of breaths per minute is 16, with cold clammy skin. D: shallow breathing that is too slow or too fast, diminished breath sounds, abnormal noises, cyanosis, inadequate minute volume.

D: breath sounds, abnormal noises, cyanosis, inadequate minute volume. Answer A describes a patient who is not breathing. Answer B describes some possible symptoms of inadequate breathing. Answer C does not contain enough information.

THE WELL BEING OF THE EMT: 11-20 According to Dr. Kubler-Ross, the stage of the grieving process identified by the open expression of grief, hopelessness, and the desire to die is: A: denial. B: acceptance. C: bargaining. D: depression.

D: depression. Depression is the open expression of grief, internalized anger, hopelessness, the desire to die

The process by which carbon dioxide moves from a high concentration in the capillaries to the lower concentration in alveoli is: A: ventilation. B: hypoxia. C: wicking. D: diffusion.

D: diffusion Diffusion is the process where the gases are exchanged from a high concentration to a low concentration. Diffusion is aided by the round shape of the alveoli.

During your focused physical exam, you find that the patient has good pulse in his feet, but has trouble moving them or feeling your touch. You should: A: ask the patient if he can take a few steps, while you hold his arm. B: bend his knees to see if the sensation improves. C: place the patient on oxygen. D: ensure that proper spinal immobilization steps have been taken.

D: ensure that proper spinal immobilization steps have been taken. This patient may have a spinal injury and should be treated for that condition until proven otherwise at the hospital.

At violent situations, EMS personnel should: A: assume that parties will not try to harm EMS providers. B: enter the scene as soon as law enforcement arrives. C: trust that bystanders will protect them from possible harm. D: enter the scene only when law enforcement indicates it is safe.

D: enter the scene only when law enforcement indicates it is safe. You should always ask for law enforcement to indicate that the scene is safe if the scene is potentially violent. EMS providers should not trust that bystanders to leave them alone or protect them.

You should NOT be concerned about the following symptoms when you suspect breathing problems in a pediatric patient? A: grunting at the end of respirations. B: the patient is breathing at 65 breaths per minute. C: nasal flaring. D: equal expansion of the lungs.

D: equal expansion of the lungs. Grunting and nasal flaring are both signs of respiratory distress in children. The range of breathing in children is: Infant (birth-1 year) 30-60, Toddlers (1-3 years) 24-40, Preschoolers (3-6 years) 22-34, School-age (6-12 years) 18-30, Adolescents (12-18 years) 12-16. Equal expansion of the lungs is one sign of adequate breathing.

The most common complication of the flow-restricted, oxygen-powered ventilation device is: A: pneumothorax. B: hypoventilation. C: cricoid pressure. D: gastric distention.

D: gastric distention. Medical literature indicates that gastric distention is the most common complication, however, patients with COPD maybe at greater risk for a pneumothorax.

During your initial assessment, you observe that the patient can only answer questions in two- to three-word sentences. Based on this finding, you should: A: apply a pulse oximeter to see if he is having trouble breathing. B: place him in a supine position and begin to give them artificial respirations. C: give him oxygen at 6 L/min by nasal cannula. D: give him oxygen at 15 L/min by nonrebreathing mask.

D: give him oxygen at 15 L/min by nonrebreathing mask. Oxygen should be given as soon as you identify trouble breathing during your initial assessment.

A Continuous Quality Improvement (CQI) system is designed to: A: identify medical mistakes and punish those who commit them. B: identify new trends in medical care and implement them. C: identify EMS providers who have to recertify. D: identify areas of improvement and appropriate education to help fix them.

D: identify areas of improvement and appropriate education to help fix them. CQI works to identify and improve areas of medical care. The CQI process should not punish the provider and should focus their education only on the skills needing assistance, not require unnecessary training. Advances in medical care are constant, and providers must work to stay up to date, but this is not the primary reason for CQI.

Following your detailed physical exam for an unstable medical patient, you should begin transport, then: A: repeat the initial assessment and vital signs every 15 minutes. B: remove the oxygen to get an accurate reading for pulse oximetry. C: wait until you are arriving at the hospital to reassess. D: repeat the initial assessment and vital signs at least every 5 minutes.

D: repeat the initial assessment and vital signs at least every 5 minutes. Vital signs, initial assessment, and interventions should be checked every 5 minutes in an unstable patient or more frequently if needed.

The EMT-B is likely to encounter children with tracheostomy tubes, artificial ventilators, central IV lines, gastrostomy tubes, or shunts in the home environment because: A: these children have poor prognosis for survival and are sent home to die. B: home health care services and visiting nurses are often incapable of providing proper care. C: parents of these children are more likely to become panicked easily and call 9-1-1. D: technology continues to improve and health care continues to focus on decreasing hospitalizations.

D: technology continues to improve and health care continues to focus on decreasing hospitalizations. The number of children with chronic illness who are living at home or in other environments outside the hospital continues to grow as their prognosis for survival is improved from the past, making it likely that the EMT-B will be called to assist these patients. These parents often know the child's history and condition better than some skilled health care workers and are rarely panicked.

What is meant by minute volume?. A: the amount of air taken in by the lungs over a two minute period. B: the amount of air that can be taken into the lungs in one breath, otherwise known as lung capacity. C: the amount of breaths per minute, minus the dead space in the lungs. D: the amount of air inhaled in one breath times the breaths per minute.

D: the amount of air inhaled in one breath times the breaths per minute. Example. A patient may inhale 14 times per minute, taking in a full breath of 500 mL. 14bpm X 500 mL = 7000 mL per minute.

The second phase of a coordinated continuum of care is: A: the patient receives assessment and stabilization in the hospital emergency department. B: the patient receives the necessary definitive specialized care. C: the patient recognizes an emergency and initiates the EMS system. D: the patient is assessed, treated, packaged, and transported to the hospital.

D: the patient is assessed, treated, packaged, and transported to the hospital. The second phase of the Coordinated Continuum of Care is assessment, treatment, packaging, and transport, and is usually provided by EMTs on an ambulance.

Children may have experienced a serious injury even though there may be little or no outward signs such as fractured ribs, bleeding, or contusions, because: A: their bodies can absorb energy better than an adult's. B: their organs are closer to the surface than an adult's. C: their organs contain more blood vessels than an adult's. D: their bodies can compensate better for significant blood loss.

D: their bodies can compensate better for significant blood loss. Children can compensate for significant blood loss, resulting in delayed external indication of serious injury. Their flexible ribs allow energy of blunt trauma to penetrate deeply into underlying organs, their organs are no more superficial than an adult's, nor do they have more blood vessels.

When you are called to assist a patient who is uncooperative and verbally abusive, you should: A: treat the patient in a similar manner to gain control of the situation. B: leave the scene and go back in service. C: threaten the patient with force if they don't calm down D: treat the patient with respect and call for law enforcement assistance.

D: treat the patient with respect and call for law enforcement assistance. Patients may not be able to effectively communicate when they are experiencing a medical crisis and must always be treated with respect. If you feel threatened, you should contact law enforcement and retreat to safety until they arrive.

The difference in attempting to clear a foreign body from the airway in the adult, child, and infant is: A: you perform blind finger sweeps in the infant, but not in the adult. B: you perform back blows in children and infants, but not in the adult. C: you perform two initial breaths in the adult, but only one in children and infants. D: you perform abdominal thrusts in adults and children, but back slaps and chest thrusts in infants.

D: you perform abdominal thrusts in adults and children, but back slaps and chest thrusts in infants. Back slaps and chest thrusts are performed on infants only. Two initial breaths are delivered in all age groups.

You encounter an 1 ½ year old who is crying, but has no tears. You notice the diaper is dry. What do you suspect?

Dehydration

When cleaning around her empty swimming pool, a 30-year-old female fell into the deep end of the pool. She presents with decreased sensation and movement in her lower extremities, a blood pressure of 80/50 mm Hg, and a heart rate of 50 beats/min. What is the MOST likely etiology of this patient's condition?

Disruption of the nervous system and relative hypovolemia

You respond to a call for an older woman who has fallen. Upon arrival at the scene, you assess the patient, who is responsive and alert to person, place, time, and event. She states that she does not want to go to the hospital; however, her son requests that you take her. What should you do?

Ensure the patient is fully aware of the consequences of refusing treatment

When first approaching a patient on scene the EMT will form a ______ based on environment, appearance and chief complaint.

General Impression

While caring for a 40-year-old male with shortness of breath and a history of tuberculosis, the AEMT should place a:

HEPA respirator on himself and a nonrebreathing mask on the patient

You are dispatched to a residence for a 69-year-old female with "breathing problems." When you arrive, the patient's husband directs you to his wife, who is sitting on the couch in obvious respiratory distress. She is semiconscious and has labored, shallow respirations. You auscultate her lungs and hear diffuse rhonchi in all lung fields. Which of the following interventions would be of LEAST benefit to her?

IV therapy with up to a 500 mL normal saline bolus

A 30-year-old male presents with a partial seizure to his left arm. His wife denies that he has ever had seizures in the past. Which of the following conditions would be the LEAST likely cause of this patient's seizure?

Idiopathic epilepsy

Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be MOST suspicious of:

a pulmonary embolism

A 19-year-old female presents with severe pain to the left lower quadrant of her abdomen. She is restless, tachypneic, and tachycardic. When you inquire about her last menstrual period, she tells you that it was approximately 2 months ago. You should suspect:

a ruptured ectopic pregnancy

A 20-year-old female with a history of chronic epilepsy, who is compliant with her anticonvulsant medication, experiences a "breakthrough" seizure. This usually happens when:

a seizure occurs despite a therapeutic medication blood level

Complete the next sentence so that it makes the most clinical sense. Your patient has been thrown form an automobile and is unresponsive to your voice, but responds to ______, leading you to assess this patient as ______.

a sternal rub, responsive to painful stimuli

A 22-year-old female was involved in a traumatic incident. She is exhibiting signs of shock, but there are no obvious external signs of trauma. You should suspect bleeding within the:

abdominal cavity

A 77-year-old man presents with hypertension, anuria, generalized edema, and tachypnea. This clinical presentation is MOST consistent with:

acute renal failure

A 22-year-old female with type 1 diabetes is unresponsive and has a blood glucose level of 29 mg/dL. She is receiving high-flow oxygen and several attempts to establish IV access have failed. You should:

administer 0.5 to 1 mg of glucagon via the intramuscular route

Your COPD patient is alert, but is breathing at 26 breaths per minute. Your next best course of action is to:

administer high flow oxygen via non-rebreathr mask

When treating a 56-year-old female with chest pain, you have placed on her oxygen, established IV access, and administered two doses of sublingual nitroglycerin. However, the patient's pain has not improved. You reassess her blood pressure and note that it is 106/66 mm Hg. You should:

administer one more dose of nitroglycerin

A 20-year-old female presents with acute respiratory distress. Auscultation of her lungs reveals diffuse expiratory wheezing. She is in moderate distress and tells you that she has a prescribed inhaler that she uses when this happens. You should suspect:

an acute asthma attack

A 72-year-old male with type 2 diabetes complains of "not feeling well." He is diaphoretic and his blood sugar reading is 110 mg/dL. You should be MOST suspicious for:

an acute myocardial infarction

Out of the following, which would be considered a the highest priority patient:

an unresponsive patient with normal vital signs and no signs of trauma or illness

A 27-year-old male complains of an acute onset of abdominal pain. He is found curled in a fetal position with his right knee drawn up into his abdomen. This position is MOST commonly seen in patients with acute:

appendicitis

You are dispatched to a local nightclub for a patient who has been stabbed. After arriving at the scene and ensuring you and your partner's safety, you find the patient sitting on the ground. He is conscious, screaming in pain, and attempting to control bright red blood that is spurting from his groin area. After taking standard precautions, you should:

apply direct pressure to control the bleeding

You arrive at the scene of a residential fire where the occupant, a 48-year-old male, has sustained partial- and full-thickness burns to his lower extremities and lower torso. Firefighters removed the patient's smoldering clothing and stopped the burning process prior to your arrival. The patient is conscious, but restless, and complains of intense pain to the burned areas. After taking the standard precautions, you should:

apply supplemental oxygen and monitor his airway.

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 he is diaphoretic, tachycardic, and tachypneic. Initial treatment for this patient should include:

applying a nonrebreathing mask at 15 L/min

A 29-year-old male experienced multiple fire-ant bites to his lower extremities. He is conscious and alert, and denies respiratory distress. His skin is warm, dry, and without urticaria and his breath sounds are clear and equal bilaterally. Appropriate management for this patient includes:

applying ice to the bites and observing for signs of an allergic reaction

A 57-year-old female with a history of peripheral vascular disease presents with an acute onset of confusion, aphasia, left-sided hemiparesis, and loss of muscle control to the right side of her face. You should suspect an:

arterial blockage in the right cerebral hemisphere

A 29-year-old confused female has a blood glucose reading of 50 mg/dL. After administering one tube of oral glucose, you note marked improvement in her mental status. As you are taking her vital signs, her level of consciousness suddenly decreases. You should:

assess her airway and treat accordingly

You are transporting a 55-year-old female with chest pain, who has not responded to 3 doses of nitroglycerin. As you are talking to her, she becomes unresponsive and apneic. You should:

assess her pulse, tell your partner to stop the vehicle, begin CPR, and analyze her cardiac rhythm with an AED

A 49-year-old male complains of acute chest discomfort. He is conscious but restless, and he is noticeably diaphoretic. As your partner is applying 100% oxygen, the patient hands you a bottle of nitroglycerin that was prescribed to him by his family physician. Prior to assisting the patient with his medication, you should:

assess his systolic BP to ensure that it is at least 100 mm Hg

You are called to the county jail for a 50-year-old male who is "drunk." When you assess him, you note the smell of alcohol on his breath and a markedly decreased level of consciousness. The sheriff's deputy tells you that this patient is a "regular." On the basis of the information that you have obtained, you should:

assess the patient's blood glucose and suspect intracranial bleeding

While assessing a semiconscious 22-year-old female's respirations, you note that they are 16 breaths/min. You should:

assess the regularity and depth of the patient's breathing

En route to the hospital, a diabetic patient regains partial consciousness. He tells you that he feels fine and that he does not want to go to the hospital. Under these circumstances, you should:

assess whether the patient's mental condition is impaired

While triaging patients at a multiple-casualty incident, you encounter a 40-year-old female with an obvious fracture of her right forearm and multiple abrasions to her face and arms. She is responsive and alert and does not appear to have any airway or breathing problems. You note that she is wearing an organ donor bracelet. You should:

assign her an appropriate triage category and move to the next patient

A young female with severe lower abdominal pain presents with a decreased level of consciousness, tachypnea, and shallow breathing. Her blood pressure is 88/48 mm Hg and her pulse is 130 beats/min and weak. You should:

assist her ventilations with a bag-mask device

Your patient is unresponsive, has pulse of 110 and is breathing at 8 breaths per minute. What's the next best treatment.

assist respirations with BVM and 100% oxygen

Your unconscious patient is breathing at 24 breaths per minute. What's the next best course of action?

assist ventilations with BVM and 100% oxygen

A 60-year-old female is in possible cardiogenic shock. She is semiconscious with shallow respirations, an irregular pulse, and hypotension. Appropriate treatment for this patient should include:

assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport

A 56-year-old male is found unresponsive by a neighbor. Your assessment reveals that he is diaphoretic, pale, and is breathing rapidly and shallowly. His blood glucose reading is 49 mg/dL. The MOST appropriate management for this patient includes:

assisted ventilation, 50 mL of D50 IV, and oropharyngeal suctioning as needed

You are assessing a 59-year-old male with an altered mental status. You should suspect an acute ischemic stroke versus hypoglycemia if the patient:

attempts to communicate with you

You are dispatched to a residence for a 4-year-old male who is not breathing. When you and your partner arrive at the scene, you find the child's father is performing mouth-to-mouth rescue breathing on him. The father tells you that his son stuck a pin in an electrical socket. After assessing the child and determining that he is pulseless and apneic, you should:

begin CPR and apply the AED as soon as possible

You are transporting a 60-year-old male to the hospital for suspected COPD exacerbation. He is receiving 100% oxygen via a nonrebreathing mask. As you reassess him, you note that his respirations have decreased and have become shallow. You should:

begin assisting his ventilations

You are dispatched to an assisted-living center for a 67-year-old male with "mental status changes." You arrive at the scene and begin to assess the patient. He is responsive to painful stimuli only, has rapid and shallow breathing, and a slow radial pulse. You should:

begin assisting the patient's ventilations

A 60-year-old male presents with shortness of breath and a productive cough of two days' duration. He denies chest pain or any other associated symptoms. Auscultation of his lungs reveals scattered bilateral rhonchi in all fields. His skin is pink, warm, and dry and the pulse oximeter reads 94% on room air. This patient is MOST likely experiencing:

bronchitis

You are assessing a young male with an acute onset of tachypnea. He is conscious and alert with shallow respirations of 40 breaths/min, and complains of numbness and tingling to his face and hands. The patient's girlfriend tells you that he has been very worried about his mother, who was recently diagnosed with cancer. Appropriate treatment for this patient includes:

coached breathing and oxygen as needed

You are caring for a 59-year-old male involved in a motor-vehicle crash. During your assessment, you note that his pelvis is unstable, he is pale and diaphoretic, and his blood pressure is 80/50 mm Hg. Use of the pneumatic antishock garment (PASG) would be absolutely contraindicated if further assessment of this patient revealed:

coarse crackles in the lungs

You receive a call to a local grocery store for a possible heart attack. Upon arrival at the scene, you find two bystanders performing CPR on the patient, a 49-year-old male. You should:

confirm that the patient is in cardiac arrest

A child with respiratory distress is:

considered to be a medical emergency.

A 61-year-old female called EMS after suddenly being awakened in the middle of the night with a feeling that she was "smothering." You arrive to find the patient, very apprehensive and restless, sitting on the living room couch in obvious respiratory distress. Her BP is 160/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. Auscultation of her lungs reveals diffuse rhonchi in all fields. Treatment for this patient should include:

continuous positive airway pressure and an IV line set to keep the vein open

A 62-year-old female with a history of type 2 diabetes has sustained partial-thickness burns to 27% of her body surface area (BSA). This burn should be classified as a:

critical burn

When attempting to ventilate an unconscious patient, you note decreased lung compliance. This indicates:

decreased alveolar expansion

Prior to administering IV dextrose to an unresponsive 43-year-old male with a blood glucose reading of 35 mg/dL, you should:

ensure that the IV line is patent and running effectively

You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:

humidified oxygen

Your patient has cool, pale and moist skin. These signs may indicate:

inadequate perfusion

You are assessing a 32-year-old female who was stung by a scorpion. She is unresponsive and has stridorous, severely labored respirations. Your partner, who is assisting the patient's ventilations with a bag-mask device, tells you that he is meeting significant resistance with each ventilation. You should:

insert an advanced airway device to protect her airway

A 70-year-old male with a history of esophageal cancer is unresponsive with slow, shallow respirations. Appropriate airway management for this patient includes:

inserting an oral airway and ventilating with a bag-mask device

Your patient is a 29-year-old male who presents with signs and symptoms of shock. However, your assessment reveals no obvious external signs of injury. You should suspect:

intraabdominal bleeding

Breathing in children:

is assessed using a stethoscope.

An AEMT witnessed a call in which his partner gave adequate physical care; however, he was deliberately rude because the patient was thought to be infected with HIV. The AEMT ignored his partner'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 AEMT is considered:

legal but unethical

A patient was struck in the right lower anterior chest with a baseball bat. In addition to fractured ribs, you should be suspicious of injury to the:

liver

A 59-year-old female with a history of poorly controlled hypertension becomes acutely dyspneic, develops profound cyanosis to the upper chest, and becomes unresponsive. She is pulseless and apneic upon your arrival. As you and your partner are performing the appropriate treatment interventions, you discuss the possible cause of her condition, which is MOST likely a(n):

massive pulmonary embolism

You are dispatched to a football game, where a spectator fell approximately 20 from the stands. As you approach the patient, you can see that he has obvious bilateral femur fractures and is not moving. Your initial action should be to:

open his airway and assess his breathing

A 33-year-old male complains of generalized weakness and chest discomfort that began following his morning workout at the gym. He is conscious and alert, but restless. Your assessment reveals a BP of 130/64 mm Hg, pulse of 78 beats/min and occasionally irregular, respirations of 16 breaths/min and unlabored, and an SpO2 of 98% on room air. He has prescribed nitroglycerin tablets and states that he took one without relief. Appropriate treatment for this patient includes:

oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport

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:

perform CPR for about 2 minutes and then apply the AED

You respond to a call for a 39-year-old female with an altered mental status. Your primary assessment reveals that she is conscious but confused, has a heart rate of 88 beats/min, and has respirations of 22 breaths/min with adequate tidal volume. After administering supplemental oxygen, you should:

perform a focused history and physical exam

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:

retreat at once and call law enforcement

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!" At this point, you should:

retreat immediately and call law enforcement.

A 69-year-old male with a history of hypertension and insulin-dependent diabetes complains of an acute onset of tearing pain in the lower quadrants of his abdomen that radiates to the back. His blood pressure is 90/50 mm Hg, pulse is 110 beats/min and thready, and respirations are 24 breaths/min and shallow. This clinical presentation is MOST consistent with:

ruptured or dissecting aortic aneurysm

A 50-year-old male with a blood sugar level of 38 mg/dL would be expected to present with all of the following, EXCEPT:

severe dehydration

A 77-year-old male with a history of emphysema complains of an acute worsening of his shortness of breath and pleuritic chest pain that occurred after a forceful cough. Auscultation of his lungs reveals scattered wheezing on the left side and diminished breath sounds on the right. This patient's clinical presentation is MOST consistent with:

spontaneous pneumothorax

A 56-year-old male with a history of coronary artery disease complains of an acute onset of substernal chest discomfort and diaphoresis while moving a heavy box. After sitting down and taking one nitroglycerin tablet, the discomfort promptly subsides. This episode is MOST consistent with:

stable angina pectoris

While attempting resuscitation of a patient in cardiac arrest, you initiate CPR, defibrillate the patient with an AED, and insert a multilumen airway prior to contacting medical control. What does this scenario most accurately describe?

standing orders

You are dispatched to a residence for a 60-year-old diabetic male who is unresponsive. As you are assessing the patient, your partner attempts to obtain a blood glucose reading; however, the glucometer reads "error" after two attempts. You should manage this patient's airway appropriately and then:

start an IV and administer 50 mL of 50% dextrose

A 55-year-old male sustained partial-thickness burns to his face and neck when he opened the hot radiator cap on his car. He is conscious and alert, but complains of dyspnea and difficulty swallowing. His oxygen saturation is 96% on room air. You should be MOST concerned about the:

status of his airway

A 38-year-old male with an inguinal hernia complains of increased pain and nausea. He tells you that he has been able to reduce the hernia himself in the past, but it will not reduce today. This patient is at GREATEST risk for:

strangulation of the bowel

You respond to a residence for a 27-year-old male with an altered mental status. As you are assessing him, his girlfriend tells you that he does not have any medical problems that she is aware of; however, he did fall two days ago and struck his head. These clinical and historical findings should make you MOST suspicious for:

subdural hemorrhaging

You are dispatched to the scene of a shooting. Upon arrival, you are directed by law enforcement to the patient, a 44-year-old male, who is unconscious. He is lying in an impressive pool of blood and you can hear gurgling from his mouth when he breathes. After your partner assumes C-spine control and opens the patient's airway, you should:

suction the patient's oropharynx

A 72-year-old male with a tracheal stoma requires ventilatory assistance. However, when you attempt to ventilate, you meet resistance. You should:

suction the stoma and mouth

40-year-old male is unconscious, has inadequate breathing, and is producing copious, continuous secretions from his mouth. This situation is MOST effectively managed by:

suctioning for 15 seconds and ventilating for 2 minutes

You are dispatched for a young male who, according to witnesses, is "not acting right." The patient is found sitting on the ground outside of a grocery store, rocking back and forth. He has blood on his arm from an apparent wound to his wrist. You should:

talk to him as you approach him, but be prepared for him to turn violent

In dark skinned patients the EMT can check the following areas:

the nailbeds and around the lips

SCENARIOS: 51-150 You respond to a nursing home's call regarding an older patient who fell. During your assessment, you note injuries that are not consistent with the mechanism described. You should:

transport the patient and report your suspicions

You arrive at the scene of an overturned semi-trailer truck. There is an odd odor in the air and you can see material leaking from the truck. After ensuring that fire department and law enforcement personnel are notified, you should:

use binoculars to try to read the placard

The 'V' in AVPU stands for:

verbal