Missed Qs # 2 NREMT

Place the following steps in the correct order for assessing a trauma patient with signifi- cant mechanism of injury. 1. SAMPLE history2. Rapid trauma assessment3. Reconsider mechanism of injury 4. Vital signs A. 3, 2, 4, 1 B. 2, 4, 3, 1 C. 1, 2, 3, 4 D. 4, 1, 2, 3

A. MOI-> Rapid trauma asst-> VS->sample The correct assessment priority in a patient with significant mechanism of injury is to reconsider the mechanism of injury, begin a rapid trauma assessment, and obtain vital signs and a SAMPLE history.

A febrile 44 year old male complains of shortness of breath and has dull chest pain. He has been coughing up "rusty" sputum for the last 3 days. What is the most likely cause? A. Pneumonia B. Congestive heart failure C. Emphysema D. Chronic bronchitis

A. Pneumonia

41. You are called to a private residence for a psychological emergency. On arrival, you find a 28-year-old male acting violently. The family states that he woke up this morning and was not himself. They also state that the patient was in an accident two days ago in which he sustained a head injury but refused medical care. As you are speaking to the family, the patient collapses. After initial assessment, Your findings show that the patient has a stable airway, is breathing, and has a good pulse rate. Your next intervention should be to A. do a neurological assessment. B. begin a secondary assessment. C. immobilize the patient and begin transport. D. examine the head for suspected injury.

A. do a neurological assessment.

Common causes of acute psychotic behavior include all of the following, EXCEPT: intense stress. schizophrenia. Alzheimer disease. mind-altering-substance use.

Alzheimer disease.

46. You encounter an infant at the scene whois unresponsive and not breathing. You palpate to check for a pulse but don't feel one initially. How long should you continue palpating for a pulse in this patient before you assume that there is not one and begin chest compressions? A. 5 seconds B. 10 seconds C. 15 seconds D. 20 seconds

B health care providers may take up to 10 seconds to attempt to find the pulse of an infant or child. If theTprovider does not feel a pulse or is unsure of whether there is a pulse, he or she should begin chest compressions.

Effective immobilization of a bone includes which of the following? a. Immobilizing the area above and below the fracture site b. Maintaining manual stabilization throughout the transport c. Immobilizing the joint above and below the fracture site d. Splinting the patient only after she is placed in the ambulance

C. To properly immo bilize a bone, the EMT should immobilize the joints above and below the fracture site. This will ensure that no movement of the bone will be possible. Unless the patient has other critical injuries, do not attempt to move the patient until painful and swollen limbs have been properly immobilized.

A closed fracture to bones may result in major internal blood loss. Of the follow- ing bones, which one can result in the most severe blood loss? A. Humerus B. Femur .C. Pelvis D. Radius

C. While any closed fracture may result in blood loss, a fracture to the pelvis can result in a large amount of blood loss. It is not uncommon to lose one to two liters (20 to 33 percent) of blood volume due to this type of injury. Any time the EMT suspects a fracture to the pelvic area, a consideration should be made as to how much associated blood loss may be endured

A newborn infant will usually begin breathing spontaneously within _______ seconds following birth. A. 3 to 5 B. 5 to 10 C. 15 to 30 D. 30 to 60

C. 15 to 30

A 49 year old male complains of severe right upper quadrant abdominal pain and nausea. He is jaundiced and febrile. Vital signs are BP 98/60, P 92, R 16. What should you suspect? A. Gall stones B. Pancreatitis C. Hepatitis D. Gastric ulcers

C. Hepatitis

Of the following, which is NOT a sign of adequate breathing? A. Abdominal movement B. Equal chest rise and fall C. Muscular retractions in the ribs D. Audible breath sounds

C. Muscular retractions in the ribs

Which of the following organs lies in the retroperitoneal space? A. liver B. spleen C. gallbladder

C. gallbladder

Diabetic coma is a life-threatening condition that results from: A. hypoglycemia, excess insulin, and dehydration. B. hyperglycemia, ketoacidosis, and dehydration. C. hypoglycemia, dehydration, and ketoacidosis. D. hyperglycemia, excess insulin, and ketoacidosis.

C. hypoglycemia, dehydration, and ketoacidosis

A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should: A. transport immediately. B. administer oral glucose. C. provide ventilatory support. D. treat her for hyperglycemia.

C. provide ventilatory support.

You and your partner are together performing CPR on a 5-year-old child. You are per- forming the chest compressions, while your partner manages the airway and performs the ventilations. What ratio of chest compres- sions to ventilations should you follow? A. 30:2 B. 20:1 C. 15:2 D. 10:1

Correct answer is C a 2 person team should maintain a compression-to-ventilation ratio of 15:2 when performing CPR on a child. A lone rescuer should maintain a compression-to-ventilation ratio of 30:2.

The normal respiratory rate for a newborn is about _____ breaths per minute. A. twelve to twenty B. fifteen to thirty C. twenty-five to fifty D. forty to sixty

D 40-60

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

D A shuffling gait when walking

You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include: A oxygen via nonrebreathing mask at 15 L/min and immediate transport. B insertion of an oropharyngeal airway and positioning him on his side. C elevation of his lower extremities and covering him with warm blankets. D BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation.

D BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation.

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma on the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: A apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport. B insert an oral airway, hyperventilate him with a bag-valve mask, apply full spinal precautions, and transport to the closest trauma center. C apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment. D assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

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

Diabetic Keto Acidosis s/s

D-ehydration K-etones in the urine and blood, Kussmaul Resp and K+ A-cidosis, Acetone breath, Anorexia d/t nausea, altered mental status

All of the following are contraindications to the application of a traction splint EXCEPT A. pelvic fracture. B. knee injury. C. acetabular fracture. D. open femur fractur

D. The traction splint is indicated for femur fractures. This includes open fractures. Injuries to the pelvis, acetabulum, and knee are not treated with traction splint application.

17. An 18 year old female has an open femur fracture after falling off a horse. She is screaming in pain. What should you do?A. Apply mechanical traction.B. Immobilize her onto a long backboard. C. Elevate her extremity. D. Assess for distal circulation.

D. Assess for distal circulation.

Which of the following is classified as a critical burn? a. A patient with superficial burns over 40 percent of her body b. A child with partial-thickness burns over 15 percent of his body c. A patient with partial-thickness burns to 18 percent of his legs d. A patient with full-thickness burns to her feet

D. Burns to the hands, feet, genitalia, and airway are always considered critical. Although they may only account for a small percentage of total body surface areas burned, they need immediate treatment.

The pocket face mask with supplemental oxygen may deliver up to ________ percent oxygen to the nonbreathing patient. A. 35 B. 50 C. 85 D. 100

D. The bag-valve- mask with supplemental oxygen can deliver almost 100 percent oxygen as a result of hav- ing an oxygen reservoir. If the device lacks a reservoir, the percent of oxygen delivery falls to nearly 50 percent.

Signs of compensated shock in the pedi- atric patient include all of the following EXCEPT A. rapid pulse. B. dry mucous membranes. C. decreased output of urine. D. decreased blood pressure.

D. decreased blood pressure.

MATCH THE FOLLOWING OXYGEN CYLINDERS TO THEIR APPROPRIATE CAPACITY. E cylinderA. 625 liters B. 350 liters C. 6,500 liters D. 3,000 liters M cylinder A. 625 liters B. 350 liters C. 6,500 liters D. 3,000 liters D cylinder A. 625 liters B. 350 liters C. 6,500 liters D. 3,000 liters

E cylinder =625l d cylinder = 350l m= 3000 l Oxygen tanks are produced in several capacities. The D and E cylinders are usually portable, with the D tank being the most popular. The M cylinder is used for a fixed onboard oxygen system.

______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant. Bacterial vaginosis Hypotension Ectopic pregnancy Menopause

Ectopic pregnancy

GEMS diamond

Geriatric Patients Environmental Assessment Medical Assessment Social Assessment\ Geriatric - impaired Environment - hazardous Medical Assessment - prescriptions, OTC Social Assessment - help daily living

Which of the following correctly lists laryn- goscope blades from smallest to largest? A. 0, 1, 2, 3, 4 B. 4, 3, 2, 1, 0 C. 8, 6, 4, 2 D. 2, 4, 6, 8

The correct answer is A. Laryngoscope blades are sized from smallest (0) to largest (4).

An 8-year-old girl with adequate ventilations is receiving oxygen via a simple oxygen mask during a long transport to the hospital. Her oxygen saturation level is 95%. She com- plains that her nose feels dried out on the inside. The best action would be to switch her to A. humidified oxygen.B. a nasal cannula.C. a bag-valve mask.D. an automatic transport ventilator.

The correct answer is A. Oxygen adminis- tration can lead to the drying of the mucous membranes that line the nasal cavity in some patients. To alleviate this problem, the EMT can administer humidified oxygen. Deliv- ery of unhumidified oxygen by any other device—such as a nasal cannula (choice B)—would not alleviate this problem and might worsen it. Also, because this patient has adequate ventilations without assistance, there is no indication for use of a bag-valve mask (choice C) or automatic transport ven- tilator (choice D).

Which of the following cardiac rhythms, when producing a pulse, would generate a shock-advise message from an AED? A. Ventricular fibrillation b. Ventricular tachycardia C. Pulseless electrical activity D. Asystole

The correct answer is B. Different forms of ventricular tachycardia may look the same on a cardiac monitor, but one produces a pulse and one does not. When the AED does not detect a pulse, it will recommend a shock for this rhythm. Delivering a shock to a patient in ventricular tachycardia with a pulse may cause great harm—to the extent of stopping the heart. To prevent this grave error, it is only advisable to attach an AED to a patient who has no pulse.

Your conscious patient with adequate venti- lations is complaining of difficulty breath- ing. In which position should you transport this patient? A. Lying down with legs elevated B. a position that is comfortable to thepatient C. Sitting forward with knees flexed D. Lying sideways, to facilitate airway management

The correct answer is B. The conscious patient with adequate ventilation should sit in a position that is most comfortable. This position (usually leaning forward in a tripod position) will ensure that the patient can maintain adequate ventilations without assis- tance. The EMT should administer supple- mental oxygen to all patients complaining of difficulty breathing.

The normal respiratory rate for a toddler is about _____ breaths per minute. A. twelve to twenty B. fifteen to thirty C. twenty-five to fifty D. forty to sixty

The correct answer is B. The normal respiratory rate for a newborn is about forty to sixty breaths per minute. The normal respiratory rate for an older child or adult is twelve to twenty breaths per minute. The rate for a toddler is about fifteen to thirty breaths per minute, and for an infant the normal respiratory rate is about twenty-five to fifty breaths per minute.

Laryngoscope blades come in several differ- ent styles. The straight blade is also known as the ________ blade, whereas the curved blade is known as the ________ blade. A. Macintosh; MillerB. Miller; MacintoshC. fiber-optic; MillerD. fiber-optic; Macintosh

The correct answer is B. The straight laryn- goscope blade is the Miller blade, and the curved laryngoscope blade is the Macintosh blade. Fiber-optic blades do exist, but they are supplied in both styles of laryngoscope blades.

A 2-year-old is unresponsive and not breath- ing but has a pulse of about 55 beats/minute. You provide ventilations and oxygen using a bag-valve mask, but the low pulse rate per- sists and the child demonstrates pallor. Your next action should be to a continue providing ventilations and oxygen with the bag-valve mask. b begin chest compressions and alternate them with ventilations. c attach an AED and analyze the child's heart rhythm. d switch the child to a nonrebreather mask with humidified oxygen.

The correct answer is B. if a child hasa pulse less than 60 beats/minute and shows signs of poor perfusion (e.g., pallor, mot- tling, cyanosis) despite receiving oxygenation and ventilation, the health care provider should begin chest compressions, alternat- ing them with ventilations

All of the following are metabolic causes of altered mental status EXCEPT a overdose. B. hypothermia. C. CVA. D. diabetic emergencies.

The correct answer is C. Metabolic causes of altered mental states are conditions caused by factors outside of the central nervous system. Many of these factors are from the outside environment. CVA (cerebrovascular accident or stroke) is a structural cause of altered mental status because it occurs in the central nervous system.

The nonrebreather mask can deliver approxi- mately what percent oxygen when attached to a delivery system at twelve to fifteen liters per minute? A. 35 to 45 B. 45 to 55 C. 80 to 90 D. 100

The correct answer is C. The nonrebreather mask can deliver oxygen concentrationsas high as 80 to 90 percent when properly hooked up and set at the proper liter flow.

When a shockable heart rhythm is identi- fied in a pulseless, unresponsive infant, the preferred next action is a chest compressions using the two-finger technique. b defibrillation with a fully automatic, standard AED. c defibrillation with an AED with a pedi- atric attenuator. ddefibrillation with a manual defibrillator.

The correct answer is D. defibrillation with a manual defibrillator is preferred when a shockable rhythm is identified in an infant. If a manual defibrillator is not available, an AED with a pediatric attenuator is pre- ferred. If neither of these is available, then an AED without a dose attenuator may be used. Chest compressions are not appropriate for defibrillation.

The bag-valve-mask ventilation device with a reservoir may deliver up to ________ per- cent oxygen to the nonbreathing patient. A. 35 to 45 B. 50 to 60 C. 75 to 85 D. 95 to 100

The correct answer is D. The bag-valve- mask with supplemental oxygen can deliver almost 100 percent oxygen as a result of hav- ing an oxygen reservoir. If the device lacks a reservoir, the percent of oxygen delivery falls to nearly 50 percent.

V/Q

Ventilation/Perfusion ratio: the ratio of alveolar ventilation to simultaneous alveolar capillary blood flow in any part of the lung; liters of gas per liter of blood

The purpose of the GEMS diamond is to: a help EMS personnel remember what is different about elderly patients. b provide the EMT with a standard format for assessing elderly patients. c replace the typical ABC approach to patient care when caring for the elderly. d provide clues about an elderly patient's problem by observing his or her home.

a help EMS personnel remember what is different about elderly patients.

EMTs are assessing a 2-year-old child who was riding in a car seat when the vehicle struck a tree while traveling at 45 MPH. The child is conscious and appears alert. There are no obvious signs of trauma to the child, and the car seat does not appear to be damaged. The EMTs should: a remove the child from the car seat and secure him to a pediatric immobilization device. b leave the child in the car seat, but pad around the child's head with towels or a pillow. c remove the child from the car seat and secure both him and his mother to the stretcher d .secure the child in the car seat with straps and apply a pediatric-sized cervical collar.

a remove the child from the car seat and secure him to a pediatric immobilization device.

diabetic ketoacidosis

acidity of the blood caused by the presence of ketone bodies produced when the body is unable to burn sugar; thus, it must burn fat for energy

Pediatric Assessment Triangle (PAT)

appearance, work of breathing, and circulation to the skin. A structured assessment tool that allows you to rapidly form a general impression of the infant or child without touching him or her;

Despite your numerous, sincere efforts to convince a 40-year-old man to consent to EMS treatment and transport, he refuses. After explaining the potential consequences of his refusal and determining that the patient has decision-making capacity, you ask him to sign an EMS refusal form, but he refuses to do that as well. You should:sign the refusal form, include the date and time, and have your partner witness it with his or her signature. document the patient's refusal, but leave the refusal form blank because only the patient can legally sign it. advise the patient that unless he signs the refusal form, he cannot legally refuse EMS treatment or transport. ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign.r

ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign.r

which of the following is a sign of compartment syndrome a absence of pain at the injury site b Pain upon passive movement of the injury site c bounding pulse distal to injury d blood loss at injury site

b Pain upon passive movement of the injury site

When should you consider transport in treating a patient in cardiac arrest with an AED and CPR? A. After six shocks have been delivered B. After three shocks have been delivered C. Only after ALS care has arrivedD. Only after the patient regains a pulse

b The EMT should consider transport after three unsuccess-ful defibrillation attempts. If the ALS unit is en route and its ETA is longer than it would take to arrive at the nearest hospital, the EMT should begin transporting the patient to the hospital. If, for any reason, the ETA of the ALS unit should change, the dispatcher can arrange for the ALS unit to intercept the BLS unit.

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

b a subdural hematoma.

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should: A continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol. b be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital. c begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles. d begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.

b be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

A 4-year-old, 16-kg female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should: a place her supine and elevate her legs. b monitor her airway and give oxygen. c determine why the ingestion occurred. d administer 16 g of activated charcoal.

b monitor her airway and give oxygen.

The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to: a estimate the child's weight based on age. b use a length-based resuscitation tape measure c .estimate the child's weight based on appearance d .ask a relative if he or she knows the child's weight.

b use a length-based resuscitation tape measure

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

be homicidal as well

Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown? a It has been largely hidden from society. b The definitions of abuse and neglect vary. c Human resource agencies fail to investigate. d Victims of elder abuse are hesitant to report it.

c Human resource agencies fail to investigate.

The term primigravida refers to a woman who:A. has never been pregnant.B. has had only one live birth.C. is pregnant for the first time.D. has had more than one live baby.

c 1st pregnancy

pulmonary embolism signs and symptoms

caused by a blockage in the pulmonary artery chest pain, pedal edema in one leg Risk factors include long sedentary periods -depends on the size and location of embolus -Dyspnea, substantial pain, low-grade fever

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called: a angina pectoris. b arteriosclerosis. c acute ischemia. d atherosclerosis.

d atherosclerosis.

After an advanced airway device has been inserted during two-rescuer CPR, you should: pause compressions to deliver ventilations. deliver one rescue breath every 6 seconds. decrease the compression rate to about 80 per minute. increase rescue breathing to a rate of 14 breaths/min.

deliver one rescue breath every 6 seconds.

hyperglycemia treatment

diabetic medications as ordered, diet, exercise, check BS frequently

peritoneal dialysis

dialysis in which the lining of the peritoneal cavity acts as the filter to remove waste from the blood

polyphagia

excessive hunger

polydipsia

excessive thirst

febrile

feverish

eaten but forgot insulin...

hyperglycemia

HHNS

hyperglycemic hyperosmolar nonketotic syndrome caused by dehydration like DKA but also visual sensory deficits, edema paralysis weakness seizures

took too much insulin, or didn't eat

hypoglycemia

Functions of dressings and bandages include all of the following, EXCEPT: prevention of contamination prevention of further injury immobilization of the injury. controlling bleeding

immobilization of the injury.

Peritonitis

inflammation of the peritoneum

Lateral decubitus

lying down on the side

CPR is in progress on a pulseless and apneic 29-year-old woman who is 37 weeks pregnant. When treating this patient, the EMT should:

manually displace the patient's uterus to the left.

the _____ plane separates the human body into right and left halves sagittal coronal transverse midsagittal

midsaggitall

Severe burns in children include: any superficial or partial-thickness burn that involves the legs or arms. partial-thickness burns covering more than 20% of the body surface. second-degree burns covering more than 10% of the body surface. superficial burns covering more than 10% to 15% of the body surface.

partial-thickness burns covering more than 20% of the body surface.

After using the pediatric assessment triangle (PAT) to form your general impression of a sick or injured child, you should: evaluate the child's baseline vital signs. obtain a SAMPLE history from the parents. perform a hands-on assessment of the ABCs. assess the child's heart rate and skin condition.

perform a hands-on assessment of the ABCs.

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called: potentiation. polypharmacy. drug tolerance. drug dependency.

polypharmacy.

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

she is capable of becoming pregnant.

The EMT should perform a "rapid scan" to determine if the patient is __________ during the __________ .stable or unstable; primary assessment breathing or not breathing; primary assessment complaining of vaginal bleeding; history taking pregnant; secondary assessment

stable or unstable; primary assessment

subdural hematoma s/s

unconsciousness, dilation of one pupil, headache, dizziness, nausea, sleepiness

Defibrillator pads are placed on the patient's chest a :with one pad to the left of the upper sternum and the other pad just to the right of the left nipple. b with one pad to the right of the upper sternum and the other pad just to the right of the right nipple. c with one pad to the left of the upper sternum and the other pad to the right lower chest below the armpit. d with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.

with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.

You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: A. oxygen. Bglucagon .C. insulin. D. dextrose.

.C. insulin.

The main legal risk in using the AED is: negligence on the part of the manufacturer. failure of the AED's internal computer chip .failing to deliver a shock when one is needed .not assessing for a pulse after a shock is delivered.

.failing to deliver a shock when one is needed

When performing CPR chest compressions on an infant, you should depress the chest approximately A. half an inch (1 cm). B. 1 inch (2.5 cm). C. 1.5 inches (4 cm). D. 2 inches (5 cm).

1.5 inches

The thoracic spine is composed of ___________ vertebrae. 10 12 14 16

12

Pulse rate is assessed by counting impulses for A thirty seconds and multi-plying by two. b impulses for fifteen seconds and multi- plying by four. c breaths for a full sixty seconds. d full chest rises for fifteen seconds.

2 The correct answer is A. To assess the pulse rate, the EMT should count impulses for thirty seconds and multiply that number by two.

During the analyze mode of AED use, CPR should be A interrupted to allow the AED to ana- lyze the rhythm. b continued as it will not interfere with the analyze phase. c interrupted, but ventilations continued. d. continued at a slower rate.

23 The correct answer is A. The EMT should prevent any unnecessary patient move- ment during the analyze phase of AED use. Although modern AEDs will be able to decipher what is artifact and what is not, there is always a chance of a false reading

Signs of compensated shock in the pediatric patient include all of the following EXCEPT A. rapid pulse. B. dry mucous membranes. C. decreased output of urine. D. decreased blood pressure

39 The correct answer is D. Decreased blood pressure is a late sign of shock in children and adults. The EMT should be aware of subtle signs of compensated shock in a child. Signs of dehydration are early signs of shock. Compensated shock should be suspected in a child with a history of diarrhea or vomiting. Sunken fontanels in infants are also a sign of dehydration as well as compensated shock.

The normal heart rate range for a toddler is A. 80-150 beats/minute. B. 70-120 beats/minute. C. 65-110 beats/minute. D. 60-100 beats/minute.

44 The correct answer is B. The normal heart rate for a toddler is about 70 to 120 beats/ minute. The normal heart rate for an infant is about 80 to 150 beats/minute. The normal heart rate for a preschooler is about 65 to 110 beats/minute. The normal heart rate for an older child or adult is about 60 to 100 beats/ minute.

Febrile seizures are MOST common in children between the ages of: 3 months and 4 years. 6 months and 6 years .8 months and 8 years. 18 months and 10 years.

6 months and 6 years

The cervical spine is composed of ___________ vertebrae. 5 6 7 8

7

Normal blood glucose level

80-120 mg/dL

Your patient is unconscious after being struck on the head with a lead pipe. In a patient with severe head injury, you would expect his pupils to be unreactive or A. unequal. B. constricted. C. dilated. D. unaffected.

A Due to the kinematics of brain injury, injury to the brain will cause bleeding on the injured side of the brain. This, in turn, will put pressure on the optic nerve on the injured side, causing unequal pupils.

42. At the scene of a motor vehicle accident, you perform an initial evaluation of a 12-year- old girl and find her unharmed and with no remarkable medical history. Later, you see her faint after standing up from a crouched position. You suspect that she has just experienced A. orthostatic hypotension. B. anaphylactic shock. C. hypoglycemia. D. vasovagal syncope.

A. Orthostatic hypotension is a sudden drop in blood pressure due to a change in body position. It commonly occurs in children and adults on standing from a seated position and may manifest as light-headedness, dizziness,or even syncope (fainting). (Other causes of syncope include vasovagal response (an exaggerated response by the body to some perceived threat, such as receiving a shot or having blood drawn), anaphylaxis (a severe allergic reaction), and hypoglycemia (low blood glucose level).

An abortion occurs when the fetus and placenta deliver before: A. 20 weeks. B. 12 weeks. C. 24 weeks. D. 16 weeks.

A. 20 weeks.

4. What is the amount of air that normally reaches the alveoli in an adult? A. 350 mL B. 500 mL C. 150 L D. 750 L

A. 350 mL

You are called to a private residence for a psychological emergency. On arrival, you find a 28-year-old male acting violently. The family states that he woke up this morning and was not himself. They also state that the patient was in an accident two days ago in which he sustained a head injury but refused medical care. As you are speaking to the family, the patient collapses. 38. What should be your initial intervention? A. Assess breathing B. Open the airway with the jaw-thrust maneuver and assess the airway C. Assess circulationD. Administer glucose paste to the patient and assess blood glucose level

B the EMT should assist him by doing a complete primary assessment. This consists of the A, B, Cs and then a neuro- logical assessment. After the neurological assessment, the patient should be immobi- lized to a long spine board with a cervical collar applied. Based on the patient's delayed response to injury, the EMT should be able to effectively rule out an epidural hematoma, as they are rapid arterial bleeds. A concus- sion will not present with severe symptoms several days later. A cervical spinal injury will not cause inappropriate behavior if itis isolated to the cervical spine. However,a subdural hematoma, which is bleeding slowly from a venous source, can surely cause this type of behavior. A subdural hematoma may take hours or even days to develop,with neurological symptoms being delayed. Treatment for this patient includes high- concentration oxygen, airway management, and rapid transport to the hospital.

During the ongoing assessment of your patient, you notice that the patient's blood pressure has dropped from 110/70 to 90/58 mmHg. Because of this pertinent finding, you should a. continue your current mode of treatment. b. completely reassess your interventions. c. immediately administer oxygen to the patient. d. advise your partner to speed up the transport.

B. If during the EMT's ongoing assessment the patient's condition worsens, the EMT should reassess the previous interventions and reevalu-ate critical areas of the initial assessment. Obtaining baseline vital signs during the initial assessment creates a reference point for patient status evaluation after treatment. If the patient status deteriorates, then addi- tional interventions may be needed, includ- ing the request for ALS assistance.

The pediatric patient with an altered mental status, rapid respiratory rate, and delayed capillary refill is probably experiencing A. compensated shock. B. decompensated shock. C. decreased blood sugar. D. head injury.

B. The child in decompensated shock presents with altera- tions of mental status and increased respi- ratory rate. The EMT must be aware that falling blood pressure is an ominous late sign and should be avoided at all costs. Inter- ventions should be attempted to prevent blood-pressure drop and circulatory collapse. Pediatric patients compensate for volume loss longer than an adult, but decompensa- tion is rapid and usually irreversible.

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

B. acute cholecystitis.

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

B. appendicitis.

If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then: A. place a folded towel behind her head to make it easier to breathe. B. elevate the right side of the board with rolled towels or blankets. C. raise the foot of the board 12 inches in order to maintain blood pressure. D. elevate the head of the board 6 inches to prevent breathing impairment.

B. elevate the right side of the board with rolled towels or blankets.

In general, oral glucose should be given to any patient who: A. has a blood glucose level that is less than 100 mg/dL. B. has an altered mental status and a history of diabetes. C. has documented hypoglycemia and an absent gag reflex .D. is unresponsive, even in the absence of a history of diabetes.

B. has an altered mental status and a history of diabetes.

All of the following adjuncts are used in artificial ventilation EXCEPT the A. bag-valve-mask .B. nonrebreather mask. C. pocket face mask. D. CPR mask.

B. nonrebreather mask. Artificial ventila- tion is the process of manually forcing air into the patient's lungs. The bag-valve- mask, pocket face mask, and CPR maskare all designed to deliver pressures great enough to produce artificial ventilation. The nonrebreather mask will not develop high pressures to ensure adequate ventilation and should never be used.