nremt practice test 1

A nasal cannula should be run at how many liters per minute?

1 to 6 liters per minute

what is the compression rate for a 10-year-old patient in cardiac arrest?

100-120/minute

When assessing APGAR at 1 and 5 minutes after birth, you can score up to 2 points for each sign. If your baby's Pulse rate is noted to be greater than 100, what Pulse score would you give?

2

A newborn (born at 39 weeks) requires positive pressure ventilation due to respiratory distress following birth. Which of the following tidal volumes is most appropriate for this patient

25ml

You have been called for a 3 kg baby who was delivered just before your arrival. After his airway has been suctioned and tactile stimulation has been provided, he still isn't breathing on his own. At what rate would you ventilate this neonate

30 to 60 breaths per minute

You arrive on the scene of an unplanned home birth. The newborn's arms and legs are moving but weak, the face is in a grimace, and is actively crying. The extremities are blue. The HR is 130, RR 50, BP 60/40. If this newborn is being assessed 3 minutes after birth, what is the APGAR score?

8

AED kits normally contain both adult and child AED pads/cables. At what age does it become appropriate to use an adult pad/cable set on a child?

8 years old

A frightened adult male calls for an ambulance complaining that he had accidentally eaten mushrooms that contain muscarine. What signs and symptoms would you expect to see if the mushrooms truly contain muscarine?

A decrease in HR & BP; his pupils would be constricted

Which of the following is true regarding the assessment findings in pregnant women?

Appendicitis is difficult to diagnose during the second and third trimesters.

You respond to a residence for a "woman shot." After ensuring that the scene is safe you find a 26-year-old woman with a bullet wound to the lower left side of the abdomen. She is conscious, verbally responsive, and very agitated. Vital signs are BP 110/90; HR 120; RR 24. Which would be the most appropriate plan of treatment?

Apply a pressure dressing, add oxygen as needed, and transport patient immediately to an appropriate medical facility

The assessment you perform on your patient reveals there is a danger of imminent self-harm as they are uncontrolled and determined to hurt themself. Application of restraints to the patient and transport to an emergency department without a combative patient's consent is:

Appropriate for combative patients in need of transport

An unresponsive patient is breathing on his own at 6-8 breaths per minute. He is cyanotic around the nose and mouth. You are unable to palpate a radial pulse, you should:

Begin assisting ventilations with a BVM and 100% O2 at 10-12 breaths per minute

You have arrived at a residence where you find a 23-year-old male in cardiac arrest. The patient appears to be normally healthy. A member of the family approaches you and requests that you not perform any life-saving measures, as the patient has a Do Not Resuscitate order. However, when asked, the family member cannot produce the order. What actions should you take?

Begin life saving measures immediately, attempt resuscitation, and transport.

When suctioning you should always do which of the following?

Begin suctioning after the catheter is placed in the airway.

The 'B' in DCAP-BTLS stands for:

Burns

On a cold winter morning, you are called to an unknown medical emergency. On arrival you find 4 patients varying in age from 12 to 36 years old all complaining of waking up this morning with an extremely dry mouth, and severe headache. What would be the BEST course of action in this case?

Clear the house and begin assessing according to severity of symptoms

The administration of epinephrine causes peripheral vasoconstriction and cardiac stimulation from its alpha properties. Epinephrine also has strong beta II stimulatory properties. What does the associated beta II stimulation do for the patient?

Dilation of bronchioles

You are called to the scene of a passenger car train derailment. Who has ultimate authority for all issues regarding patient care at the scene of a mass-casualty incident?

EMS medical director

a non-modifiable risk factor for cardiac arrest is which of the following?

Family history

You are partnered with a paramedic and have been dispatched to the scene of a motor vehicle accident, the paramedic has placed an endotracheal tube on a patient and began providing manual ventilation. On the way to the trauma center, you note that the patient's SpO2 is high but her lung sounds are absent despite mechanical ventilation. After you mention this to your partner, he evaluates the patient and pulls the ET tube. He places an oropharyngeal airway and uses a BVM on the patient until you arrive at the trauma center. You can hear air moving in and out of the lungs now. What is the most likely explanation for your partner's actions?

He decided that there was a ventilation problem related to the ET tube.

Infectious disease exposure requires

Immediate reporting to a designated reporting officer.

You are on the scene of a 2-car MVC. Your paramedic partner tells you that patient #1 is not hemodynamically stable. This indicates that your patient:

Is hypotensive

You are called to an area park for a possible snake bite. On arrival, you find a 22 year old that states she was bitten by a snake on the ankle. There are a set of fang marks approximately 1 cm apart on her right ankle. Her vitals are stable. Which of the following would be the most appropriate way to treat this patient?

Keep the site of the bite lower than the heart and restrict patient activity

When trying to assess heart tones during an assessment, where is the point of maximum impulse (PMI) located on most adult patients?

Left anterior chest at the fifth intercostal space in the midclavicular line

You are called to see a woman who has just delivered her baby and placenta. You note that she is bleeding profusely from her vagina, although she is stable in all of her vital signs. Visual inspection of her vagina shows no tears. She states milk is leaking from her nipples and wants to breastfeed her baby immediately. You should:

Let her breastfeed the baby

You have received a call of a man down. The only information relayed through the dispatcher is of a white male lying in the ditch. The call is in an area where you have responded to violence and many drug overdoses in the past. What actions should you take prior to arrival?

Locate a safe place away from the incident to stage and request police assistance.

You have been dispatched to a 45-year-old male in respiratory distress. When you arrive on the scene, the patient's wife tells you that her husband is having trouble breathing and was diagnosed with TB several years ago. Which of the following pieces of personal protective equipment will give you the BEST protection against exposure to tuberculosis?

N-95 mask

EMS is called for a 16-year-old female who has become short of breath and is tachycardic at rest. She has recently started birth control and just got out of the car after an 8-hour car ride about 12 hours ago, which has likely predisposed her to which of the following?

PE

You have responded to a suicidal subject that has cut his wrists and is bleeding profusely. The subject refuses to cooperate and is running around in his apartment to stay away from medical care providers and law enforcement. What action should you take?

Protect yourself until law enforcement personnel subdue the patient for treatment.

Your unit is alerted to a "man down" unconscious and unresponsive. Upon arrival on scene, you observe a man lying face down in his garage in a pool of blood. As you roll the patient over, you see an entry wound to the temporal area of the patient's head, and see a handgun laying under the body of the patient. The patient has fast, shallow respirations, and there appears to be no exit wound. What should you do next?

Request law enforcement assistance for a potential suicide, move the patient if the handgun hinders your ability to perform aide, and begin life saving measures.

You are on the scene of a pulseless and apneic patient and have completed your first 2 minutes of CPR. Your partner attached the AED and delivered a shock as prompted by the AED. What is the next step in the BLS algorithm?

Resume high quality compressions

What clinical significance is associated with injuries to the upper quadrants of the abdomen?

Significant blood loss and compromised breathing

What is the main goal of integrating preparedness into resource management, command and coordination, and communications and information management according to NIMS?

To achieve a unified approach to emergency management and incident response activities.

Why should responders wait one second before talking after pressing the push to talk button?

To allow a space for the radio to begin transmitting so your message is not cut off at the beginning.

Your patient has sustained blunt force abdominal trauma and complains of severe pain, leading you to believe that she may have sustained an internal injury with bleeding. If so, which of the following signs and symptoms would NOT be present?

Warm, dry skin

You witness an adult beginning to choke at a local restaurant. He is presenting the universal choking sign, so you prepare to help. After concluding the patient has a complete occlusion, what is the best way to dislodge the foreign object from his airway?

Wrap your arms around his upper abdomen and deliver upper fisted abdominal thrusts until the obstruction is cleared

Transport is requested for a 2-month-old that is presenting with 1 week of increased vomiting, mild fever, decreased activity, and low oral intake. Which of the following exam/history findings is most likely to be seen with this child's diagnosis?

a depressed area of the fontanelle

A patient with a known history of asthma is having an acute increase in shortness of breath, chest discomfort, and cough. Which of the following respiratory sounds do you expect to hear in the lungs of this patient?

a high pitched whistling on expiration

You are called to treat a patient covered in alpha-radioactive material after an accidental spill. An adequate level of shielding against alpha radioactive particles would be:

a plastic sheet

If a large disaster such as an earthquake or hurricane occurs that requires cooperation across state lines, which of the following would allow for cooperation between states, enabling the sharing of EMS personnel and equipment?

an emergency management assistance compact

A patient fell from a 30-foot ladder and sustained a wound in the chest that is expelling blood with respiration and producing noise with inspiration. Which of the following is the best first step to take in treating this patient?

apply a 3 sided occlusive dressing to the chest wound

You have responded to a 38-year-old male who was in an altercation with the police after they responded to a domestic assault call. The patient has a history of violence and drug abuse. Upon arrival, police officers state he seemed confused. When they open the rear door of the police cruiser, you find the male subject handcuffed, prone, and face down in the seat. Upon closer examination of the patient, you find him unresponsive with emesis on the seat around the location of his head, and not breathing. Of the choices listed, what is the most likely cause of the patient's condition?

aspiration

Which drug is contraindicated with GI bleed, ulcer, hemorrhagic stroke, bleeding disorders, and in pediatric patients with flu symptoms?

aspirin

You are called to see a child who has possibly eaten a packet of laundry detergent. You should first:

assess the child's airway, breathing, and circulation

While treating a sick 4-year-old for respiratory distress, it quickly becomes apparent that they require ventilatory assistance. Which of the following devices is the best option to assist this patient's ventilations?

bag valve mask with pop off valve activated

Which of the following is part of the lower airway?

bronchi

Organophosphates, also called nerve agents, kill in which of the following ways?

by compromising the ability to absorb oxygen

You are the first on the scene of a 25-car pileup on the interstate. What is the best first step to take after you ensure the scene is safe?

call for additional units and begin triaging patients

You are called to a local residence for an unknown medical emergency. On arrival you find 3 patients ranging in age from 15 - 40 years old. They are all complaining of dizziness, headache, and severe fatigue. Vitals are within normal limits but they each have cherry red cheeks in a warm house. Which of the following is MOST likely in this case?

carbon monoxide posioning

You are dispatched for a motor vehicle collision, while responding you receive a further report that there are two people in the vehicle. You are the first unit to arrive on the scene. You find two patients in the vehicle, one in the front, partially under the dash, and one leaning against the left rear seat. You will be providing patient care during extrication. While inside a vehicle during extraction, what is the safest place for you as a rescuer?

center of the back seat

During the physical exam on an unresponsive infant, you first:

check for signs of life or recent life

Which of the following symptoms are commonly associated with acute coronary syndromes? Select the 3 correct options.

chest pain, diaphoresis, and nausea/vomiting

You are treating an unconscious 19-year-old male that was hit in the back of the head with a baseball bat. While assessing the patient's respirations you notice he has progressively deeper, faster breathing alternating gradually with shallow, slower breathing along with periods of apnea. This type of breathing pattern is referred to as:

cheyne-stokes respirations

A patient having a seizure is exhibiting rapid alternation between flexion and relaxation that takes the appearance of violent shaking, which of the following is the name for this type of seizure activity?

clonic

A patient is involved in a motor vehicle accident and is presenting with an inability to take a breath despite gasping motions of the upper body. Which of the following is most likely to be the root cause of this patient's distress?

compromised airway

You are examining a patient with suspected hypothermia. You check their capillary refill time and find it to be 7 seconds. What is the most likely explanation for this finding?

constriction of the arterioles due to cold

You are called to care for a 6-month-old patient who is in respiratory distress and with a seal-like barking cough. Which of the following would be the most likely cause of this complaint in this age group?

croup

Imminent delivery of the baby's head, in which the head can be seen protruding from the vagina, is called:

crowning

You find a patient unresponsive after an apparent fall from a roof. After checking for any life-threatening conditions and assessing their airway, breathing, and circulation, what is the next step in managing this patient?

decide treatment priority

Which of the following could cause an airway obstruction if not removed prior to starting artificial ventilation?

dentures

You arrive on the scene of a motor vehicle accident to find an adult male in his early twenties with a large gash on his forearm that is spurting blood. You immediately apply pressure with your gloved hand as you reach for a trauma dressing. The patient is alert and responsive but appears pale with a weak rapid pulse and respirations of 30 breaths per minute. As you finish your initial assessment and bandage the wound, the patient becomes agitated and demands that you stop treating him. What should be done at this point?

discontinue treatment if he refuses, while ensuring the wound is adequately stabilized and prepared for transfer

You are called to see an elderly woman with a narrow oblique strip of exquisitely painful skin on one side of her chest. This most likely represents:

early shingles

What action should be performed prior to transportation of any patient with a foley catheter and collection bag?

empty out the foley collection bag and notate how much was emptied

You are the first arriving responder to a mass casualty incident. What is the first action or actions you should take?

establish command and request additional resources

Which of the following assessment findings is MOST likely to require positive pressure ventilation?

flail segment

A patient is found choking after taking a large bite of a meal. Which of the following structures, when food enters, induces the sensation of choking?

glottis

You are performing CPR on an 11-year-old patient who went into arrest while exercising. You called 911 and have been doing CPR for 3 minutes when a bystander who knows CPR rushes over asking how they can help. What is the best response?

go search for an AED while I perform CPR

You are preparing to suction the mouth of an adult patient who is not breathing. Which of the following is true regarding what you should do when suctioning this patient?

have a container of sterile water on hand

You are assessing a 76-year-old male complaining of chest pain and shortness of breath that is slowly worsening. He is conscious and alert but is struggling to breathe with audible rales auscultated. These signs and symptoms most likely indicate which of the following?

heart failure

This legislation created the first ALS pilot programs with $142,000,000 in taxpayer funds and resulted in the creation of the NHTSA.

highway safety act of 1966

A hot climate alone is rarely enough to cause hyperthermia. Which of the following, when combined with a hot climate, predisposes to hyperthermia to the greatest degree?

humidity

COPD patients may develop a condition characterized by the constantly high carbon dioxide level in the blood due to poor gas exchange in the lungs. This results in the body no longer being able to use the level of carbon dioxide as a signal for how fast/deep to breathe. What is this condition called?

hypercapnia

Which of the following is the BEST to utilize to preserve evidence after a sexual assault?

inside a brown paper bag

Your shortness of breath patient is experiencing hypoxia, what does this term mean?

insufficient oxygen reaching the tissues

What are the key elements to assess when evaluating a child's work of breathing using the Pediatric Assessment Triangle (PAT)? Choose the three options that are correct.

intercostal retractions, neck muscle use, and pulse quality

Which of the following describes how the trachea differs from the esophagus?

it has cartilage rings that support it

Mr. Doe is a 27-year-old male who presents with a small tree branch protruding from the lower abdomen following a violent encounter. Which of the following treatments is the best initial treatment to minimize the complications of his injury?

layering of gauze around the object and anchoring it in place

Your patient is a 16-year-old male who got into a fight at school and is complaining of abdominal pain 8 on a 10 scale in his upper right abdominal quadrant after having been struck there by a golf club. Based on the mechanism of injury and the location of the pain, which of the following organs is most likely to have sustained injury?

liver

You respond to an unknown problem with law enforcement on the scene. On arrival, you find a middle-aged male, unconscious in the driver's seat of his vehicle with the engine running. There are no witnesses to the event and there is no obvious damage to the vehicle. When gathering a medical history on this patient which of the following would be the MOST appropriate?

look for any evidence of a medic-alert identification

Which of the following is one of the most important indicators of potential Central Nervous System injury?

loss of consciousness

You are called to see a child who had just been transported to the ER a week earlier with severe digestive issues and abdominal pain. The mother states the child apparently inherited this from her since the symptoms began during infancy. When you arrive, you note the child is gagging and spitting, and the father is holding the child on his lap in an attempt to comfort him. You should have a high suspicion for which of the following?

medical child abuse

Blood pressure is measured in:

millimeters of mercury (mmHg)

A mother calls EMS after weighing her breast fed infant and noticing that his weight has been consistently decreasing in the first week since he has been born, what intervention is most likely to be necessary for this infant?

no intervention is likely to be necessary

You are called to assist an adult at a local bar for an unknown reason. On arrival, you are met by a man that is grasping at his throat with both hands and is unable to speak to you. What should you do at this point to assist your patient?

perform the Heimlich maneuver while he remains conscious

The Q in the V/Q ratio stands for which of the following?

perfusion

A group of bus passengers involved in a collision is being triaged. Which of the following external signs is the best indicator of internal abdominal bleeding?

periumbilical bruising

You have responded to a residence where the patient is complaining of fever, headache, and muscle tenderness. Upon arrival you find that the patient has many rodents as pets. While performing your primary survey you notice that the patient has large swollen and painful lymph nodes. You should suspect which of the following?

plague

What is the term used for a rapid delivery occurring within 3 hours from the onset of regular contractions that can cause tissue damage?

precipitous delivery

An adolescent child is known for being a troublemaker at school, failing to work with groups, and repeatedly losing friends due to causing them physical or emotional harm. Despite this, the child is well behaved at home and does not get in trouble with the law. Based on this description, which of the following social situations was most likely absent in the child's development?

prolonged play with peer groups at a young age

You are on scene with a 60-year-old male that was just discharged from the hospital. The patient reports a sudden onset of difficulty breathing and sharp chest pain that increases with breathing. His skin remains cyanotic and his oxygen saturation remains low, despite high-flow oxygen. What is the patient most likely experiencing?

pulmonary embolism

Which of the following acronyms refers to a cardiac event that is not inherently life-threatening?

pvc

You respond to a motor vehicle accident but upon arrival to the scene, you find multiple other vehicles have crashed in the time since EMS was called, what is the first action you should take in this situation?

request additional resources

The difference between hospice and euthanasia is that hospice __________ but euthanasia __________. Which of the following answers most accurately fills in this sentence?

seeks to maximize the quality of life for the remainder of the person's life, ends the person's life

You are called to see an adolescent with hepatitis B. She is jaundiced, combative, and acting wildly. She has no open cuts. Your biggest risk in dealing with her is:

she is combative

Which is NOT a correct method to control bleeding?

sling and swathe

Which of the following is an adventitious breath sound associated with upper airway obstruction that is heard during inspiration?

stridor

You are on a fire standby when one of the firemen complains of smoke inhalation; when you check his airway, you note laryngeal edema. What sounds would you expect to hear?

stridor

While treating a patient, in which of the following situations are you MOST likely required by law to document and report?

suspected elder abuse

You are called for a blood pressure check in an environment too noisy to adequately hear through a stethoscope. You palpate the radial pulse during cuff deflation to determine what?

systolic pressure

Which of the following is one of the first common cardiovascular sign/symptoms that a patient in anaphylaxis may be experiencing?

tacychardia

Level of consciousness in children is best assessed by which of the following?

the AVPU scale

Baroreceptors are used by the body to regulate which of the following to the greatest degree?

the blood pressure

You have responded to a mass casualty incident where it appears that there is the presence of a chemical agent. Which of the following should you consider?

the establishment of hot, warm, and cold zones

Sickle cell disease tends to result in hypertension due to its damaging effects on which of the following organs?

the kidneys

Which of the following anatomical structures is considered the division between the upper and lower respiratory tracts?

the larynx

The optimal 10-minute time window between arrival on scene and transport of a trauma or critical patient is known as _________.

the platinum 10

You are called to see a 78-year old man complaining of chest pain. His wife says this is the first time he's complained of this. Before pharmacological intervention, what should you ask about?

the use of erectile dysfunction medications

Which of the following is the primary purpose of the epiglottis?

to cover the larynx when food is swallowed

What is the main purpose of a pocket mask in CPR?

to provide assisted ventilations

When talking with patients, why should EMS professionals position themselves at a lower or equal level to the patient?

to send non threatening nonverbal cues to the patient

Which of the following situations must be reported by an emergency medical services provider to local law enforcement?

trauma caused by animals/pets

What valve is the valve that separates the right atrium from the right ventricle?

tricuspid valve

You are called to treat a 9-month-old male patient for difficulty breathing. At which point should you begin using the Pediatric Assessment?

upon visual contact

You are the 3rd unit on the scene of a multiple casualty incident involving a bus rollover. Your patient is the ejected driver of the bus, a 52-year-old male who is apneic, with a very slow pulse palpated over the femoral artery. Which of the following interventions would be best for initial care?

ventilate with a BVM connected to high flow oxygen

You are the first to arrive on scene of MVC. The vehicle is resting on its side and the patient is still in the vehicle. Which of the following should be your first action?

wait on rescue to arrive on scene to secure the vehicle

Which of the following questions would be most appropriate to ask when assessing a patient with chest pain?

what does the pain feel like

A whistling or musical sound heard on exhalation is referred to as what abnormal breath sound?

wheezing

When is it best to put a patient in a position of comfort for injuries such as broken bones or muscle strains?

when the patient is alert and orientated

EMS is dispatched to a man down at a bar. Witnesses report an intoxicated patron had a seizure and then became uncooperative. As the rescuers begin assessing the patient, he begins yelling profanities and kicking his legs. Despite efforts to calm the patient, he continues to resist treatment and will not answer your questions. Law enforcement is on the scene and ensuring safety for all personnel. Which action will protect the rescuers from being successfully sued for negligence?

with assistance from law enforcement, preparing to transport the victim to the hospital with implied consent in mind

You are on scene with a patient in cardiac arrest. You turn the AED on and attach the pads to the patient. When the AED begins to analyze the patient's cardiac rhythm, it signals "low battery" and then shuts off. The patient subsequently dies. Which of the following statements regarding this scenario is MOST correct?

you and your partner may be held liable for negligence