EMT 37, 38, 39 Obstetrics, Pediatrics, Geriatrics philip_olcese
Assessment of a newborn indicates that his heart rate is 120 beats per minute. How many points should he be awarded according to the APGAR scoring system? Select one: a. 2 b. 0 c. 1 d. 3
2
The EMT should recognize a full-term pregnancy in which one of the following patients? Select one: a. 33-year-old pregnant with twins in the eighth month of pregnancy b. 21-year-old who is 39 weeks pregnant and feeling dizzy c. 40-year-old beginning her third trimester but whose water just broke d. 25-year-old who is 220 days into pregnancy and complaining of pain
21-year-old who is 39 weeks pregnant and feeling dizzy
Which one of the following patients should the EMT be most suspicious of having a spontaneous abortion? Select one: a. 16-year-old, 24 weeks pregnant, with painless contractions b. 38-year-old, 36 weeks pregnant, having abdominal pain with painless vaginal bleeding c. 32-year-old, in third trimester, passing foul smelling and bloody vaginal discharge d. 21-year-old, six weeks pregnant, passing vaginal blood clots
21-year-old, six weeks pregnant, passing vaginal blood clots
You are treating a 6-month-old patient who was accidently dropped down a flight of steps, when her mother stumbled at the top of the steps. The infant will only open her eyes and moan to deep painful stimuli, and tries to withdraw from the pain. Given these findings, you calculate her Glasgow Coma Score to be: Select one: a. 4. b. 10. c. 8. d. 6.
8.
What would be the minimally acceptable blood pressure for a 9-year-old girl who is suffering from a significant bleed from broken glass? Select one: a. 96 mmHg b. 79 mmHg c. 100 mmHg d. 88 mmHg
88 mmHg
The EMT would recognize which one of the following babies as premature? Select one: a. A baby weighing 7 pounds 4 ounces born at 37 weeks b. A baby weighing 8 pounds 6 ounces born at 39 weeks c. A baby weighing 8 pounds 6 ounces born at 41 weeks d. A baby weighing 6 pounds 2 ounces born at 38 weeks
A baby weighing 7 pounds 4 ounces born at 37 weeks
The EMT shows that he understands the seriousness of a prolapsed cord when he states: Select one: a. The priority when treating a patient with a prolapsed umbilical cord is keeping the cord moist. b. A baby can bleed to death inside the uterus if the cord is compressed for more than 10 minutes. c. If the cord is observed protruding from the vagina, it should be clamped and cut immediately. d. A prolapsed cord can stop the flow of oxygen to the baby.
A prolapsed cord can stop the flow of oxygen to the baby.
At what point in the delivery process should the EMT first suction the baby? Select one: a. After the head is delivered, but before the torso is out of the vaginal opening b. When the baby has been delivered and has been dried and warmed c. Before the cord has been cut, but after the baby has been assessed and determined stable d. When the chest is delivered but before the legs are free of the vaginal canal
After the head is delivered, but before the torso is out of the vaginal opening
The EMT shows he understands care of the post-delivery mother when he states: Select one: a. Allowing the baby to nurse immediately after delivery can help to control uterine bleeding. b. Post delivery hemorrhage can best be controlled by inserting some sterile gauze into the vagina. c. We should be concerned if there is any bleeding from the vagina following delivery. d. If blood is observed coming from the vagina after the baby has been delivered, the mother should be placed in the shock position.
Allowing the baby to nurse immediately after delivery can help to control uterine bleeding.
You are assessing a 6-year-old girl with possible pneumonia. She has labored breathing and a fever of 101°F. When you are assessing and classifying her respiratory status, which of the following signs would provide the strongest evidence that she is in decompensated or late respiratory failure? Select one: a. Altered mental status b. Respiratory rate of 36 c. Fever of 101°F d. Nasal flaring
Altered mental status
Which one of the following shows that the EMT is correctly performing a uterine massage? Select one: a. Both hands are positioned at the symphysis pubis and she pushes with an upward motion. b. She places her hands on the upper abdomen and pushes the uterus toward the pelvis. c. She uses the lower palms of both hands to firmly press downward on the uterus. d. Both hands cup the uterus, with one of the hands positioned just above the symphysis pubis.
Both hands cup the uterus, with one of the hands positioned just above the symphysis pubis.
You are delivering a baby in the patient's house. As the baby's head appears at the vaginal opening, you notice that the amniotic membrane is still intact. Which one of the following should you do next? Select one: a. Continue with the delivery of the baby. b. Break open the amniotic sac with your fingers. c. Transfer the patient to the stretcher for immediate transport. d. Cut the sac with the sterile scissors in the OB kit.
Break open the amniotic sac with your fingers.
You are in the process of a field delivery and have just delivered the baby's head. Which one of the following should you do next? Select one: a. Turn the baby clockwise and continue delivery. b. Suction the baby's mouth, and then nose. c. Check the neck for the umbilical cord. d. Gently pull the baby toward you.
Check the neck for the umbilical cord.
A woman informs you that she is eight months pregnant and fatigues easily. She is apprehensive because when she lies down, she gets dizzy and feels as though she is going to vomit. Which one of the following is the best response? Select one: a. You should really call your doctor. During the eighth month of pregnancy energy levels usually increase. b. As long as the baby is still moving you are okay. Just try to get through one more month. c. Check with your obstetrician, but you may want to rest and sleep on your left or right side. d. I would get to the hospital right away to make sure that your baby is okay. This does not sound good.
Check with your obstetrician, but you may want to rest and sleep on your left or right side.
You arrive at the side of a pregnant patient in her third trimester who has been vaginally bleeding for several hours. Observation reveals several blood-soaked towels on the bed. She is alert and oriented with a patent airway and adequate breathing. Her pulse is 88 beats per minute and her blood pressure is 104/66 mmHg. As part of your care of the patient, which one of the following is most appropriate? Select one: a. Cleansing the outside of the vagina with sterile water and peroxide b. Informing and preparing her for the possibility that the baby may have died c. Rapid transport in a supine position d. Collecting all towels with blood and transporting them with the patient
Collecting all towels with blood and transporting them with the patient
You have been called to a lower-income housing complex for a 4-year-old who is short of breath and has a fever. When assessing this patient, you would employ which of the following techniques? Select one: a. Performing the primary assessment after the secondary assessment b. Checking capillary refill by pressing on the skin of the fingers c. Auscultating breath sounds over the anterior chest d. Determining the respiratory rate before laying hands on the child
Determining the respiratory rate before laying hands on the child
Which one of the following lists the stages of labor in the order in which they occur? Select one: a. Dilation, delivery, placental, and afterbirth b. Dilation, expulsion, and placental c. Uterine, expulsion, placental, and recovery d. Uterine, delivery, and recovery
Dilation, expulsion, and placental
You are suspicious that a child is being physically abused and neglected. Which of the following best describes your best course of action in such a situation? Select one: a. Placement of the child in a safe home b. Confrontation of the alleged abuser c. Notification of other family members d. Documentation of the situation
Documentation of the situation
Which of the following behaviors would the EMT recognize as uncharacteristic of a conscious and stable 2-year-old boy who fell and hurt his hand? Select one: a. Becomes upset when you lift his shirt to assess his abdomen b. Does not cry or protest when taken from his mother c. Apologizes several times for falling and hurting his hand d. Cries any time you or your female partner touch him
Does not cry or protest when taken from his mother
You have arrived at the Emergency Department with a young child who you believe is the victim of child abuse. To which person would it be best to report your suspicion? Select one: a. Security guard b. Hospital administrator c. Emergency physician d. Registered nurse
Emergency physician
A patient is 7 cm dilated and complaining of painful contractions. What stage of labor should the EMT identify? Select one: a. Expulsion b. First stage c. Third stage d. Uterine
First stage
When should the EMT instruct his partner to cut the umbilical cord? Select one: a. After the one-minute APGAR score has been obtained b. Immediately after delivery of the placenta c. Following delivery and after the baby has been dried and suctioned d. Just prior to passage of the legs through the vaginal canal
Following delivery and after the baby has been dried and suctioned
The EMT shows she understands resuscitation of the newborn when she states: Select one: a. Most newborns require aggressive resuscitation. b. CPR should only be used when the baby is unresponsive, apneic, and pulseless. c. The EMT must use high-flow oxygen sparingly because it can be toxic to a baby. d. Interventions should be performed for 30 seconds followed by reassessment.
Interventions should be performed for 30 seconds followed by reassessment.
You are assessing a 29-year-old who has signs of imminent delivery. Her past medical history includes HIV infection. In relation to a patient with no infectious disease, how will BSI precautions differ for this patient? Select one: a. A HEPA filter mask should be used for the patient with HIV, but not for the noninfectious patient. b. Gloves, a gown, and goggles will be used for this patient; only gloves and a gown are required for a healthy patient in labor. c. Gloves are needed for a noninfectious patient in labor; goggles and gloves must be worn for the patient with HIV. d. Gloves, a gown, and goggles must be worn for both the patient with HIV and the noninfectious patient.
Gloves, a gown, and goggles must be worn for both the patient with HIV and the noninfectious patient.
You are assessing a female patient who informs you that she has been pregnant four times before but only delivered once. Which one of the following shows how you should document that information on the prehospital care report? Select one: a. Para III; Gravida I b. Para IV; Gravida I c. Gravida IV; Para I d. Gravida III; Para I
Gravida IV; Para I
You have arrived on the scene to help a child who is short of breath. The mother is screaming hysterically that her 3-year-old boy cannot breathe, making assessment of the patient very difficult. What should be your initial action in managing this situation? Select one: a. Quickly remove the child to the ambulance and assess while transporting. b. Summon the police to the residence to subdue the mother. c. Inform the mother that you will call the police if she does not calm down. d. Have your partner talk to the mother while you assess the child.
Have your partner talk to the mother while you assess the child.
Which one of the following actions indicates that the EMT is properly suctioning the newborn? Select one: a. He squeezes the bulb syringe prior to placing it in the baby's nose. b. He suctions the nose first followed by the mouth. c. He inserts the bulb syringe deep into the oropharynx to get thick secretions. d. He uses the portable suction unit on the high setting.
He squeezes the bulb syringe prior to placing it in the baby's nose.
Which one of the following assessment findings indicates that the newborn is distressed? Select one: a. Loud crying b. Heart rate of 90 c. Respiratory rate of 50 d. APGAR score of 8
Heart rate of 90
You are transporting a female patient who is seven months pregnant. She has been diagnosed with preeclampsia and is currently hypertensive. Which one of the following statements made by the patient indicates she may be transitioning from preeclampsia to eclampsia? Select one: a. I think that I may have to vomit. b. I have gained 10 pounds just this month. c. I am seeing spots in my eyes. d. My legs and feet are more swollen.
I am seeing spots in my eyes.
Which one of the following statements best indicates that the patient is in the second stage of labor? Select one: a. I think that my water just broke. b. I feel like I have to move my bowels. c. The contractions are beginning to hurt now. d. It feels good not to have to push anymore.
I feel like I have to move my bowels.
When assessing a 27-year-old patient who is eight months pregnant, which one of the following statements should the EMT be most concerned about? Select one: a. My last baby came two weeks late. b. I have not been able to see the doctor this pregnancy. c. I had some belly cramps two weeks ago. d. I was a drug addict when I was a teenager.
I have not been able to see the doctor this pregnancy.
You are caring for an emotionally distraught female who just suffered a miscarriage. During transport, which one of the following statements is most appropriate? Select one: a. It is better to have this happen at five weeks instead of 25 weeks b. I really do not know what to say, but let me know how I can help you. c. Let's just think of the two beautiful children that you have at home. d. Maybe at some time in the future, you can get pregnant again and things will turn out okay.
I really do not know what to say, but let me know how I can help you.
Which of the following statements made by the EMT is most appropriate regarding dealing with caregivers and children during a medical emergency? Select one: a. I tell the caregiver that everything will be okay so they are more calm and better able to help the child. b. It is best to separate the caregiver from the child so that a proper assessment and care can be given. c. I try to include the caregiver in all that I do with his or her child so that the child and caregiver are more comfortable. d. I include the caregiver in the care until I get the information that I need, then I remove the child to continue the assessment in the ambulance.
I try to include the caregiver in all that I do with his or her child so that the child and caregiver are more comfortable.
After a 7 year-old boy's father who is complaining of chest pain is placed on a stretcher and taken from the house, the boy throws a temper tantrum. His mother is embarrassed and states that he has not done this since he was two years old. Given the situation, your response would be: Select one: a. A 7-year-old is too old for this type of behavior. You may want to talk to his pediatrician. b. You really need to correct this behavior now so it does not happen in the hospital. They will make you take him home. c. It may be wise to contact your pediatrician and let him know about the temper tantrum, it may be controllable with medications. d. I would not be concerned. This is a stressful event he doesn't understand, and he may just be having trouble coping with it.
I would not be concerned. This is a stressful event he doesn't understand, and he may just be having trouble coping with it.
A newborn's first APGAR score was 6. His second APGAR score is 9. This indicates which one of the following? Select one: a. Total score of 15 b. Need for extensive resuscitation c. Poor heart and lung function d. Improvement
Improvement
You have completed the assessment of a 32-year-old patient who is starting her seventh month of pregnancy. Which one of the following assessment findings should the EMT be most concerned about? Select one: a. Increased weight over the past month b. Several painless contractions c. Increased desire to eat d. Intermittent vaginal bleeding
Intermittent vaginal bleeding
You are transporting a young female who just had a miscarriage at home. During the transport the woman weeps continually. Which one of the following is most appropriate for you to say? Select one: a. It may be best to stay strong; your other child needs your support. b. Is there anything that I can do to help you right now? c. If you want another child, wait a few months and then get pregnant again. d. I think in the long run you will be okay and things will work out.
Is there anything that I can do to help you right now?
Which one of the following statements about the umbilical cord is true? Select one: a. It produces hormones for the baby. b. It contains one vein and two arteries. c. It connects the placental and uterus. d. It detoxifies blood before delivery to the baby.
It contains one vein and two arteries.
Which of the following statements made by another EMT regarding treatment of the pediatric patient in the prehospital setting would you agree with? Select one: a. It is critical that the EMT be able to determine the respiratory status of the patient as this commonly is the reason for acute deterioration. b. When treating a sick pediatric patient in the prehospital setting, the EMT must determine the exact illness so as to provide the most appropriate treatment. c. Since pediatric patients can deteriorate very quickly, they must all be transported with lights and sirens during the ride to the hospital. d. If the primary assessment of a sick pediatric patient shows no deficits to the ABCs, the patient is stable and will not deteriorate.
It is critical that the EMT be able to determine the respiratory status of the patient as this commonly is the reason for acute deterioration.
You have been asked to speak to a group of new mothers regarding the emergency treatment of a fever. During your presentation, one of the mothers asks you what temperature would cause a child to seize. Your response would be: Select one: a. When a child's temperature rises above 105°F, seizure activity will occur. b. It is not the specific temperature that is of concern, but the rate at which the body temperature rises. c. If the temperature of a child's fever rises slowly over several hours, she is at greater risk for seizures. d. For a child to seize when she has a fever, she must also have a history of seizures or a cardiac condition.
It is not the specific temperature that is of concern, but the rate at which the body temperature rises.
An EMT is presenting a continuing education class on the care of the pregnant female. When discussing the amniotic sac, he is correct to emphasize which one of the following points? Select one: a. It contains a fluid called Wharton's jelly that enables the baby to breathe and move. b. It protects and insulates the baby during pregnancy. c. It contains fluid and surrounds and protects the uterus. d. It must rupture during the second trimester of pregnancy for fetal development to progress.
It protects and insulates the baby during pregnancy.
A patient has acute onset of right-sided abdominal pain, describes it as sharp, and rates it a 9/10. Her ABCs are intact, but her skin is cool and diaphoretic. She states that she has been going to the bathroom more and is worried because her father is a diabetic. Her last period was nine weeks ago and she has a history of irregular periods. Her heart rate is 122, respirations 20, blood pressure 138/68, and SaO2 at 97%. In this scenario, which one of the following is of most concern to the EMT? Select one: a. Increased urination b. Family history of diabetes c. Last period nine weeks ago d. Periods irregular in nature
Last period nine weeks ago
While performing the reassessment of a 2-year-old male who is severely dyspneic, you note that he is now unresponsive and not breathing. He has a heart rate of 32 beats per minute and his skin is cool and diaphoretic. What instruction would you provide to another EMT who is helping you transport the patient? Select one: a. We need to try humidified oxygen to see if he will improve with that. b. Please increase the oxygen in the non-rebreather face mask to 15 liters per minute. c. We need to get a blood pressure and then I will call medical direction. d. Let's start chest compressions and positive pressure ventilations.
Let's start chest compressions and positive pressure ventilations.
When cutting the umbilical cord, how should the baby be positioned? Select one: a. Upright and on the mother's chest (if possible. b. Prone and in a head-down position c. Six inches below the vaginal opening d. Level with the vaginal opening
Level with the vaginal opening
What is the best location for assessing breath sounds in the pediatric patient? Select one: a. Anteriorly at the base of the lung b. Posteriorly just below the scapula c. Anteriorly at the apex of the lung d. Midaxillary region of the lungs
Midaxillary region of the lungs
Which one of the following statements made by a pregnant patient in labor should be of most concern to the EMT? Select one: a. I just passed a lot of blood and mucus. b. My water broke two days ago. c. The contractions seem to last about 30 seconds. d. I have terrible pains in my lower back.
My water broke two days ago.
You have been called for a 2-week-old baby who is sick. Assessment reveals him to have a fever and rhonchi in the lungs. Which of the additional assessment findings would be most concerning to you given the age of this patient? Select one: a. Respiratory rate of 30 breaths per minute b. Wet diaper in need of changing c. Continual moaning and crying d. Nasal passages occluded by mucus
Nasal passages occluded by mucus
When should the EMT use the APGAR scoring system on a newborn? Select one: a. Just prior to delivery and then five minutes after delivery b. One and five minutes after the baby has been delivered c. Ten minutes after birth and then at 20 minutes, if needed d. Before and after the baby is dried and warmed
One and five minutes after the baby has been delivered
After delivery, you note some blood oozing from the mother's vaginal canal. The sanitary pads that you placed between her legs continue to become soaked. Which one of the following should you do next? Select one: a. Insert sterile gauze into the vaginal canal. b. Perform a uterine massage. c. Place the mother on her left side. d. Transport with lights and sirens.
Perform a uterine massage.
Prior to delivery, the EMT prepares to create a sterile field around his patient's vaginal opening. Which one of the following describes the best way to do that? Select one: a. Place sheets from the OB kit over both the patient's legs and her abdomen. b. Use towels from the patient's residence to wrap each leg and cover her abdomen. c. Place a sheet from the OB kit under the patient's hips and another over her abdomen and legs. d. Use the sheet from the patient's bed to cover her abdomen and groin.
Place a sheet from the OB kit under the patient's hips and another over her abdomen and legs.
You have been called to assist another crew with the birth of a baby. On scene another EMT informs you that the mother's perineum tore and is bleeding heavily. What should you do? Select one: a. Place a cold pack to the mother's abdomen just below the umbilicus. b. Place a sterile dressing between the mother's vagina and rectum. c. Apply a sterile gauze dressing with gentle pressure above the vagina. d. Insert sterile gauze into the vagina and leave in place until bleeding stops.
Place a sterile dressing between the mother's vagina and rectum.
You are immobilizing a 4-year-old-boy on a long spine board. Which of the following would be appropriate when performing this intervention? Select one: a. Place padding between his shoulders and the spine board. b. Secure the chest and legs to the board after the head. c. Do not apply the chest strap across the thorax. d. Place a pillow under the neck to keep the airway open.
Place padding between his shoulders and the spine board.
You have been dispatched for a young female in labor. On arrival you find an arm protruding from the vaginal canal. Which one of the following should you do next? Select one: a. Attempt to replace the arm into the vaginal canal. b. Insert a gloved hand into the vagina to locate the baby's head. c. Place the mother in a knee-chest position. d. Have the mother push when she feels a contraction.
Place the mother in a knee-chest position.
Assessment of a pregnant patient in labor reveals what appears to be the baby's buttocks presenting at the vaginal opening. Which one of the following should the EMT do immediately? Select one: a. Put the patient in a semi-Fowler's position on the stretcher and immediately transport. b. Place both hands on the abdomen and attempt once to turn the baby into a head-down position. c. Place the mother in a supine, head-down position with hips elevated and administer high-flow oxygen. d. Lay her on her left side and administer high-flow oxygen.
Place the mother in a supine, head-down position with hips elevated and administer high-flow oxygen.
A 31-year-old is in labor. After ensuring her airway, breathing, and circulation, you assess her perineum. You observe the umbilical cord protruding from the vagina, but do not see the baby. Which one of the following should you do immediately? Select one: a. Gently pull the cord to assist in delivery. b. Prepare and apply high-flow oxygen to the mother. c. Place a saline-soaked dressing over the cord. d. Place the patient in a knee-chest position.
Place the patient in a knee-chest position.
Why is the uterus essential to a healthy pregnancy? Select one: a. Protects abdominal organs during fetal growth b. Powerfully contracts to force the fetus from the mother's body c. Permits the excretion of waste from the baby to the mother d. Manufactures specific blood cells needed for fetal survival
Powerfully contracts to force the fetus from the mother's body
After successfully delivering a baby, the EMT notes that the protruding umbilical cord is lengthening and a small gush of blood came out of the vagina. What should the EMT do in response? Select one: a. Apply a sanitary pad over the vaginal opening. b. Open the vaginal canal using obstetric forceps. c. Massage the patient's uterus. d. Prepare for delivery of the placenta.
Prepare for delivery of the placenta.
Which one of the following statements shows an understanding of the relationship between seizures and pregnancy? Select one: a. Prolonged seizures can easily cause the mother and baby to become hypoxic. b. If the pregnant patient is seizing, the EMT must quickly make a decision to administer or withhold her anti-seizure medications. c. A short seizure in the pregnant female with a seizure history generally does not require transport. d. Seizure activity in the pregnant female is typically not life-threatening unless the patient has had seizures in the past.
Prolonged seizures can easily cause the mother and baby to become hypoxic.
You have been called to an apartment for a child who is sick. As you approach the 4-year-old boy, you note that he is sitting upright in his mother arms with his chin thrust forward. He has a very lethargic and sickly appearance and is drooling. His airway appears open and his breathing is adequate. His radial pulse is strong and his skin is hot to the touch. Which of the following interventions would be most appropriate in the care of this patient? Select one: a. Provision of blow-by oxygen b. Suctioning secretions from the back of the airway c. Placing the boy supine for transport d. Placement of an oropharyngeal airway
Provision of blow-by oxygen
You have been dispatched to a residence for a female patient who is dizzy and passing out. An Emergency Medical Responder meets you at the door and reports that the patient is lying in bed and is nine months pregnant. Her pulse rate is 112 and her blood pressure is 84/50 mmHg. Respirations are 24 per minute and she has a room air pulse oximetry reading of 97%. Which one of the following should you do as soon as you reach the patient's side? Select one: a. Roll her onto her side. b. Start positive pressure ventilation. c. Recheck the blood pressure. d. Determine any complications of the pregnancy.
Roll her onto her side.
You are by the side of a 19-year-old female who is 36 weeks pregnant. When assessing this patient, which one of the following findings best indicates that she is in preterm labor? Select one: a. Complaint of lower back pain b. Rupture of the amniotic sac c. Contractions 12 minutes apart d. Feeling nauseated with each contraction
Rupture of the amniotic sac
You have been called to a home for a female patient in labor. On scene the family tells you that the 37-year-old patient is 42 weeks pregnant and wanted to have her baby at home naturally. They tell you that she has been in labor for over 24 hours and suddenly began complaining of severe and tearing abdominal pain. What condition should the EMT suspect? Select one: a. Ectopic pregnancy b. Placenta previa c. Ruptured uterus d. Preeclampsia
Ruptured uterus
You are responding to a low-income apartment complex for a 16-year-old who is five weeks pregnant and experiencing vaginal bleeding. When mentally reviewing possible causes of hemorrhage for this patient, which one of the following should you be prepared to encounter? Select one: a. Spontaneous abortion b. Ruptured uterus c. Dysfunctional placenta d. Drug addiction
Spontaneous abortion
As the head of a baby is delivered, the EMT identifies the presence of meconium. Which one of the following shows that the EMT is properly managing the situation? Select one: a. I need you to push harder. We have to deliver as quickly as possible. b. I need someone to provide blow-by oxygen to the baby as it is delivered from this point on. c. As the mother is pushing, I need you to wipe the baby down to prevent skin irritation. d. Stop pushing. I need to take time to suction the mouth and nose.
Stop pushing. I need to take time to suction the mouth and nose.
After the unsuccessful resuscitation of a 3-year-old boy who was shot by his mother's boyfriend, you find yourself extremely stressed and anxious over the call. You are having trouble sleeping and the resultant anxiety is affecting your home life. Which of the following should be your initial action, given this situation? Select one: a. Talk to a close friend about your feelings. b. Make a conscious effort not to think about the event. c. Resolve to find a profession outside of medicine. d. Make a resolution to perform better the next time.
Talk to a close friend about your feelings.
While in an apartment to provide care for a 52-year-old female with shortness of breath, you note a baby sleeping in a nearby crib. Which of the following observations related to the baby would prompt you to intervene and speak to the family? Select one: a. The baby is sleeping in the afternoon. b. The crib is near a closed window. c. The baby is sleeping on her abdomen. d. The baby is sleeping on a hard mattress.
The baby is sleeping on her abdomen.
An Emergency Medical Responder asks you why you should not overextend the airway when performing a head tilt-chin lift on a pediatric patient. Your reply would be: Select one: a. The pediatric cervical spine is delicate and can be injured if the neck is hyper extended. b. The trachea of the pediatric patient is very short and can be injured by extension. c. The cartilage of the trachea is very soft and can 'kink' if the neck is extended too far. d. The pediatric esophagus is very thick and will occlude the airway if the neck is hyper extended.
The cartilage of the trachea is very soft and can 'kink' if the neck is extended too far.
When you are assessing a 9-month-old boy who had a fever for the past two days, which of the following assessment findings would most strongly suggest that the fever has caused dehydration? Select one: a. The heart rate is at the high end of the normal range. b. The mother informs you that the baby is wetting very few diapers. c. Palpation of the anterior fontanel reveals it to be bulging. d. Respirations are labored and rapid.
The mother informs you that the baby is wetting very few diapers.
Which one of the following statements about the placenta after the baby has been born is accurate? Select one: a. The EMT must deliver the placenta by applying gentle pressure to the abdomen after the baby has been born. b. It is essential that the mother not be moved until the placenta has been delivered. c. The placenta typically delivers itself within 20 minutes of the birth of the baby. d. The placenta is full of bacteria and should not be transported in the ambulance near the baby.
The placenta typically delivers itself within 20 minutes of the birth of the baby.
The EMT shows she has a proper understanding of Braxton-Hicks contractions when she says: Select one: a. They often are called false contractions and do not require hospital evaluation. b. They are painless, but are capable of delivering the baby very quickly. c. They can be differentiated from labor contractions by the presence of vaginal discharge. d. They are often irregular and painless and should be evaluated in the hospital.
They are often irregular and painless and should be evaluated in the hospital.
The EMT should use the sterile scissors found in the OB kit to cut which one of the following? Select one: a. Towels to create a sterile field b. Patient's clothing c. Amniotic sac (if not ruptured) d. Umbilical cord
Umbilical cord
If the placenta attaches over the cervix, the patient and baby would be at risk for what condition? Select one: a. Placenta previa b. Placental abruption c. Ectopic pregnancy d. Uterine tear
Uterine tear
Which one of the following findings should be of greatest concern when assessing a 33-year-old female who is eight months pregnant? Select one: a. Shortness of breath when lying flat b. Vaginal bleeding not associated with pain c. Daily contractions that are irregular and painful d. Recent onset of a fever of 99.3°F
Vaginal bleeding not associated with pain
When asked, a young female with abdominal pain replies that she is not sure if she is pregnant or not. Which one of the following questions provides the best opportunity to determine if the patient is pregnant? Select one: a. Does it feel like the last time you were pregnant? b. When was your last menstrual period? c. Have you been vomiting in the morning? d. Do you feel pressure in your belly area?
When was your last menstrual period?
You have been called for a 35-year-old female who is experiencing vaginal spotting. The patient states that she has noted the discharge of blood from her vagina and is concerned because she is 36 weeks pregnant. She also states that she noted some abdominal pain, which she further describes as sharp. Your assessment reveals bleeding as noted and tenderness on palpation just right to the midline of her abdomen. Her pulse is 122, respirations 22, blood pressure 118/82 mmHg, and oral temperature 97.3oF. Based on this presentation, you should: Select one: a. massage the abdomen, provide high-flow oxygen, and nonemergently transport. b. place the patient in a supine position and immediately transport. c. administer high-flow oxygen and immediately transport. d. provide low concentration oxygen and nonemergently transport.
administer high-flow oxygen and immediately transport.
When providing care to the pediatric patient who has been injured or ill, the EMT must recognize that the most important aspect of care normally revolves around: Select one: a. assessment and support of circulation. b. airway and respiratory support. c. knowledge of illnesses that affect children. d. ability to provide rapid transport.
airway and respiratory support.
An infant is short of breath and has rhonchi in both lungs. He is alert with adequate respirations at a rate of 38 per minute. His skin color is pink but slightly cool to the touch. When you place a pediatric mask on his face, he becomes very upset and begins to physically struggle to remove it. In this situation you would: Select one: a. allow the mother to hold the infant and provide blow-by oxygen. b. secure the mask to his face using tape. c. place a nasal airway and start positive pressure ventilation. d. transport the infant with no further attempt at oxygen therapy.
allow the mother to hold the infant and provide blow-by oxygen.
You are caring for an 8-month-old boy who is unresponsive after choking on a piece of hard candy he managed to find. As you look into his mouth, you can see the candy in the back of his oropharynx. Your next action would be to: Select one: a. check the brachial pulse. b. attempt to retrieve and remove it. c. perform a blind finger sweep. d. provide five abdominal thrusts.
attempt to retrieve and remove it.
The EMT would recognize that pediatric patients range in age from: Select one: a. 1 year to 8 years. b. 1 year to 15 years. c. birth to 18 years. d. birth to 12 years.
birth to 18 years.
The increased pliability of the child's ribs makes him more prone to: Select one: a. cardiac arrest. b. over inflation of the lungs. c. rib fractures. d. bruising of the lung.
bruising of the lung.
You have been called to a residence for a 21-year-old female in labor. On location you immediately see that the head of the baby is out of the vagina. While delivering the head, the mother screams that she is having twins. The EMT should immediately: Select one: a. provide blow-by oxygen to the baby. b. place the mother on her left side. c. place her on the stretcher for transport. d. call for another EMT crew.
call for another EMT crew.
Assessment of an alert and oriented 9-year-old child with a history of asthma reveals him to be breathing 20 times a minute with adequate chest rise and fall. You also note that he exhibits nasal flaring and has slight retractions of the intercostal muscles. His heart rate is 100 beats per minute and his blood pressure is 102/64 mmHg. On room air, he has a pulse oximeter reading of 98 percent. The EMT would recognize: Select one: a. decompensated respiratory failure. b. compensated respiratory distress. c. hypoxic respiratory failure. d. late respiratory failure.
compensated respiratory distress.
After you obtain a refusal at a residence in a neighborhood, a couple approaches the ambulance and inform you that they have concerns that a 6-year-old child may be being physically abused in a home two doors away. They state that they heard the child crying and what sounded like physical abuse occurring. In this situation, you would: Select one: a. inform the couple that they must contact a child welfare agency. b. contact the police and wait in the ambulance until they arrive. c. attempt entry into the home to determine if the child is injured. d. knock on the door and confront the parents about the complaint.
contact the police and wait in the ambulance until they arrive.
On scene at a school cafeteria, you are presented with a 9-year-old boy who attempted to eat a small plum whole. He is conscious with stridorous respirations and unable to cough when instructed to do so. His skin color is gray and cyanotic. Your immediate action would be to: Select one: a. check for a radial and carotid pulse. b. deliver five abdominal thrusts. c. provide positive pressure ventilation. d. place an oral pharyngeal airway.
deliver five abdominal thrusts.
As soon as the baby is delivered from the vaginal canal, it is critical that the EMT immediately: Select one: a. clamp and cut the umbilical cord. b. perform the APGAR assessment. c. obtain a complete set of vital signs. d. dry and warm the newborn.
dry and warm the newborn.
The mother is 34 weeks along, and you are delivering the baby. As soon as the baby is completely delivered, you should immediately: Select one: a. perform a secondary assessment on the mother. b. dry the baby with a warm towel. c. check the baby's breath sounds. d. administer high-flow oxygen to the baby.
dry the baby with a warm towel.
A 32-year-old female is complaining of the sudden inset of sharp pain to the left side of her abdomen. She denies any medical history and when asked, admits to being sexually active. Her last menstrual period was two months ago. As an EMT, you should immediately suspect: Select one: a. mittelschmerz. b. pelvic inflammatory disease. c. ectopic pregnancy. d. abruptio placentae.
ectopic pregnancy.
A young female is complaining of sharp pain to the left lower quadrant of her abdomen. She states that her last period was seven weeks ago. With this information, the EMT should be suspicious of: Select one: a. placenta previa. b. abruptio placenta. c. ectopic pregnancy. d. appendicitis.
ectopic pregnancy.
You have been called to a local daycare for a sick child. On scene, panicked daycare workers inform you that the 4-year-old child was lethargic all morning and wanted to sleep. After resting for several minutes, she began to shake all over. This lasted for approximately 30 seconds. Your assessment reveals her to be responsive to painful stimuli and breathing adequately. Her airway is open and her radial pulse is strong and bounding. Her skin is hot and moist to the touch with no signs of cyanosis noted. You are told that she has no medical history. En route to the hospital, the patient's mental status improves. Based on this presentation and information, you assume that the seizure occurred secondary to: Select one: a. hypoglycemia. b. altered mental status. c. hypoxia. d. fever.
fever.
The components of the APGAR scoring system include: Select one: a. airway, breathing, level of consciousness. b. airway, breathing, circulation. c. heart rate, activity, respirations. d. grimace, movement, skin moisture.
heart rate, activity, respirations.
When treating a patient you believe to be suffering from an ectopic pregnancy, you know that the primary threat to the patient's life is: Select one: a. severe pain. b. pelvic organ damage. c. infection. d. hemorrhage.
hemorrhage.
You arrive at the residence of a physician who informs you that his pregnant wife requires immediate transport to the hospital because she is bleeding and has a history of abruptio placenta. As a knowledgeable EMT, you should recognize that the greatest threat to the baby is: Select one: a. maternal shock. b. pain. c. infection. d. hypoxia.
hypoxia.
A 31-year-old female in her third trimester of pregnancy lost her balance and fell down a flight of stairs. When treating her, the EMT should: Select one: a. transport in a semi-Fowler's position with a cervical collar in place. b. avoid immobilization, given the stage of pregnancy. c. immobilize her, and then tilt the long spine board to the left. d. apply a cervical collar and transport her on her side.
immobilize her, and then tilt the long spine board to the left.
The EMT recognizes the underlying pathophysiology associated with an ectopic pregnancy as a fertilized egg that is: Select one: a. developing without a placenta. b. stuck in the abdomen. c. lodged in a fallopian tube. d. contaminated with abdominal bacteria.
lodged in a fallopian tube.
You have arrived at a residence to find a 6-month-old girl in her crib in cardiac arrest. Quick assessment reveals no rigor mortis or lividity. The mother states that she put the baby to bed at 9 p.m. last night and awoke at 3 a.m. to find her in her present state. Your first action would be to: Select one: a. ask if the baby has any medical conditions. b. inquire if the mother wants resuscitation started. c. open the airway and provide 2 ventilations. d. apply oxygen and move the baby to the ambulance.
open the airway and provide 2 ventilations.
A 6-year-old male has a decreased level of consciousness. His mother states that they do not have health insurance so they did not take him to the hospital last week when he started vomiting and had massive diarrhea. She continues by stating that he has not had anything to eat or drink since then. He has snoring respirations that are rapid and inadequate. His radial pulse cannot be located, and his carotid pulse is rapid and weak. His capillary refill is five seconds and his skin is cool to the touch. Your first intervention in caring for this child would be: Select one: a. providing positive pressure ventilation. b. taking manual in-line spinal immobilization. c. opening the airway using the head tilt-chin lift. d. attaching the automated external defibrillator.
opening the airway using the head tilt-chin lift.
A female patient who is eight and a half months pregnant states that she does not feel well. She denies chest pain, shortness of breath, and dizziness. She states that she did vomit earlier in the morning and still feels somewhat nauseated. She is alert and oriented and has a patent airway. She is breathing 18 times per minute and has a heart rate of 88 beats per minute. Her blood pressure is 116/70 mmHg. The most appropriate care for this patient should include: Select one: a. quiet and calm transport in the supine position. b. rapid transport to a hospital with specialized obstetrical services. c. refusal of transport with suggested follow-up with her obstetrician. d. oxygen at 15 lpm via nonrebreather face mask.
oxygen at 15 lpm via nonrebreather face mask.
After placing a small rock in her mouth, a 7-month-old girl begins to choke. You are on scene within minutes and find her unresponsive in her mother's arms. You attempt to provide ventilation with the bag-valve mask, but are unsuccessful. Your next action would be to: Select one: a. start cardiopulmonary resuscitation. b. attempt ventilation with a pocket mask. c. administer five chest thrusts. d. provide five abdominal thrusts.
start cardiopulmonary resuscitation.
The APGAR scoring system is useful in determining: Select one: a. status of overall condition. b. type of resuscitation needed. c. precise age of gestation. d. maturity of heart and lungs.
status of overall condition.
You have been called to a preschool for a child in seizure activity. On your arrival, staff direct you to a bed in which a 4-year-old boy is lying. Staff state that the child began making funny noises in his sleep then began to seize for approximately 60 seconds. Your assessment indicates that the boy is responsive to painful stimuli and is breathing, but has gurgling sounds coming from the upper airway. His radial pulse is rapid and strong and his skin is cool and diaphoretic. Your immediate action in caring for this child would be to: Select one: a. place a cervical collar. b. suction the airway. c. start positive pressure ventilation. d. apply oxygen.
suction the airway.