EMT - Chapter 39: incident Management, EMT - Chapter 9: Patient Assessment, EMT - Chapter 41: A Team Approach to Healthcare, EMT - Chapter 34: Pediatric Emergencies, EMT - Chapter 14: Medical Overview, EMT - Chapter 7: Life Span Development, EMT - Ch...

When a rehabilitation area is established at the scene of a mass-casualty incident, it should: A. be in a location that prevents visualization of the scene itself. B. be mandated that responders participate in a defusing session. C. provide rehabilitative services to both responders and patients. D. be staffed by the treatment supervisor and at least one physician.

A. be in a location that prevents visualization of the scene itself.

When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A. constricting. B. enlarging. C. dilating. D. fluttering.

A. constricting.

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should: A. immediately check for a pulse. B. triage him or her as expectant. C. give five rescue breaths and reassess. D. open the airway and reassess breathing.

A. immediately check for a pulse.

A carboy is a container that would MOST likely be used to store and transport: A. explosives. B. corrosives. C. flammable liquids. D. combustible materials.

B. corrosives.

A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding: A. time and place. B. date and event. C. event and person. D. person and place.

B. date and event.

As a triage supervisor, you: A. must prepare patients for transport before they leave the triage area. B. must not begin treatment until all patients have been triaged. C. are responsible for providing initial treatment to all patients. D. should communicate with area hospitals regarding their capabilities.

B. must not begin treatment until all patients have been triaged.

If an incident increases in scope and complexity, the IC should consider: A. ceasing all operations until a revised plan is established. B. maintaining responsibility for all of the command functions. C. relinquishing command to someone with more experience. D. requesting a second IC to assist him or her.

C. relinquishing command to someone with more experience.

The __________ area is where incoming ambulances meet and await further instructions at the scene of a mass-casualty incident. A. triage B. support C. staging D. transportation

C. staging

After recognizing that an incident involves a hazardous material, you should contact the hazardous materials team and then: A. don standard equipment before gaining access to any patients. B. not allow anyone within 25′ to 50′ of the incident scene. C. take measures to ensure the safety of yourself and others. D. identify the chemical using the Emergency Response Guidebook.

C. take measures to ensure the safety of yourself and others.

Which of the following chemicals requires identification with a placard, regardless of how many pounds the shipment weighs? A. air-reactive solids B. flammable liquids C. water-reactive solids D. nonflammable gases

C. water-reactive solids

A patient who does not respond to your questions but moves or cries out when his or her trapezius muscle is pinched, is said to be: A. conscious and alert. B. completely unresponsive. C. responsive to verbal stimuli. D. responsive to painful stimuli.

D. responsive to painful stimuli.

The reference used as a base for your initial actions at a HazMat incident is/are: A. the bill of lading. B. your local EMS protocols. C. the material safety data sheet (MSDS). D. the Emergency Response Guidebook.

D. the Emergency Response Guidebook.

A patient in respiratory arrest at the scene of a mass-casualty incident would typically be classified as a fourth priority (black tag; expectant) patient, unless: A. he or she has signs of an injury to the cervical spine. B. he or she has external signs of severe thoracic trauma. C. there are at least three other patients in respiratory arrest. D. there are enough resources to provide care for him or her.

D. there are enough resources to provide care for him or her.

The ____________ supervisor is responsible for notifying area hospitals and determining their availability and capabilities. A. triage B. medical C. treatment D. transportation

D. transportation

During an EMS call, you should take standard precautions: A. any time before you load the patient into the ambulance. B. after it has been determined that the patient is bleeding. C. immediately after completion of your primary assessment. D. upon exiting the ambulance, but before actual patient contact.

D. upon exiting the ambulance, but before actual patient contact.

The MOST appropriate location to park your ambulance at a HazMat incident is: A. downwind at least 200′ from the scene. B. downhill at least 100′ from the incident. C. uphill at least 25′ from the incident site. D. upwind at least 100′ from the incident.

D. upwind at least 100′ from the incident.

A patient who has experienced a back injury, with or without spinal cord damage, would be triaged with a __________ tag during a mass-casualty incident. A. red B. green C. black D. yellow

D. yellow

The heart muscle is called the: A. epicardium. B. myocardium. C. pericardium. D. endocardium.

B. myocardium.

The most superior portion of the sternum is called the: A. manubrium. B. costal arch. C. angle of Louis. D. xiphoid process.

A. manubrium.

Which of the following is NOT a facial bone? A. mastoid B. maxilla C. mandible D. zygoma

A. mastoid

Which of the following nerves carry information from the body to the brain via the spinal cord? A. motor B. central C. somatic D. sensory

D. sensory

For an adult, the normal resting pulse should be between: A. 50 and 60 beats/min. B. 50 and 70 beats/min. C. 60 and 100 beats/min. D. 70 and 110 beats/min.

C. 60 and 100 beats/min.

The cervical spine is composed of _____ vertebrae. A. 5 B. 6 C. 7 D. 8

C. 7

The cervical spine is composed of ___________ vertebrae. A. four B. five C. six D. seven

D. seven

When assessing the skin of an unconscious patient, you note that it has a bluish tint to it. This finding is called: A. pallor. B. flushing. C. cyanosis. D. mottling.

C. cyanosis.

A drip set that delivers 1 mL for every ____ drops will allow for the MOST rapid delivery of intravenous fluid.

10

What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? A. 5,600 mL B. 6,000 mL C. 7,400 mL D. 8,000 mL

A. 5,600 mL

A child may begin to show signs of separation anxiety as early as: A. 6 months. B. 12 months. C. 18 months. D. 24 months.

A. 6 months.

When ventilating an apneic patient with a bag- valve-mask device, each breath should be delivered over: A) 1 second. B) 2 seconds. C) 3 seconds. D) 4 seconds.

A) 1 second. When ventilating any apneic patient, each breath should be delivered over a period of 1 second--just enough to produce visible chest rise. Excessive ventilation duration and/or volume increases the likelihood of gastric distention, especially if the patient's airway is not secured with an advanced device (ie, ET tube, multilumen airway, supraglottic airway), and may result in increased intrathoracic pressure, decreased venous return to the heart, and decreased cardiac output.

Which of the following patients has signs of inadequate breathing? A) 41-year-old woman with shallow respirations of14 breaths/min B) A 60-year-old man with clear and equal breath sounds bilaterally C) A 30-year-old man with respirations of 12 breaths/min with adequate depth D) A 50-year-old woman with respirations of12 breaths/min and pink, dry skin

A) 41-year-old woman with shallow respirations of14 breaths/min Although the 41-year-old woman has a respiratory rate that falls within the normal range for an adult, the depth of her breathing is shallow (reduced tidal volume). Signs of inadequate breathing in the adult include a slow (less than 12 breaths/min) or fast (greater than 20 breaths/min) respiratory rate, shallow depth (reduced tidal volume), altered level of consciousness, tachycardia, an irregular pattern of inhalation and exhalation, diminished breath sounds during auscultation, and cyanosis. It is important to assess ALL components of a patient's breathing: rate, regularity, depth, and quali ty. Do not rely solely on one parameter.

The EMT is auscultating an adult patient's breath sounds after the paramedic has inserted an endotracheal (ET) tube. Which of the following would indicate that the ET tube was advanced too far into the trachea? A) Absent breath sounds over the left chest B) A gurgling sound over the epigastric region. C) Crackles over the lower lobe of the left lung. D) Weak breath sounds over the right lung apex.

A) Absent breath sounds over the left chest Anatomically, the right mainstem bronchus is shorter and straighter than the left. Therefore, if an ET tube is advanced too far into the trachea, it will come to rest in the right mainstem bronchus. Clinically, this would be evidenced by strong breath sounds over the right side of the chest and weak or absent breath sounds on the left. Simply withdrawing the ET tube slightly until breath sounds are bilaterally equal will solve this problem. Crackles heard in the lungs indicates fluid in the lower airway; diffuse crackles suggests pulmonary edema, whereas localized crackles suggests pneumonia. A gurgling sound over the epigastrium indicates that the ET tube is in the esophagus, not the trachea.

A patient presents with ineffective breathing that has no identifiable pattern. What term is used to describe this type of breathing? A) Ataxic B) Eupnea C) Kussmaul D) Cheyne-Stokes

A) Ataxic Respirations that are irregular, ineffective, and do not have an identifiable pattern are called ataxic respirations. Patients with severe brain injury or other conditions that can cause increased intracranial pressure can cause ataxic respirations. Eupnea is the term for normal breathing. Kussmaul respirations are characterized by a pattern of deep, rapid breathing; patient's with ketoacidosis commonly present with Kussmaul respirations. Cheyne-Stokes respirations are characterized by an alternating pattern of deep irregular breathing, followed by shallow breathing, followed by periods of apnea.

In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min. A. 60, 100 B. 50, 110 C. 40, 120 D. 30, 130

A. 60, 100

Which of the following interventions would result in passive ventilation? A) Chest recoil during chest compressions B) Ventilation with a bag-valve-mask device C) High-flow oxygen with a nonrebreathing mask D) CPAP device set at greater than 10 cmH20

A) Chest recoil during chest compressions When the chest is compressed during CPR, air is forced from the lungs. However, during the recoil phase, negative intrathoracic pressure causes a vacuum in the chest, no differently than when a patient inhales naturally. This vacuum causes air to passively flow into the lungs (passive ventilation). The same mechanism that pulls air into the lungs pulls blood back to the heart. Oxygen via nonrebreathing mask or nasal cannula provides passive oxygenation, not ventilation. Positive-pressure ventilation, such as what is created during bag-valve-mask ventilation or continous positive airway pressure (CPAP) therapy involves the pushing of air into the lungs. Positive-pressure ventilation can impair blood return back to the heart, especially when performed too aggressively.

You are assessing a 66-year-old man who has emphysema and complains of worsened shortness of breath. He is confused, has a heart rate of 120 beats/min, and has an oxygen saturation of 83%. Which of the following assessment findings should concern you the MOST? A) Confusion B) Tachycardia C) Low oxygen saturation D) Worsened shortness of breath

A) Confusion All of your assessment findings in th is patient are significant. Worsened shortness of breath in a patient with a preexisting respiratory disease could indicate exacerbation of his or her condition or a new problem. Tachycardia and a low oxygen saturation (Sp02) are signs of hypoxemia, a low level of oxygen in arterial blood. Of all the patient's assessment findings, the fact that he is confused should concern you the most. Altered mentation in a patient with respiratory distress indicates that the brain is not getting enough oxygen and that carbon dioxide is accumulating in the blood. It is important to recognize the signs of hypoxemia and begin immediate treatment (eg, high-flow oxygen via a nonrebreathing mask, assisted ventilation) to prevent hypoxia, a dangerous condition in which the body's cells and tissues do not receive enough oxygen. Left untreated, hypoxia may cause permanent brain damage or death.

A 69-year-old man complains of dyspnea that began two days ago and has gotten worse. Which of the fo llowing assessments would give you the MOST information regarding the possible cause of his dyspnea? A) Lung sounds B) Mental status C) Oxygen saturation D) Pulse rate and quality

A) Lung sounds Auscultation of the patient's lung sounds is the most specific assessment of the options listed and would be the most likely to provide you with information regarding the possible cause of the patient's respiratory distress. Lung sounds can help you differentiate an upper from a lower airway problem; if they are normal, an upper airway problem should be suspected. If abnormal lung sounds are heard, however, you could further determine the possible underlying cause based on the type of abnormal lung sounds heard. For example, wheezing indicates bronchospasm (ie, wheezing), whereas crackles indicate pulmonary edema. Oxygen saturation is used to assess the patient's oxygenation status. If it is low (less than 94%), it indicates that the patient is hypoxemic; however, it does not tell you why. Abnormalities in heart rate and quality, as well as mental status, may be observed in patients with respiratory distress; however, they do not tell you why the patient is experiencing respiratory distress.

During your assessment of a trauma patient, you note massive facial injuries, weak radial pulses, and clammy skin. What should be your MOST immediate concern? A) Potential obstruction of the airway B) Internal bleeding and severe shock C) Applying 100% supplemental oxygen D) Providing rapid transport to a trauma center

A) Potential obstruction of the airway Any trauma patient with severe maxillofacial trauma is at an extremely high risk of airway compromise. The airway can be compromised by either mandibular fractures, in which the tongue may occlude the airway, or severe oral bleeding, in which blood clots can obstruct the airway. Correct ANY airway problems immediately upon discovery, ensure adequate ventilation and oxygenation, assess for and treat other life-threatening injuries, and prepare for rapid transport.

Which of the following clinical find ings is common with emphysema, but not congestive heart fa ilure? A) Pursed-lip breathing B) Abdominal distention C) Distended jugular veins D) Pink, frothy sputum

A) Pursed-lip breathing Emphysema is characterized by progressive alveolar dysfunction and destruction caused by a loss of pulmonary surfactant, a compound that allows the alveoli to expand and recoil. Without surfactant, alveolar surface tension increases, resulting in air trapping in the lungs (this causes the barrel-shaped chest commonly seens in patients with advanced emphysema). In an effort to generate positive-end expiratory pressure (PEEP), the patient with emphysema exhales through pursed-lips; this generates resistance against the alveoli, which may force them open and facilitate air removal. Pursed lip breathing is not typically observed in patients with congestive heart failure (CHF) because alveolar dysfunction is not the underlying cause of the disease. In CHF, fluid backs up in the lungs (left heart failure) or the systemic circulation (right heart failure) secondary to poor cardiac contractility. Signs of left heart failure include respiratory distress, inability to lie flat (orthopnea), coughing up pink frothy sputum, and wet lung sound (ie, crackles). Signs of right heart failure include jugular vein distention, abdominal distention, and peripheral edema.

Which of the following yields the lowest minute volume? A) Respiratory rate of 14 breaths/min; tidal volume of 300 mL B) Respiratory rate of 12 breaths/min; tidal volume of 500 mL C) Respiratory rate of16 breaths/min; tidal volume of 400 mL D) Respiratory rate of 10 breaths/min; tidal volume of 500 mL

A) Respiratory rate of 14 breaths/min; tidal volume of 300 mL Minute volume is the amount of air moved through the lungs each minute; it is calculated by multiplying tidal volume and respiratory rate. Therefore, a respiratory rate of 14 breaths/min and a tidal volume of 300 mL would yield a minute volume of 4200 mL (4.2 L), which is less than the sum of any of the other values listed. Minute volume is affected by tidal volume, respiratory rate, or both. An increase in tidal volume, respiratory rate, or both will cause an increase in minute volume. A decrease in tidal volume, respiratory rate, or both will cause a decrease in minute volume.

Which of the following is an obvious sign of respiratory distress? A) Retractions above and below the clavicles B) Respiratory rate greater than 20 breaths/min C) Heart rate that is greater than 100 beats/min D) Skin that is pale, moist, and clammy

A) Retractions above and below the clavicles Objective signs of respiratory distress include retractions (above and/or below the clavicles or in between the ribs) during inhalation, a prolonged expiratory phase, nasal flaring (more common in children), and a tripod position. Tachycardia and bradycardia, as well as fast or slow breathing, can occur with many conditions, not ll of which are respiratory in nature. Of the choices listed, retractions are an obvious sign of a patient who is working hard to breathe.

Which of the following assessment findings would indicate that a patient with a foreign body airway obstruction has poor air exchange? A) Stridor B) Anxiety C) Wheezing D) Tachycardia

A) Stridor If a patient thas ANY type of airway obstruction, you would expect him or her to be anxious and tachycardic, so these findings are not specific to a patient with poor air exchange. If the patient has adequate air exchange, he or she will be coughing forcefully, although you may hear wheezing (a whistling sound) in between coughs. The skin may be flushed and the patient's level of consciousness is not altered. Poor air exchange is characterized by a weak, ineffective cough; progressive respiratory distress; stridor (high-pitched sound heard during inhalation); cyanosis; and a decreasing level of consciousness.

A patient with slow shallow breathing has a large volume of blood and secretions in his oropharnx. What should you do? A) Suction his airway until it is clear and ventilate with a bag-mask device B) insert a nasopharyngeal airway and suction the airway for 30 seconds C) Turn the patient onto his side and provide immediate transport D) Insert an oropharyngeal airway and suction for 10 to 15 seconds

A) Suction his airway until it is clear and ventilate with a bag-mask device Slow, shallow breathing should be treated with assisted ventilation. However, if the patient has blood, vomitus, or other secretions in the airway, they must be removed first. Suction the oropharynx until it is clear, and then begin ventilation assistance. Fifteen or 30 seconds of suction may not be enough time to remove all of the secretions. Ventilating a patient with secretions in the airway virtually assures aspiration, and mortality dramatically increases if aspiration occurs. Insert the appropriate airway adjunct after the ai1way is clear of secretions, continue to ventilate, and monitor the airway for ongoing secretions; provide additional suctioning as needed.

A 60-year-old woman presents with acute respiratory distress. She is conscious and alert, but restless. Her respiratory rate is 26 breaths/min with adequate chest expansion, her breath sounds are clear to auscultation bilaterally, and her oxygen saturation is 84%. Which of the following is the MOST appropriate treatment for this patient? A) Supplemental oxygen with a nonrebreathing mask B) A nasopharyngeal airway and assisted ventilations C) A nasopharyngeal airway and supplemental oxygen D) A nasal cannula with the flowmeter set at 4 to 6 L/min

A) Supplemental oxygen with a nonrebreathing mask Although the patient is restless (a sign of hypoxemia), she is conscious and alert and able to maintain her own airway; therefore, an airway adjunct is not needed at this point. Furthermore, her respirations, although increased in rate, are producing adequate tidal volume as evidenced by adequate chest expansion. Therefore, she is not in need of assisted ventilation at this point. Considering her oxygen saturation of 84%, the most appropriate treatment would be to administer high-flow oxygen with a nonrebreathing mask and closely monitor her for signs of inadequate breathing (ie, shallow breaths [reduced tidal volume], decreased level of consciousness, cyanosis). An acutely hypoxemic patient often requires more oxygen than a nasal cannula can provide.

Which of the following processes occurs during inhalation? A) The intercostal muscles and diaphragm both contract. B) The intercostal muscles relax and the diaphragm descends. C) The diaphragm contracts and the intercostal muscles relax. D) The diaphragm descends and the intercostal muscles relax.

A) The intercostal muscles and diaphragm both contract. During the active process of inhalation, the diaphragm contracts, causing it to descend. This increases the vertical dimensions of the chest. At the same time, the intercostal muscles (muscles between the ribs) contract, increasing the horizontal dimensions of the chest. These two processes cause intrathoracic pressure to fall, and air rushes in to fill the lungs. The drawing of air into the lungs by the actions of these muscles is called negative-pressure ventilation.

Your partner is ventilating an apneic woman at a rate of 24 breaths/min while you reassess her vital signs. You notice that her systolic BP has decreased by 20 mm Hg and her heart rate has increased by 25 beats/min. Which of the following is the MOST likely cause of these vital sign changes? A) The patient is being ventilated to fast B) The patient is in a supine position C) The patient overdosed on cocaine D) The patient has an intracranial hemorrhage

A) The patient is being ventilated to fast The patient is being ventilated twice as fast as she should be. You should ventilate an apneic adult at a rate of 10 to 12 breaths/min (one breath every 5 to 6 seconds). Ventilating too fast or with too much force can cause a dangerous elevation in intrathoracic pressure; as a result, venous return to the heart can be compromised and cardiac output can fa ll. Of the choices listed, this is the most likely cause of the change in her vital signs. Reduced cardiac output (secondary to decreased venous return) is causing the drop in her systolic BP, and her heart rate is elevating in an attempt to compensate for the lowered blood pressure. A supine position would not cause the vital sign changes the patient is experiencing. Cocaine and other CNS stimulants would be expected to cause hypertension and tachycardia, and intracranial hemorrhage would be expected to cause hypertension and bradycardia.

The MOST appropriate treatment for a semiconscious patient with slow, shallow respirations includes: A) a nasopharyngeal airway and assisted ventilation with a bag- valve-mask device. B) an oropharyngeal airway and high-flow oxygen via a nonrebreathing mask. C) a nasopharyngeal airway and high-flow oxygen via a nonrebreathing mask. D) an oropharyngeal airway and assisted ventilation with a bag- valve-mask device.

A) a nasopharyngeal airway and assisted ventilation with a bag- valve-mask device. Semiconscious patients are not fully able to protect their own airway and require an airway adjunct. The nasopharyngeal airway is indicated for semiconscious patients because they often have an intact gag reflex; the oropharyngeal airway is contraindicated in any patient with an intact gag reflex. Slow, shallow respirations will not provide the minute volume needed to support adequate oxygenation and should be treated with positive-pressure ventilation with a bag-valve-mask device.

A 5O-year-old woman presents with acute shortness of breath. Her skin is pale and she is anxious. You should: A) administer high-flow oxygen and assess the adequacy of her breathing. B) place her supine and ventilate her with a bag-valve-mask device. C) deliver humidified oxygen and administer an inhaled bronchodilator. D) give supplemental oxygen only if her oxygen saturation is less than 90%.

A) administer high-flow oxygen and assess the adequacy of her breathing. Patients with respiratory distress and signs of hypoxemia (ie, pale or cyanotic skin, tachycardia, anxiety or restlessness, oxygen saturation less than 94%) should be given supplemental oxygen and then assessed for signs of inadequate ventilation (ie, shalllow breathing [reduced tidal volume]). If the patient is breathing inadequately, assist his or her ventilationss. Patients with labored breathing will probably not allow you to place them in a supine position, as this will make it more difficult for them to breathe. An inhaled bronchodilator is indicated if you hear wheezing when auscultating the patient's lung sounds, which you have not done at this point. You should administer oxygen in a concentration sufficient to maintain an oxygen saturation that is equal to or greater than 94%.

When ventilating an unresponsive apneic adult with a bag-valve-mask device, you should ensure that: A) an airway adjunct has been inserted. B) you are positioned alongside the patient. C) ventilations occur at a rate of 20 breaths/min. D) the pop-off relief valve is manually occluded.

A) an airway adjunct has been inserted. When ventilating an unresponsive apneic patient with a bag-mask device, you should ensure that an oral or nasal airway adjunct is inserted, which will keep the tongue off of the posterior pharynx and facilitate effective ventilation. When ventilating a patient with a bag-mask device, it is best for you to be positioned at the patient's head to aUow for better control of the head. Ventilations in the apneic adult with a pulse (ie, not in cardiac arrest) should be provided at a rate of 10 to 12 breaths/min (one breath every 5 to 6 seconds). Generally, only pediatric-sized bag-mask devices have pop-off relief valves, which should NOT be occluded, because they help prevent overinflation of the patient's lungs.

In an otherwise heathy individual, breathing is stimulated when: A) arterial carbon dioxide levels increase. B) arterial blood pressure decreases. C) arterial oxygen levels decrease. D) pH of the cerebrospinal fluid increases.

A) arterial carbon dioxide levels increase. In healthy patients without respiratory disease, breathing is stimulated by increasing levels of carbon dioxide in arterial blood, which triggers a decrease in the pH of the cerebrospinal fluid. This decrease in pH stimulates the respiratory centers in the brainstem to send messages to the diaphragm and intercostal muscles, resulting in breathing. In some patients with chronic respiratory disease (for example, COPD) who have chronic hypercarbia (elevated carbon dioxide levels in the blood), the brainstem becomes less sensitive to increased carbon dioxide levels and more sensitive to decreased oxygen levels. As a result, breathing is stimulated by low oxygen levels (hypoxic drive). Arterial blood pressure (low or high) does not stimulate breathing.

A patient with respiratory distress and signs of pulmonary edema is receiving continuous positive airway pressure (CPAP) therapy set at 5 cm H20. During reassessment, you note that the patient is fat igued and is no longer fo llowing verbal commands. You should: A) begin assisted ventilation with a bag-mask device. B) increase the CPAP setting to greater than 10 cmH20. C) apply a nonrebreathing mask with high-flow oxygen. D) administer a beta-2 agonist through the CPAP device.

A) begin assisted ventilation with a bag-mask device. When treating a patient with CPAP, you must monitor him or her for signs of both clinical improvement and deterioration. A fatigued appearance and an inability to follow verbal commands indicate that the patient is not breathing adequately; therefore, he is no longer a suitable candidate for CPAP therapy. You should begin assisting his ventilations with a bag-mask device in order to improve his minute volume and oxygenation status. Passive oxygenation via nonrebreathing mask will be of little to no benefit if the patient's tidal volume is markedly reduced. A beta-2 agonist is not indicated for this patient because there is no evidence of bronchospasm (ie, wheezing).

Oxygen that is administered through a nasal cannula would be of LEAST benefit to a patient who: A) breathes through his or her mouth. B) is in need of long-term oxygen therapy. C) has COPD and an oxygen saturation of 92%. D) is breathing more than 12 times per minute.

A) breathes through his or her mouth. A patient who breathes through the mouth or has a nasal obstruction will get little or no benefit from a nasal cannula. Many patients with COPD (eg, emphysema, chronic bronchitis) require long-term, low-flow oxygen therapy; the nasal cannula is ideal in this situation. Considering their chronic respiratory problem, an oxygen saturation of 94% in a COPD patient is good; in fact, many COPD patients maintain an oxygen saturation lower than 94%, even with supplemental oxygen. A nasal cannula is appropriate to use in patients breathing more than 12 times per minute, provided they have adequate tidal volume and are not significantly hypoxemic. Regardless of the oxygen delivery device used, you should maintain a patient's oxygen saturation at greater than 94%.

A young female experienced massive facial trauma and is unresponsive. After several attempts, you are unable to adequately open her airway with the jaw-thrust maneuver. You should: A) carefully tilt her head back and lift up on her chin. B) insert a nasopharyngeal airway and apply oxygen. C) apply oxygen and reattempt the jaw-thrust maneuver. D) assist her ventilations with a bag- valve-mask device.

A) carefully tilt her head back and lift up on her chin. The jaw-thrust maneuver should be used to open the airway of any trauma patient because it does not require manipulation of the neck. However, if the jawthrust maneuver does not adequately open the patient's airway, you should carefully perform the head tilt-chin lift maneuver. The patient's airway must be patent, regardless of the situation. After opening an unresponsive patient"s airway, ensure that it is clear of secretions (suction as needed), insert an airway adjunct, and assess breathing. If the patient is breathing adequately, administer high-flow oxygen via a nonrebreathing mask. If the patient is breathing inadequately, assist his or her ventilations with a bag-valve-mask device. You should avoid the use of a nasopharyngeal airway in patients with massive head or facial trauma. If the airway is accidentally pushed through a hole caused by the fracture, it may penetrate the cranium and enter the brain.

You are assessing an elderly man with respiratory distress. He is coughing up bloody sputum and has an oxygen saturation of 85%. You auscultate his breath sounds and hear coarse crackles in all lung fields. This patient MOST likely has: A) congestive heart failure. B) acute-onset emphysema. C) decompensated asthma. D) severe bacterial pneumonia.

A) congestive heart failure. This patient's signs and symptoms are classic for left-sided congestive heart failure and pulmonary edema. As the left side of the heart weakens, so that it can no longer effectively pump blood, blood backs up into the lungs, resulting in pulmonary edema. As pulmonary edema gets worse, the patient begins coughing up pink, frothy sputum (hemoptysis). The presence of fluid in the lungs impairs the exchange of oxygen and carbon dioxide, resulting in hypoxemia and a low oxygen saturation (Sp02). Auscultation of the patient's lungs often reveals coarse crackles, which indicates the presence of fluid . Emphysema is a chronic respiratory disease, not an acute one. Furthermore, hemoptysis is not a common finding with emphysema. Likewise, patients with decompensated asthma often have markedly diminished lung sounds owing to severe bronchospasm; hemoptysis and crackles are not common. Bacterial pneumonia can cause respiratory distress; however, it usually presents with fever and diminished breath sounds to a localized area of a lung (eg, the left lower lobe).

The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible is called: A) dead space. B) vital capacity. C) residual volume. D) min ute volume.

A) dead space. Vital capacity is the volume of air that can be forcibly expelled from the lungs following a maximal inhalation. Dead space is the portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange. Anatomically, the dead space extends from the nose and mouth to the large bronchi. Residual volume is the air that remains in the lungs after maximal exhalation. Minute volume is the volume of air moved through the lungs in one minute; it is calculated by multiplying tidal volume and respiratory rate.

Shallow breathing is an indication of: A) decreased tidal volume. B) increased minute volume. C) increased oxygen intake. D) severe hypocarbia.

A) decreased tidal volume. Shallow breathing is an indication of decreased tidal volume. Tidal volume is the amount of air (in milliliters [mL]) breathed into or out of the lungs in a single breath. Adequate tidal volume is needed to bring in adequate amounts of oxygen and eliminate adequate amounts of carbon dioxide. Shallow breathing would cause hypercarbia, not hypocarbia. Patients with shallow breathing often need some form of positive-pressure ventilation (eg, bag-valve-mask, pocket face mask device), especially if they have signs of hypoxia (ie, altered mental status, low oxygen saturation, cyanosis). Minute volume is the volume of air that is moved through the lungs per minute; it is the product of the tidal volume multiplied by the respiratory rate. If tidal volume is reduced, minute volume will be reduced as well unless there is a compensatory increase in the respiratory rate.

An unresponsive 60-year-old male is apneic and has a weak, rapid pulse. His oxygen saturation reads 79%. You should: A) deliver one breath over 1 second every 5 to 6 seconds. B) use a pocket face mask to deliver 12 to 20 breaths/min. C) hyperventilate him until his oxygen saturation improves. D) deliver a maximum of10 breaths/min, each over 1 second.

A) deliver one breath over 1 second every 5 to 6 seconds. When ventilating an apneic adult with a pulse, deliver one breath every 5 to 6 seconds (10 to 12 breaths/min). A ventilation rate of 12 to 20 breaths/min (one breath every 3 to 5 seconds) is appropriate for infants and children. Regardless of the patient's age and the ventilation device you are using (eg, bag-valvemask device, pocket face mask), each breath should be delivered over a period of 1 second (enough to produce visible chest rise). Do NOT hyperventilate the patient, as this may cause a decrease in venous return to the heart secondary to hyperinflation of the lungs. Hyperventilation also increases the risks of gastric distention, regurgitation, and aspiration. After an advanced airway device has been inserted (eg, ET tube, multilumen airway, supraglottic airway) in a cardiac arrest patient, you should no longer perform "cycles" of CPR; the compressor delivers compressions at a rate of 100 to 120/min and the ventilator delivers 10 breaths/min (one breath every 6 seconds). This ventilation rate during cardiac arrest applies to all age groups, except the newborn.

An unresponsive apneic patient's chest fails to rise after two ventilation attempts. You should: A) immediately proceed to chest compressions. B) suction the airway and reattempt venti lations. C) attempt to ventilate again using more volume. D) reposition the head and reattempt to ventilate.

A) immediately proceed to chest compressions. If your initial attempt to ventilate an apneic patient is unsuccessful (ie, you meet resistance or the chest fa ils to visibly rise), reposition the patient's head and reattempt to ventilate. If the second ventilation is unsuccessful, you should proceed under the as umption that the patient has a severe (complete) airway obstruction. Perform 30 chest compressions, open the airway, and visualize the mouth (remove an object only if you can see it). If you are able to remove the foreign object, attempt to venti late. If you cannot see a foreign object, continue chest compressions. Continue this sequence until the obstruction is rel ieved or an advanced life support (ALS) ambulance arrives. If ALS response will be delayed, transport the patient, continuing your attempts to relieve the obstruction en route, and coordinate a rendezvous with the ALS unit.

A patient with a mild foreign body airway obstruction: A) is typically not cyanotic. B) presents with a weak cough. C) has a low oxygen saturation. D) has progressive difficulty breathing.

A) is typically not cyanotic. Patients with a mild (par-tial) airway obstruction are able to move adequate amounts of air, but will have varying degrees of respiratory distress. The patient can cough forcefully, although you may hear wheezing in between coughs. Because the patient is able to move air effectively, the level of oxygen in his or her blood remains adequate; therefore, cyanosis is typically absent. By contrast, the patient with a severe (complete) airway obstruction cannot move air effectively and cannot speak. If a cough is present, it is weak and ineffective. As the level of oxygen in the blood falls, cyanosis develops, oxygen saturation falls, and the patient's level of consciousness decreases. A foreign body airway obstruction, mild or severe, is an acute event that presents with an acute onset of difficulty breathing. Progressive (gradually worsening) difficulty breathing is more consistent with diseases such as congestive heart failure and pneumonia.

Blood pressure is usually not assessed in children younger than _____ years. A. 3 B. 4 C. 5 D. 6

A. 3

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb. A. 40 B. 50 C. 60 D. 70

A. 40

A young woman overdosed on heroin and is unresponsive with slow, shallow breathing. She begins to gag after you insert an oropharyngeal airway. You should: A) remove the oralpharangeal airway and be prepared to suction her mouth. B) place her on her side until she stops gagging and then suction her mouth. C) suction the patient's oropharynx as you insert a nasopharyngeal airway. D) make sure you are using the most appropriate size of oropharyngeal airway.

A) remove the oralpharangeal airway and be prepared to suction her mouth. If an unresponsive patient begins to gag after insertion of an oropharyngeal airway, you must remove the airway immediately and be prepared to suction if vomiting should occur. Turn the patient on his or her side to facilitate drainage of secretions. Once the airway has been cleared, a nasopharyngeal airway, which is better tolerated in patients with a gag reflex, should be inserted.

An inaccurate pulse oximetry reading may be caused by: A) severe peripheral vasoconstriction. B) excessive red blood cell production. C) heat illnesses, such as heatstroke. D) a heart rate greater than 100 beats/min.

A) severe peripheral vasoconstriction. A pulse oximeter measures the percentage of hemoglobin that is saturated with oxygen. Under normal conditions, a patient's oxygen saturation (SpO2) ranges between 95% and 100% while breathing room air. Although no definitive threshold for normal SpO2 va lues exists, an SpO2 that is less than 95% in a nonsmoker may indicate hypoxemia. Of the factors listed, severe peripheral vasoconstriction (ie, hypothermia, cigarette smoking, chronic hypoxia) would be the most likely to produce an inaccurate SpO2 reading. When the peripheral vasculature constricts, blood is shunted to the core of the body; in such cases, the pulse oximeter would likely yield a falsely low reading (or no reading at all). Other factors that can cause inaccurate readings include dark or metallic nail polish, dirty fingers, and abnormal hemoglobin binding (ie, carbon monoxide [CO] poisoning). It is important to note that the pulse oximeter is designed to detect gross abnormalities, not subtle changes, and should be used in conjunction with a thorough clinical assessment of the patient.

Tidal volume is defined as the: A) volume of air inhaled or exhaled per breath. B) volume of air that remains in the upper airway. C) total volume of air that the lungs are capable of holding. D) volume of air moved in and out of the lungs each minute.

A) volume of air inhaled or exhaled per breath. Tidal volume (VT) is the amount of air that is inhaled or exhaled per breath; it is normally about 500 mL in an average adult male. Tidal volume is assessed by noting the depth of a patient's breathing. Shallow breathing, for example, indicates a reduced tidal volume. The volume of air that remains in the upper respiratory tract (eg, larger bronchi, trachea) is called dead space volume (VD); it is approximately 30% of the adult male's tidal volume and does not participate in pulmonary gas exchange. The volume of air that moves in and out of the lungs each minute, and does participate in pulmonary gas exchange, is called minute alveolar volume {VA}. It is calculated by multiplying the tidal volume (minus the dead space volume) and the respiratory rate. Therefore, if an adult male has a tidal volume of 500 mL and a respiratory rate of 18 breaths/min, his minute alveolar volume is 6300 mL (500 mL [VT] - 150 mL [VD] x 18 [breaths/min]= 6300 mL [VA]). The maximum volume of air that the lungs are capable of holding is called the total lung capacity {TLC); it is approximately 6 Lin the healthy adult male.

Which of the following statements would NOT be appropriate to say to the family of a dying patient? A. "Things will get better in time." B. "It is okay to be angry and sad." C. "This must be painful for you." D. "Tell me how you are feeling."

A. "Things will get better in time."

Which of the following questions is used to determine a patient's chief complaint? A. "What seems to be the matter?" B. "When did the chest pain begin?" C. "Are you having trouble breathing?" D. "Do you have a history of diabetes?"

A. "What seems to be the matter?"

A disposable oxygen humidifier should be considered for ambulance services that often transport patients on runs longer than: A. 1 hour. B. 2 hours. C. 3 hours. D. 4 hours.

A. 1 hour.

According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA. A. 1% B. 2% C. 4% D. 6%

A. 1%

Femoral shaft fractures can result in up to _____ mL of internal blood loss. A. 1,000 B. 1,500 C. 2,000 D. 4,000

A. 1,000

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA. A. 18% B. 27% C. 36% D. 45%

A. 18%

The mastoid process is located approximately: A. 1″ posterior to the external opening of the ear. B. ½″ anterior to the external opening of the ear. C. 1″ inferior to the external opening of the ear. D. 1″ posterior to the angle of the mandible.

A. 1″ posterior to the external opening of the ear.

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A. 2 B. 3 C. 4 D. 6

A. 2

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: A. 2 seconds. B. 3 seconds. C. 4 seconds. D. 5 seconds.

A. 2 seconds.

An abortion occurs when the fetus and placenta deliver before: A. 20 weeks. B. 24 weeks. C. 26 weeks. D. 28 weeks.

A. 20 weeks.

An unstable patient should be reassessed at least every: A. 5 minutes. B. 10 minutes. C. 15 minutes. D. 20 minutes.

A. 5 minutes.

What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? A. 5,600 mL B. 6,000 mL C. 7,200 mL D. 8,000 mL

A. 5,600 mL

During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of: A. 7. B. 8. C. 9. D. 10.

A. 7.

Which of the following represents a low normal systolic blood pressure for a 6-year-old child? A. 82 mm Hg B. 88 mm Hg C. 90 mm Hg D. 98 mm Hg

A. 82 mm Hg

A person's ability to shiver is lost when his or her body temperature falls below: A. 90°F (32°C). B. 92°F (33°C). C. 94°F (34°C). D. 95°F (35°C).

A. 90°F (32°C).

Which of the following statements regarding a breech presentation is MOST correct? A. A breech presentation occurs when the buttocks are the presenting part. B. There is minimal risk of trauma to the infant with a breech presentation. C. It is impossible to deliver a breech presentation in the prehospital setting. D. Breech deliveries occur rapidly, so the EMT should deliver at the scene.

A. A breech presentation occurs when the buttocks are the presenting part.

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct? A. A decreased level of consciousness is not a normal part of the aging process. B. Most elderly patients have some deterioration in their level of consciousness. C. A decreased level of consciousness is most often the result of chronic dementia. D. The AVPU scale is an ineffective tool when assessing an elderly patient's level of consciousness.

A. A decreased level of consciousness is not a normal part of the aging process.

Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct? A. A mentally competent adult can withdraw his or her consent to treat at any time. B. Any patient who refuses EMS treatment must legally sign a patient refusal form. C. Because of your suspicions, the best approach is to transport him to the hospital. D. Once a patient is in the ambulance, he or she cannot legally refuse EMS treatment.

A. A mentally competent adult can withdraw his or her consent to treat at any time.

Which of the following scenarios MOST accurately depicts abandonment? A. A paramedic transfers patient care to an EMT. B. An AEMT transfers patient care to a paramedic. C. A physician assumes patient care from an EMT. D. An EMT gives a verbal report to an emergency room nurse.

A. A paramedic transfers patient care to an EMT.

Which of the following scenarios is an example of a direct injury? A. A passenger fractures her patella after it strikes the dashboard. B. A skier dislocates his knee after a twisting injury to the ankle. C. A person lands on his or her feet and fractures the lumbar spine. D. A child dislocates his elbow after falling on his outstretched arm.

A. A passenger fractures her patella after it strikes the dashboard.

Which of the following general statements regarding consent is MOST correct? A. A patient can consent to transport but can legally refuse to be treated. B. Patients who are intoxicated are generally allowed to refuse treatment. C. Expressed consent is valid only if given in writing by a family member. D. All patients older than 18 years can legally refuse treatment or transport.

A. A patient can consent to transport but can legally refuse to be treated.

Which of the following statements regarding smooth muscle is correct? A. A person has no voluntary control over smooth muscle. B. Smooth muscle is found exclusively within blood vessels. C. The biceps and quadriceps are examples of smooth muscle. D. Smooth muscle is under control of the voluntary nervous system.

A. A person has no voluntary control over smooth muscle.

_____________ is defined as the ability to reach the patient. A. Access B. Rescue C. Extrication D. Disentanglement

A. Access

Which of the following statements regarding the aging process is correct? A. Aging is a linear process; the rate at which a person loses functions does not increase with age. B. Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. C. Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. D. The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver.

A. Aging is a linear process; the rate at which a person loses functions does not increase with age.

Which of the following statements regarding psychosocial development in the adolescent age group is correct? A. Antisocial behavior and peer pressure peak around 14 to 16 years of age. B. Family conflict decreases as the adolescent gains control of his or her life. C. Adolescents are less fixated on their public image than younger children. D. Because they think rationally, adolescents are at the lowest risk for suicide.

A. Antisocial behavior and peer pressure peak around 14 to 16 years of age.

During your visual inspection of a 19-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? A. Apply gentle pressure to the baby's head as it delivers. B. Tell the mother not to push and transport her immediately. C. Place your fingers in the vagina to assess for a nuchal cord. D. Maintain firm pressure to the head until it completely delivers.

A. Apply gentle pressure to the baby's head as it delivers.

Which of the following statements regarding middle adults is correct? A. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer. B. Women in the middle adult age group typically experience menopause in their late 50s or early 60s. C. Significant impairments in hearing and vision begin to occur in persons between the ages of 41 and 44 years. D. Increased cholesterol levels in the middle adult age group often do not respond to exercise and diet.

A. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer.

Which of the following statements regarding compartment syndrome is correct? A. Compartment syndrome typically develops within 6 to 12 hours after an injury. B. Compartment syndrome occurs because of increased pressure within the bone cavity. C. In most cases, compartment syndrome develops within a few minutes after an injury. D. Most cases of compartment syndrome occur following a severe fracture of the pelvis.

A. Compartment syndrome typically develops within 6 to 12 hours after an injury.

Which of the following statements regarding cerebral palsy is correct? A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. B. Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis. C. Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay. D. A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator.

A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

Which of the following would indicate that the endotracheal tube is NOT in the trachea? A. Decreased resistance when ventilating B. Absence of sounds over the epigastrium C. Steady increase in the oxygen saturation D. Absence of an end-tidal CO2 waveform

A. Decreased resistance when ventilating

Which of the following statements regarding electrical burns is correct? A. Entrance wounds are small relative to the amount of internal tissue damage. B. Respiratory or cardiac arrest following an electrical burn is very uncommon. C. The exit wound caused by electrical burns is smaller than the entrance wound. D. The size of the entry and exit wounds is a reliable indicator of internal damage.

A. Entrance wounds are small relative to the amount of internal tissue damage.

Which of the following statements regarding penetrating injuries is correct? A. External bleeding may be minimal but internal injuries can be extensive. B. The degree of internal injury can often be estimated by the external injury. C. It is important to distinguish between entrance and exit wounds in the field. D. The depth of a penetrating injury should be thoroughly assessed by the EMT.

A. External bleeding may be minimal but internal injuries can be extensive.

Which of the following statements regarding hepatitis A is correct? A. Hepatitis A can only be transmitted by a patient who has an acute infection. B. Infection with hepatitis A causes chronic illness with a high mortality rate. C. Hepatitis A is primarily transmitted via contact with blood or other body fluids. D. Although there is no vaccine against hepatitis A, treatment is usually successful.

A. Hepatitis A can only be transmitted by a patient who has an acute infection.

___________ pressure is the pressure exerted by a liquid and occurs when blood is moved through the artery at relatively high pressures. A. Hydrostatic B. Osmotic C. Oncotic D. Diffusion

A. Hydrostatic

A type _____ ambulance features a conventional, truck cab-chassis with a modular ambulance body that can be transferred to a newer chassis as needed. A. I B. II C. III D. IV

A. I

Which of the following statements regarding the use of the warning lights and siren on the ambulance is correct? A. If it is necessary to use the siren, you should tell the patient beforehand. B. If the patient is stable, you may use the warning lights without the siren. C. Warning lights and siren should be avoided, even if the patient is unstable. D. It is generally acceptable to increase your speed if lights and siren are in use.

A. If it is necessary to use the siren, you should tell the patient beforehand.

Which of the following statements regarding age-related changes in the nervous system is correct? A. Interconnections between brain cells often prevent a loss of knowledge or skill, despite a loss of neurons. B. The metabolic rate in the brain increases with age, but the consumption of oxygen decreases significantly. C. Generally speaking, the brain increases in size by 10% to 20% by the time a person reaches 80 years of age. D. Because of a decrease in the number of brain cells, a person's level of intelligence decreases with age.

A. Interconnections between brain cells often prevent a loss of knowledge or skill, despite a loss of neurons.

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? A. It forces the alveoli open and pushes more oxygen across the alveolar membrane. B. It pushes thick, infected pulmonary secretions into isolated areas of the lung tissue. C. It decreases intrathoracic pressure, which allows more room for the lungs to expand. D. It prevents alveolar collapse by pushing air into the lungs during the inhalation phase.

A. It forces the alveoli open and pushes more oxygen across the alveolar membrane.

Which of the following statements regarding the heart is correct? A. It is under control of the autonomic nervous system. B. It can tolerate an interruption of oxygen for 5 minutes. C. It receives its blood supply from the pulmonary arteries. D. It relies on an external electrical source to correctly function.

A. It is under control of the autonomic nervous system.

Which of the following statements regarding lightning strikes is correct? A. Lighting often results in a brief period of asystole that resolves spontaneously. B. The tissue damage pathway caused by lightning usually occurs through the skin. C. Victims who are struck by lightning often experience severe full-thickness burns. D. Cervical spine fractures are the most common cause of lightning-related deaths.

A. Lighting often results in a brief period of asystole that resolves spontaneously.

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect: A. Lyme disease. B. an allergic reaction. C. exposure to poison ivy. D. Rocky Mountain spotted fever.

A. Lyme disease.

Which of the following statements regarding suicide in the older patient is correct? A. Older patients tend to use more lethal means than younger patients. B. Older females have a higher rate of suicide than any other group. C. Depression and hopeless feelings are often not predisposing factors. D. Most suicidal patients readily seek care and do not deny the problem.

A. Older patients tend to use more lethal means than younger patients.

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: A. pneumonia. B. osteoporosis. C. heart failure. D. ischemic stroke.

A. pneumonia.

Which of the following items would MOST likely require special protocols in order to be carried on the ambulance? A. PASG B. pediatric nonrebreathing masks C. automated external defibrillator (AED) D. devices for restraining a patient

A. PASG

Which of the following statements regarding plasma is correct? A. Plasma transports the blood cells and nutrients. B. Approximately 45% of the blood is composed of plasma. C. Plasma has no role in the body's blood-clotting mechanism. D. Most of the body's plasma is contained within the large veins.

A. Plasma transports the blood cells and nutrients.

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A. SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure. B. Most cases of SARS are caused by a bacterium that is spread from person to person via direct contact with infected blood. C. SARS is caused by a virus that occurs naturally in the bird population, although it usually does not cause illness in humans. D. Although SARS can cause pneumonia and other respiratory infections, it rarely causes death, even in immunocompromised patients.

A. SARS is caused by a virus and usually starts with flulike symptoms that deteriorate to pneumonia and respiratory failure.

Which of the following is a physical change that typically occurs in the adolescent age group? A. Secondary sexual development begins. B. Muscle and bone growth both decrease. C. The normal pulse rate steadily increases. D. The systolic blood pressure decreases.

A. Secondary sexual development begins.

Which of the following statements regarding the AED and defibrillation is correct? A. The AED will not analyze the rhythm of a moving patient. B. Defibrillation is the first link in the American Heart Association chain of survival. C. The AED will shock any rhythm not accompanied by a pulse. D. CPR should be performed for 5 minutes before using the AED.

A. The AED will not analyze the rhythm of a moving patient.

Which of the following processes occurs during the inflammation phase of the healing process? A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling. B. White blood cells are forced away from the injury site, thus allowing an increase in the flow of red blood cells, resulting in increased blood flow. C. The blood vessels in and around the injury site constrict, which forces bacteria and other microorganisms away, thus preventing significant infection. D. The veins and arteries at the injury site constrict and platelets aggregate, which stops bleeding and causes a temporary increase in the size of the wound.

A. The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.

Which of the following statements regarding the neonatal isolette is correct? A. The isolette serves to keep the neonate warm and protects from excess handling. B. A freestanding isolette should be used, not one that is secured to the stretcher. C. The safest type of isolette is one that takes the place of the ambulance stretcher. D. If an isolette is not available, the neonate can safely be transported on the stretcher.

A. The isolette serves to keep the neonate warm and protects from excess handling.

Which of the following statements regarding the kidneys is correct? A. The kidneys eliminate toxic waste products from the body and control its balance of water and salt. B. Both kidneys are located in the anterior abdominal cavity and lie in between the liver and the spleen. C. Since the kidneys require little oxygen, only 5% of your blood volume passes through them each minute. D. A series of small blood vessels attach the kidneys directly to the superior vena cava and renal arteries.

A. The kidneys eliminate toxic waste products from the body and control its balance of water and salt.

Which of the following statements regarding patient weight distribution is correct? A. The majority of a horizontal patient's weight is in the torso. B. Most of the patient's weight rests on the foot end of the stretcher. C. A semi-sitting patient's weight is equally distributed on both ends. D. The EMT at the patient's head will bear the least amount of weight.

A. The majority of a horizontal patient's weight is in the torso.

Which of the following statements regarding the placenta is correct? A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus. B. The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus. C. The placenta, also referred to as the afterbirth, provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born. D. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus.

A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.

Which of the following statements regarding the secondary assessment is correct? A. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint. B. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient's condition. C. A secondary assessment should be performed, even if you must continually manage life threats that were identified in the primary assessment. D. During the secondary assessment, the EMT's primary focus should be on taking the patient's vital signs and obtaining a SAMPLE history.

A. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

Which of the following is a metabolic cause of a seizure? A. poisoning B. head trauma C. brain tumor D. massive stroke

A. poisoning

Which of the following statements regarding the use of nasopharyngeal airways in children is correct? A. They are rarely used in infants younger than 1 year. B. It is the recommended adjunct for children with head trauma. C. They are usually not well tolerated in children with a gag reflex. D. Blanching of the nares after insertion indicates correct placement.

A. They are rarely used in infants younger than 1 year.

Which of the following statements regarding motor nerves is correct? A. They carry information from the CNS to the muscles. B. They perform special functions such as sight, smell, and hearing. C. They transmit information from the body to the brain via the spinal cord. D. They are part of the CNS and control reflexes.

A. They carry information from the CNS to the muscles.

You arrive at the scene of a motor vehicle versus pedestrian accident. The patient, a 13-year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene in approximately 15 minutes. What should you do? A. Transport the child immediately and have the parents meet you at the hospital. B. Treat the child at the scene and wait for the parents to arrive and give consent. C. Begin transport at once and have the parents meet you en route to the hospital. D. Withhold treatment until the parents arrive and give you consent for treatment.

A. Transport the child immediately and have the parents meet you at the hospital.

Which of the following is an example of a brand (trade) name of a drug? A. Tylenol B. ibuprofen C. furosemide D. nitroglycerin

A. Tylenol

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect: A. a black widow spider bite. B. envenomation from a pit viper. C. a brown recluse spider bite. D. Rocky Mountain spotted fever.

A. a black widow spider bite.

Which of the following patients is breathing adequately? A. a conscious male with respirations of 19 breaths/min and pink skin B. a conscious female with facial cyanosis and rapid, shallow respirations C. a conscious male with respirations of 18 breaths/min and reduced tidal volume D. an unconscious 52-year-old female with snoring respirations and cool, pale skin

A. a conscious male with respirations of 19 breaths/min and pink skin

In which of the following situations would a direct ground lift be the MOST appropriate method of moving a patient? A. a conscious patient complaining of abdominal pain B. a patient who complains of hip pain following a fall C. a pedestrian with back pain after being struck by a car D. an unconscious patient with a possible ischemic stroke

A. a conscious patient complaining of abdominal pain

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: A. a decreased ability to cough. B. baseline respiratory distress. C. an increased risk of COPD. D. air-trapping within the alveoli.

A. a decreased ability to cough.

A decrease in the blood pressure may indicate: A. a loss of vascular tone. B. arterial constriction. C. increased blood volume. D. forceful cardiac contraction.

A. a loss of vascular tone.

Which of the following situations would require the use of a specialized rescue team? A. a patient trapped in a cave or a confined space B. a patient in a badly damaged car, not entrapped C. an obese patient who must be moved to the ambulance D. a patient found floating facedown in a swimming pool

A. a patient trapped in a cave or a confined space

Situations in which you should use the rapid extrication technique include all of the following, EXCEPT: A. a patient who can be properly assessed while still in the vehicle. B. a patient who blocks access to another seriously injured patient. C. a patient who needs immediate care that requires a supine position. D. a patient whose condition requires immediate transport to the hospital.

A. a patient who can be properly assessed while still in the vehicle.

An indicator of an expanding intracranial hematoma or rapidly progressing brain swelling is: A. a rapid deterioration of neurologic signs. B. a progressively lowering blood pressure. C. an acute increase in the patient's pulse rate. D. acute unilateral paralysis following the injury.

A. a rapid deterioration of neurologic signs.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? A. a rapid heart rate B. syncope or dizziness C. heart rate less than 60 beats/min D. generalized weakness

A. a rapid heart rate

Signs of adequate breathing in the adult include all of the following, EXCEPT: A. a reduction in tidal volume. B. respirations of 20 breaths/min. C. bilaterally clear breath sounds. D. rhythmic inhalation and exhalation.

A. a reduction in tidal volume.

A folding or portable stretcher is MOST beneficial when: A. a second patient must be transported on the squad bench of the ambulance. B. an injured patient cannot be placed on a long board due to severe back pain. C. a conscious, alert patient must be carried down several flights of steep stairs. D. a patient requires full spinal immobilization when spinal injury is suspected.

A. a second patient must be transported on the squad bench of the ambulance.

Putrefaction is defined as: A. decomposition of the body's tissues. B. profound cyanosis to the trunk and face. C. blood settling to the lowest point of the body. D. separation of the torso from the rest of the body.

A. decomposition of the body's tissues.

Which of the following MOST accurately describes a simple partial seizure? A. a seizure that begins in one extremity B. a seizure that causes the patient to stare blankly C. a seizure that is not preceded by an aura D. a generalized seizure without incontinence

A. a seizure that begins in one extremity

When caring for a patient with documented hypoglycemia, you should be MOST alert for: A. a seizure. B. an acute stroke. C. respiratory distress. D. a febrile convulsion.

A. a seizure.

Gas exchange in the lungs is facilitated by: A. adequate amounts of surfactant. B. water or blood within the alveoli. C. surfactant-destroying organisms. D. pulmonary capillary constriction.

A. adequate amounts of surfactant.

A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: A. administer 100% oxygen via a nonrebreathing mask. B. insert a nasal airway in case her mental status decreases. C. perform a secondary assessment and then begin treatment. D. assist her breathing with a bag-mask device and 100% oxygen.

A. administer 100% oxygen via a nonrebreathing mask.

A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should: A. administer oxygen, give her 324 mg aspirin, and assess her further. B. obtain a SAMPLE history and contact medical control for advice. C. give her 100% oxygen, attach the AED, and transport immediately. D. give her one nitroglycerin and reassess her systolic blood pressure.

A. administer oxygen, give her 324 mg aspirin, and assess her further.

The process of binding or sticking to a surface is called: A. adsorption. B. absorption. C. suspension. D. digestion.

A. adsorption.

A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should: A. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. B. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside. C. let them know that because of the circumstances of their child's death, they will not be permitted to see him at this time. D. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer.

A. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.

The general adaptation syndrome is characterized by which of the following phases? A. alarm response, reaction and resistance, and recovery B. delayed reaction, alarm response, and physical recovery C. reaction and resistance, euphoria, and physical exhaustion D. immediate reaction, psychological exhaustion, and recovery

A. alarm response, reaction and resistance, and recovery

Submersion injuries in the adolescent age group are MOST commonly associated with: A. alcohol. B. child abuse. C. hyperthermia. D. swimming pools.

A. alcohol.

When decontaminating the back of your ambulance after a call, you should: A. allow surfaces to air dry unless otherwise indicated in the product directions. B. use a bleach and water solution at a 1:2 dilution ratio to thoroughly wipe all surfaces. C. clean all surfaces and patient contact areas with a mixture of alcohol and water. D. spray the contaminated areas and then immediately wipe them dry with a towel.

A. allow surfaces to air dry unless otherwise indicated in the product directions.

In addition to severe bleeding, the MOST life-threatening complication associated with an open neck injury is: A. an air embolism. B. a spinal fracture. C. an ischemic stroke. D. nerve fiber damage.

A. an air embolism.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for: A. an aortic aneurysm. B. acute appendicitis. C. a strangulated bowel. D. myocardial infarction.

A. an aortic aneurysm.

Vector-borne transmission of an infectious organism occurs via: A. animals or insects. B. smoke or dust. C. direct contact. D. inanimate objects.

A. animals or insects.

As an EMT, the performance of your duties will be compared to that of: A. another EMT. B. the general public. C. the medical director. D. a paramedic supervisor.

A. another EMT.

The major artery that supplies all other arteries with blood is the: A. aorta. B. carotid. C. brachial. D. femoral.

A. aorta.

The ___________ of the heart is the inferior portion of the left ventricles. A. apex B. base C. dorsum D. septum

A. apex

The components of the PAT are: A. appearance, work of breathing, and skin circulation. B. mental status, heart rate, and systolic blood pressure. C. skin condition, respiratory rate, and level of alertness. D. activity, respiratory quality, and level of consciousness.

A. appearance, work of breathing, and skin circulation.

You are transporting a 40-year-old male with respiratory distress. The patient tells you that he recently had a positive tuberculosis (TB) skin test and is currently being evaluated for possible TB. You should: A. apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself. B. remain at least 3 feet away from the patient and apply a surgical mask on him. C. apply a sterile surgical mask on yourself and a HEPA respirator on the patient. D. apply a nasal cannula on the patient and a sterile surgical mask on yourself.

A. apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself.

Cardiogenic shock following AMI is caused by: A. decreased pumping force of the heart muscle. B. a profound increase in the patient's heart rate. C. hypovolemia secondary to severe vomiting. D. widespread dilation of the systemic vasculature.

A. decreased pumping force of the heart muscle.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should: A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport. B. assist ventilations with a bag-mask device, immobilize her spine, suction her oropharynx for 30 seconds, and transport. C. fully immobilize her spine, attempt to locate the dislodged teeth, tilt the backboard to the left side, and transport. D. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

A. apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

In moving joints, the ends of the bones are covered with: A. articular cartilage. B. synovial tendons. C. muscular fascia. D. gliding cartilage.

A. articular cartilage.

You are called to the scene of a 56-year-old female patient who was the driver of a car that struck a telephone pole. The patient is sitting in her vehicle with her seat belt on and the air bag has deployed. A bystander approaches as you arrive and informs you that he is an off-duty firefighter and was first on the scene. The bystander wishes to provide you with a patient care report. You should: A. ask your partner to perform the primary survey while you listen to the report. B. ask the bystander to wait and you will take their report after you have finished your assessment. C. listen to the report while you perform a primary survey and render care to the patient. D. ask the bystander for any formal identification and listen to the report once it is verified.

A. ask your partner to perform the primary survey while you listen to the report.

You receive a call to a local gymnasium for a basketball player with a dislocated shoulder. Upon arrival, you find the patient, a 17-year-old male, sitting on the ground. He is holding his left arm in a fixed position away from his body. There is an obvious anterior bulge to the area of injury. You should: A. assess distal pulse, motor, and sensory functions. B. gently attempt to move his arm toward his body. C. place a pillow under his arm and apply a swathe. D. flex his arm at the elbow and then apply a sling.

A. assess distal pulse, motor, and sensory functions.

A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should: A. assess the rate, regularity, and quality of her carotid pulse. B. advise your partner that the patient's blood pressure is low. C. immediately take her blood pressure to see if she is hypotensive. D. conclude that she is perfusing adequately since she is conscious.

A. assess the rate, regularity, and quality of her carotid pulse.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: A. assess the scene for potential hazards. B. determine if you need additional help. C. request a paramedic unit for assistance. D. gain immediate access to the patient.

A. assess the scene for potential hazards.

A 37-year-old male is found unconscious in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of: A. asthma. B. heart disease. C. hypertension. D. allergic reactions.

A. asthma.

Minimum staffing in the patient compartment of a basic life support (BLS) ambulance includes: A. at least one EMT. B. at least two EMTs. C. an EMT and a paramedic. D. an EMT and an AEMT.

A. at least one EMT.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: A. at the feet. B. at the head. C. in the ambulance. D. en route to the hospital.

A. at the feet.

When palpating the carotid pulse of a responsive older patient, you should: A. avoid compressing both carotid arteries simultaneously. B. ensure that his or her head is in a hyperextended position. C. avoid gentle pressure so that weak pulses can be detected. D. firmly compress the artery because the pulse is often weak.

A. avoid compressing both carotid arteries simultaneously.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A. avoid placing him in a supine position if possible and administer oxygen. B. notify the receiving facility and advise them of the patient's weight and status. C. perform a secondary assessment, focusing on his respiratory system and back. D. ask a member of your team to locate the best route to move him to the ambulance.

A. avoid placing him in a supine position if possible and administer oxygen.

An EMT may injure his or her back, even if it is straight, if the: A. back is bent forward at the hips. B. hands are held close to the legs. C. shoulder is aligned over the pelvis. D. force is exerted straight down the spine.

A. back is bent forward at the hips.

An adult patient who is NOT experiencing difficulty breathing will: A. be able to speak in complete sentences without unusual pauses. B. assume a position that will facilitate effective and easy breathing. C. exhibit an indentation above the clavicles and in between the ribs. D. have a respiratory rate that is between 20 and 24 breaths/min.

A. be able to speak in complete sentences without unusual pauses.

When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: A. blood can pass from the atria to the ventricles. B. blood returning from the body can fill the atria. C. the impulse can spread through the Purkinje fibers. D. the SA node can reset and generate another impulse.

A. blood can pass from the atria to the ventricles.

The term "hyphema" is defined as: A. blood in the anterior chamber of the eye. B. an acute rupture of the globe of the eye. C. inflammation of the iris, cornea, and lens. D. compression of one or both optic nerves.

A. blood in the anterior chamber of the eye.

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. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital. B. continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol. 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.

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

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: A. begin CPR and apply the AED. B. begin CPR and transport at once. C. assess for entry and exit wounds. D. fully immobilize his spinal column.

A. begin CPR and apply the AED.

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: A. begin high-quality CPR and apply the AED without delay. B. have your partner perform CPR while you question the bystanders. C. perform two-rescuer CPR for 5 minutes and request ALS backup. D. immediately apply the AED pads and analyze his cardiac rhythm.

A. begin high-quality CPR and apply the AED without delay.

When faced with a situation in which a patient is in cardiac arrest, and a valid living will or DNR order cannot be located, you should: A. begin resuscitation at once. B. contact medical control first. C. determine the patient's illness. D. notify the coroner immediately.

A. begin resuscitation at once.

You respond to the home of a 59-year-old man who is unconscious, has slow, shallow breathing, and has a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient; however, they are unable to locate it. You should: A. begin treatment and contact medical control as needed. B. honor the patient's wishes and withhold all treatment. C. transport the patient without providing any treatment. D. decide on further action once the DNR order is produced.

A. begin treatment and contact medical control as needed.

You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should: A. begin ventilations using the mouth-to-mask technique. B. hyperextend the patient's head and reattempt ventilations. C. continue attempted ventilations and transport immediately. D. suction the patient's airway for 30 seconds and reattempt ventilations.

A. begin ventilations using the mouth-to-mask technique.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. belly button. B. pubic bone. C. xiphoid process. D. superior diaphragm.

A. belly button.

An increase in heart rate and contractility occurs due to stimulation of: A. beta-1 receptors. B. beta-2 receptors. C. alpha-1 receptors. D. alpha-2 receptors.

A. beta-1 receptors.

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should: A. bind his legs together on the backboard, keep him warm, and transport without delay. B. apply traction splints to both of his legs, keep him warm, and transport without delay. C. splint each of his deformed femurs with long board splints and transport immediately. D. apply the PASG to stabilize his femurs and transport at once.

A. bind his legs together on the backboard, keep him warm, and transport without delay.

Carbon monoxide blocks the ability of the blood to oxygenate the body because it: A. binds with the hemoglobin in the red blood cells. B. fills the lungs with secretions. C. causes the body to expel too much carbon dioxide. D. destroys the number of circulating red blood cells.

A. binds with the hemoglobin in the red blood cells.

An epidural hematoma is MOST accurately defined as: A. bleeding between the skull and dura mater. B. bleeding between the dura mater and brain. C. venous lacerations that occur within the brain. D. an injury caused by a damaged cerebral artery.

A. bleeding between the skull and dura mater.

Death caused by shaken baby syndrome is usually the result of: A. bleeding in the brain. B. multiple open fractures. C. intra-abdominal hemorrhage. D. fracture of the cervical spine.

A. bleeding in the brain.

When ventilating a pediatric patient with a bag-mask device, the EMT should: A. block the pop-off valve if needed to achieve adequate chest rise. B. squeeze the bag 40 times/min when ventilating an infant. C. ensure that he or she uses a neonatal device for children younger than 12 months. D. ventilate the child with sharp, quick breaths at the appropriate rate.

A. block the pop-off valve if needed to achieve adequate chest rise.

Which of the following MOST accurately describes the cause of an ischemic stroke? A. blockage of a cerebral artery B. acute atherosclerotic disease C. rupture of a cerebral artery D. narrowing of a carotid artery

A. blockage of a cerebral artery

The process of removing dirt, dust, blood, or other visible contaminants from a surface or equipment is called: A. cleaning. B. disinfection. C. sterilization. D. high-level disinfection.

A. cleaning.

Patients with generalized hypothermia are at an increased risk of a local cold injury because: A. blood is shunted away from the extremities to the body's core. B. peripheral vasodilation brings warm blood to the skin's surface. C. the major muscles of the body become rigid during hypothermia. D. the patient is usually unable to escape the cold ambient temperature.

A. blood is shunted away from the extremities to the body's core.

Which of the following sets of vital signs depicts Cushing's triad? A. blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min B. blood pressure, 90/50 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min C. blood pressure, 200/100 mm Hg; pulse, 140 beats/min; respirations, 28 breaths/min D. blood pressure, 80/40 mm Hg; pulse, 30 beats/min; respirations, 32 breaths/min

A. blood pressure, 190/110 mm Hg; pulse, 55 beats/min; respirations, 30 breaths/min

The musculoskeletal system refers to the: A. bones and voluntary muscles of the body. B. nervous system's control over the muscles. C. connective tissue that supports the skeleton. D. involuntary muscles of the nervous system.

A. bones and voluntary muscles of the body.

The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to: A. bradycardia and a slowing of the metabolic rate. B. laryngospasm that protects the lungs from water. C. tachycardia and a lowering of the blood pressure. D. increases in the metabolic rate and oxygen demand.

A. bradycardia and a slowing of the metabolic rate.

The central nervous system is composed of the: A. brain and spinal cord. B. brain and sensory nerves. C. motor and sensory nerves. D. spinal cord and sensory nerves.

A. brain and spinal cord.

The _________ is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems. A. brain stem B. cerebellum C. spinal cord D. cerebral cortex

A. brain stem

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: A. brain stem. B. cerebrum. C. cerebellum. D. cerebral cortex.

A. brain stem.

Cerebral palsy is a condition that results from damage or injury to the: A. brain. B. spinal cord. C. voluntary muscles. D. peripheral nervous system.

A. brain.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: A. brain. B. kidneys. C. abdomen. D. legs.

A. brain.

The ONLY indications for placing your gloved fingers in the vagina during delivery are: A. breech presentation and prolapsed umbilical cord. B. limb presentation and severe vaginal hemorrhage. C. vertex presentation and delivery of the placenta. D. nuchal cord and presentation of an arm or leg.

A. breech presentation and prolapsed umbilical cord.

Health care teams that infrequently train and work together: A. can create delays in patient care. B. need less-explicit verbal direction. C. often work better under pressure. D. are unable to accomplish their tasks.

A. can create delays in patient care.

When caring for a patient with a possible fracture of the scapula, the EMT should: A. carefully assess the patient for breathing problems. B. apply rigid board splints across the chest and back. C. assume that minimal force was applied to the back. D. recognize that scapular fractures are life threatening.

A. carefully assess the patient for breathing problems.

The spread of HIV and hepatitis in the health care setting can usually be traced to: A. careless handling of sharps. B. a lack of proper immunizations. C. excessive blood splashing or splattering. D. a noncompliance with standard precautions.

A. careless handling of sharps.

Syncope in the older patient is: A. caused by an interruption of blood flow to the brain. B. generally of no concern unless the patient was injured. C. most commonly caused by a silent myocardial infarction. D. rarely life threatening but should be evaluated by a physician.

A. caused by an interruption of blood flow to the brain.

The _________ contain(s) about 75% of the brain's total volume. A. cerebrum B. cerebellum C. brain stem D. meninges

A. cerebrum

The largest portion of the brain, which is commonly referred to as the "gray matter," is called the: A. cerebrum. B. cerebellum. C. brain stem. D. diencephalon.

A. cerebrum.

Children with N meningitides would MOST likely present with: A. cherry-red spots or a purplish rash. B. a low-grade fever and tachycardia. C. hypothermia and an irregular pulse. D. a generalized rash with intense itching.

A. cherry-red spots or a purplish rash.

With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in: A. children who are younger than 6 years of age. B. patients who are significantly hypotensive. C. children who are older than 6 years of age. D. patients with decreased peripheral perfusion.

A. children who are younger than 6 years of age.

Vagal nerve stimulators may be an alternative treatment to medication for patients with: A. chronic seizure disorders. B. inherently slow heart rates. C. certain psychiatric conditions. D. chronic muscle pain and fatigue.

A. chronic seizure disorders.

Geriatric patients are at a higher risk for heatstroke because: A. circulation to the skin is reduced. B. most geriatric patients are obese. C. their ability to sweat is enhanced. D. their ability to shiver is reduced.

A. circulation to the skin is reduced.

Which of the following is a severe burn in a 35-year-old patient? A. circumferential partial-thickness burn to the chest B. full-thickness burn to 5% of the body surface area (BSA) C. partial-thickness burn to 20% of the BSA D. superficial burn covering 50% of the BSA

A. circumferential partial-thickness burn to the chest

What three bones make up the shoulder girdle? A. clavicle, scapula, humerus B. acromion, clavicle, scapula C. acromion, scapula, humerus D. acromion, humerus, clavicle

A. clavicle, scapula, humerus

The MOST commonly fractured bone(s) in the body is the: A. clavicle. B. scapula. C. radius and ulna. D. midshaft femur.

A. clavicle.

You are attending to a 46-year-old male patient complaining of chest pain. Shortly after you begin to render care, an ALS unit arrives and the transfer of care is made. The decision is made to start an intravenous line and administer medication. You should: A. clear space and, if necessary, explain the procedure to the patient. B. move out of the ALS provider's way and clear the scene. C. ensure that enough assessments have been done to justify the decision. D. acknowledge that it is no longer your patient and stand back, allowing the ALS provider to work.

A. clear space and, if necessary, explain the procedure to the patient.

A 39-year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: A. close her eyes and cover them with a moist dressing. B. secure her eyes open so you can reassess her pupils. C. inspect her eyes and gently remove impaled objects. D. irrigate her eyes with water to prevent mucosal drying.

A. close her eyes and cover them with a moist dressing.

The germinal layer of the epidermis contains pigment granules that are responsible for skin: A. color. B. texture. C. moisture. D. temperature.

A. color.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): A. colostomy. B. gastrostomy. C. gastric stoma. D. intestinal shunt.

A. colostomy.

A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition? A. compression of the head against the roof B. lateral bending of the neck during the crash C. impact of the head against the steering wheel D. whiplash injury to the neck during the rollover

A. compression of the head against the roof

You are treating a middle-aged man with chest discomfort. He has a history of three previous heart attacks and takes nitroglycerin as needed for chest pain. You have standing orders to administer aspirin to patients with suspected cardiac-related chest pain or discomfort. While your partner is preparing to give oxygen to the patient, you should: A. confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given. B. contact medical control, apprise him or her of the patient's chief complaint and vital signs, and request permission to give him aspirin. C. ensure that the patient's systolic blood pressure is at least 100 mm Hg since aspirin dilates the blood vessels and can cause a drop in blood pressure. D. assist the patient in taking one of his prescribed nitroglycerin, assess his vital signs, and give him aspirin if he is still experiencing chest discomfort.

A. confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given.

The connecting nerve, a nerve of the peripheral nervous system, functions by: A. connecting the sensory and motor nerves and bypassing the brain. B. connecting motor nerves directly to the walls of the blood vessels. C. connecting sensory nerves directly to the posterior cerebral cortex. D. connecting the spinal cord directly to the target muscle or organ.

A. connecting the sensory and motor nerves and bypassing the brain.

Common signs and symptoms of a serious head injury include all of the following, EXCEPT: A. constricted pupils. B. combative behavior. C. CSF leakage from the ears. D. decreased sensory function.

A. constricted pupils.

A construction worker fell approximately 30′ and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10″ steel rod impaled in his left leg. You should: A. control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately. B. remove the steel rod, control the bleeding, apply an automated external defibrillator (AED), begin CPR, and transport to a trauma center. C. stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center. D. control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.

A. control the bleeding, begin cardiopulmonary resuscitation (CPR), stabilize the steel rod, immobilize his spine, and transport immediately.

To select the proper size oropharyngeal airway, you should measure from the: A. corner of the mouth to the earlobe. B. center of the mouth to the posterior ear. C. corner of the mouth to the superior ear. D. angle of the jaw to the center of the mouth.

A. corner of the mouth to the earlobe.

Patients with tuberculosis pose the greatest risk for transmitting the disease when they: A. cough. B. vomit. C. are bleeding. D. have a fever.

A. cough.

The __________ cartilage is a firm ring that forms the inferior part of the larynx. A. cricoid B. thyroid C. laryngeal D. pyriform

A. cricoid

You are assessing a woman who was thrown from her horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should: A. crouch down in a position so that only your feet are touching the ground. B. sit down, bend your knees, and hold your crossed arms close to your body. C. quickly cover the patient with a blanket and then lie down flat on the ground. D. immediately lie down on your side and draw your knees into your abdomen.

A. crouch down in a position so that only your feet are touching the ground.

A viral infection that may cause obstruction of the upper airway in a child is called: A. croup. B. asthma. C. bronchitis. D. epiglottitis.

A. croup.

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: A. cyanosis. B. tachypnea. C. retractions. D. abnormal airway noise.

A. cyanosis.

Which of the following conditions is more common in women than in men? A. cystitis B. hepatitis C. pancreatitis D. cholecystitis

A. cystitis

You should be MOST suspicious that a patient has experienced a significant head injury if his or her pulse is: A. slow. B. weak. C. rapid. D. irregular.

A. slow.

The effectiveness of pit crew CPR is dependent on: A. defining clear roles and responsibilities before the call is received. B. protocols that allow the EMT to function without medical control. C. a team leader who is capable of performing all of the patient care tasks. D. rapidly assessing the patient before assigning roles and responsibilities.

A. defining clear roles and responsibilities before the call is received.

You are caring for a 35-year-old female with pregnancy-related complications. She is clearly experiencing significant stress and is crying uncontrollably. Your MOST appropriate action would be to: A. demonstrate courtesy and speak with a professional tone of voice. B. discourage her from expressing fears until a counselor is available. C. explain to her that "everything will be all right" in order to calm her down. D. restrain her if she is extremely emotional and will not calm down.

A. demonstrate courtesy and speak with a professional tone of voice.

Burns are classified according to: A. depth and extent. B. location and pain. C. degree and location. D. extent and location.

A. depth and extent.

Which of the following skin layers contains sweat and oil glands, hair follicles, blood vessels, and nerve endings? A. dermis B. epidermis C. sebaceous D. subcutaneous

A. dermis

When assessing a conscious patient with an MOI that suggests spinal injury, you should: A. determine if the strength in all extremities is equal. B. rule out a spinal injury if the patient denies neck pain. C. defer spinal immobilization if the patient is ambulatory. D. ask the patient to move his or her head to assess for pain.

A. determine if the strength in all extremities is equal.

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to: A. determine the onset of the patient's symptoms. B. ascertain about a history of atrial fibrillation. C. administer 324 mg of aspirin as soon as possible. D. determine if the patient has risk factors for a stroke.

A. determine the onset of the patient's symptoms.

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should: A. determine the patient's baseline mental status. B. inquire about a history of Alzheimer disease. C. obtain a complete list of the patient's medications. D. ask an attendant for the patient's medical records.

A. determine the patient's baseline mental status.

Nitroglycerin relieves cardiac-related chest pain by: A. dilating the coronary arteries and improving cardiac blood flow. B. increasing the amount of work that is placed on the myocardium. C. contracting the smooth muscle of the coronary and cerebral arteries. D. constricting the coronary arteries and improving cardiac blood flow.

A. dilating the coronary arteries and improving cardiac blood flow.

External bleeding from an extremity can usually be controlled by a combination of: A. direct pressure and elevation. B. direct pressure and a tourniquet. C. elevation and chemical ice packs. D. elevation and pressure point control.

A. direct pressure and elevation.

Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should: A. direct your partner to apply manual in-line support of the patient's head. B. apply a cervical collar and quickly remove the patient with a clothes drag. C. apply a vest-style extrication device before attempting to move the patient. D. slide a long backboard under his buttocks and lay him sideways on the board.

A. direct your partner to apply manual in-line support of the patient's head.

A fracture of the humerus just above the elbow would be described as a: A. distal humerus fracture. B. proximal elbow fracture. C. distal forearm fracture. D. proximal humerus fracture.

A. distal humerus fracture.

Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT: A. distrust of the EMT. B. mental disorders. C. history of chronic disease. D. fear of medical personnel.

A. distrust of the EMT.

When a driver is in a car equipped with an air bag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact. A. door B. dashboard C. windshield D. steering wheel

A. door

Esophageal varices MOST commonly occur in patients who: A. drink a lot of alcohol. B. have severe diabetes. C. have a history of esophagitis. D. have weak immune systems.

A. drink a lot of alcohol.

Where would you MOST likely find information regarding a patient's wishes to be an organ donor? A. driver's license B. insurance card C. Social Security card D. voter registration card

A. driver's license

During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: A. during the tertiary phase. B. during the secondary phase. C. during the primary phase. D. as a direct result of the pressure wave.

A. during the tertiary phase.

Breathing is often more labor intensive in older adults because the: A. elasticity of the lungs decreases. B. surface area of the alveoli increases. C. overall size of the airway decreases. D. diaphragm and intercostal muscles enlarge.

A. elasticity of the lungs decreases.

Phases of an ambulance call include all of the following activities, EXCEPT: A. emergency care provided at the scene. B. transport of the patient to the hospital. C. checking equipment on the ambulance. D. transferring the patient to the ambulance.

A. emergency care provided at the scene.

You are attending to a 66-year-old male patient in cardiac arrest. As you gather history and begin the resuscitation, an Advanced Life Support (ALS) provider arrives on scene. You should: A. ensure that CPR is ongoing by the other providers present and then provide a patient care report off to the side. B. stay focused on the resuscitation and allow the ALS provider to make his or her own assessment. C. pause the resuscitation and provide a patient care report as quickly as possible. D. continue the resuscitation and provide a patient care report while you work.

A. ensure that CPR is ongoing by the other providers present and then provide a patient care report off to the side.

The compliance monitoring component of an infection control plan should: A. ensure that employees understand what they should do and why it is important. B. identify who to notify after an exposure and where treatment should be provided. C. consist of a list of tasks that pose a risk for contact with blood or other body fluids. D. address issues such as medical waste collection, storage, and ambulance disinfection.

A. ensure that employees understand what they should do and why it is important.

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 9- 1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should: A. ensure that he is aware of the risks of refusing medical care. B. err in the best interest of the patient and transport him at once. C. have him sign a refusal of care form and then return to service. D. tell him that he is having a heart attack and needs medical care.

A. ensure that he is aware of the risks of refusing medical care.

After a baby is born, it is important to: A. ensure that it is thoroughly dried and warmed. B. position it so that its head is higher than its body. C. cool the infant to stimulate effective breathing. D. immediately clamp and cut the umbilical cord.

A. ensure that it is thoroughly dried and warmed.

The rescue team is in the process of extricating a 40-year-old male from his truck. The patient's wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should: A. ensure that she is in a safe area, away from the scene. B. allow her to observe the extrication and keep her calm. C. ask her follow-up questions about the crash. D. allow her to talk to her husband during the extrication.

A. ensure that she is in a safe area, away from the scene.

The purpose of the pin-indexing system that has been established for compressed gas cylinders is to: A. ensure that the correct regulator is used for the cylinder. B. help you determine what type of oxygen regulator to use. C. prevent destroying or stripping the threads on the cylinder. D. reduce the cylinder pressure to a safe and more useful range.

A. ensure that the correct regulator is used for the cylinder.

The leaf-shaped structure located superior to the larynx is called the: A. epiglottis. B. vallecula. C. cricoid ring. D. thyroid cartilage.

A. epiglottis.

A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is: A. epilepsy. B. a brain tumor. C. a serious infection. D. intracranial bleeding.

A. epilepsy.

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called: A. external respiration. B. cellular metabolism. C. pulmonary ventilation. D. alveolar ventilation.

A. external respiration.

The MOST common error associated with the use of the AED is: A. failure of the EMT to ensure the battery is charged. B. malfunction of the AED's internal computer processor. C. inappropriately placed adhesive defibrillation electrodes. D. inability of the EMT to recognize ventricular fibrillation.

A. failure of the EMT to ensure the battery is charged.

It would be MOST appropriate to perform a focused secondary assessment on a patient who: A. fainted and fell to the ground from a standing position. B. was restrained during a high-speed motor vehicle crash. C. has blood draining from the ears following a head injury. D. struck his or her head and is experiencing nausea or vomiting.

A. fainted and fell to the ground from a standing position.

Which of the following is the MOST common mechanism of injury in older patients? A. falls B. burns C. abuse D. suicide

A. falls

Two of the MOST common mechanisms of injury for blunt trauma are: A. falls and motor vehicle collisions. B. low-caliber gunshot wounds and falls. C. gunshot wounds and vehicle ejections. D. motor vehicle collisions and stabbings.

A. falls and motor vehicle collisions.

The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT: A. family history of hepatitis. B. postvaccine antibody titers. C. vaccine safety and efficacy. D. record keeping and tracking.

A. family history of hepatitis.

Which of the following are central pulses? A. femoral and carotid B. brachial and radial C. temporal and pedal D. popliteal and ulnar

A. femoral and carotid

The iliac arteries immediately subdivide into the: A. femoral arteries. B. peroneal arteries. C. anterior tibial arteries. D. posterior tibial arteries.

A. femoral arteries.

Typical chief complaints in patients with an infectious disease include: A. fever, rash, nausea, and difficulty breathing. B. crushing chest pain, vomiting, and weakness. C. headache, low back pain, and arm numbness. D. joint pain, muscle aches, and blurred vision.

A. fever, rash, nausea, and difficulty breathing.

A patient with high blood pressure would be expected to have skin that is: A. flushed and red. B. mottled and cool. C. pale and moist. D. cyanotic and dry.

A. flushed and red.

When performing a secondary assessment on a conscious patient with nontraumatic abdominal pain and stable vital signs, you should: A. focus on his or her chief complaint. B. examine him or her from head to toe. C. prepare the patient for transport first. D. only palpate tender areas of the abdomen.

A. focus on his or her chief complaint.

The spinal cord exits the cranium through the: A. foramen magnum. B. vertebral foramen. C. foramen lamina. D. cauda equina.

A. foramen magnum.

What medication form does oral glucose come in? A. gel B. liquid C. suspension D. fine powder

A. gel

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: A. grunting. B. wheezing. C. assuming a tripod position. D. retracting the intercostal muscles.

A. grunting.

In contrast to a full-term infant, a premature infant: A. has an even proportionately larger head. B. is often covered with excess vernix material. C. is one who is born before 38 weeks' gestation. D. retains heat better because of excess body hair.

A. has an even proportionately larger head.

The skin and underlying tissues of the face: A. have a rich blood supply and bleed profusely. B. swell minimally when exposed to blunt trauma. C. are well protected by the maxillae and mandible. D. contain a relatively small number of nerve fibers.

A. have a rich blood supply and bleed profusely.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: A. have chronic hypertension. B. regularly take illegal drugs. C. have had a stroke in the past. D. are older than 40 years of age.

A. have chronic hypertension.

Patients with autism: A. have extreme difficulty with complex tasks that require many steps. B. prefer to maintain eye contact with whomever is talking with them. C. often speak with speech patterns that alternate in tone and speed. D. use and understand nonverbal means of communicating messages.

A. have extreme difficulty with complex tasks that require many steps.

When a child experiences a blunt injury to the abdomen: A. he or she can compensate for blood loss better than adults. B. his or her blood pressure falls with as little as 5% blood loss. C. your assessment will most often reveal bruising to the abdomen. D. delayed capillary refill indicates a state of decompensated shock.

A. he or she can compensate for blood loss better than adults.

Covering a patient's _________ will significantly minimize radiation heat loss. A. head B. chest C. abdomen D. extremities

A. head

When placing a patient onto a long backboard, the EMT at the patient's _________ is in charge of all patient movements. A. head B. chest C. waist D. lower extremities

A. head

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience? A. head injury B. cardiac contusion C. pulmonary contusion D. multiple rib fractures

A. head injury

Signs and symptoms of preeclampsia include: A. headache and edema. B. marked hypoglycemia. C. dyspnea and bradycardia. D. dysuria and constipation.

A. headache and edema.

The cervical spine is MOST protected from whiplash-type injuries when the: A. headrest is appropriately positioned. B. air bag correctly deploys upon impact. C. patient tenses up at the time of impact. D. rear end of the vehicle is initially struck.

A. headrest is appropriately positioned.

A by-product of involuntary muscle contraction and relaxation is: A. heat. B. oxygen. C. nitrogen. D. lactic acid.

A. heat.

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.

The elbow is an example of a ____________ joint. A. hinge B. saddle C. gliding D. ball-and-socket

A. hinge

You suspect that a 75-year-old man has internal injuries after he fell and struck his ribs and abdomen on the corner of a table. When assessing and treating an injured patient of this age, you must recall that: A. his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output. B. it is not uncommon to observe heart rates in excess of 150 beats/min in elderly patients with internal injuries. C. blood pressure is usually adequately maintained because the blood vessels of older people can contract easily. D. functional blood volume in patients of this age steadily increases due to increased production of red blood cells.

A. his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output.

What part of the patient assessment process focuses on obtaining additional information about the patient's chief complaint and any medical problems he or she may have? A. history taking B. general impression C. primary assessment D. secondary assessment

A. history taking

When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of his or her problem? A. history taking B. rapid body scan C. baseline vital signs D. primary assessment

A. history taking

Major risk factors for AMI include all of the following, EXCEPT: A. hypoglycemia. B. hypertension. C. diabetes mellitus. D. elevated cholesterol.

A. hypoglycemia.

The medical term for an extremely low blood glucose level is: A. hypoglycemia. B. hyperglycemia. C. hypotension. D. hypertension.

A. hypoglycemia.

The backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called the: A. hypoxic drive. B. pneumotaxic drive. C. hypocarbic drive. D. oxyhemoglobin drive.

A. hypoxic drive.

The effectiveness of positive-pressure ventilations when treating a head-injured patient can ONLY be determined by: A. immediate reassessment following the intervention. B. a neurosurgeon or emergency department physician. C. reassessing the patient's blood pressure after at least 10 minutes. D. noting a decrease in the heart rate during ventilations.

A. immediate reassessment following the intervention.

Functions of dressings and bandages include all of the following, EXCEPT: A. immobilization of the injury. B. prevention of contamination. C. protection from further injury. D. control of external hemorrhage.

A. immobilization of the injury.

A hiker was injured when he fell approximately 20′ from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The MOST appropriate method of immobilizing and moving the patient to the ambulance is to: A. immobilize his spine with a long backboard and place him in a basket stretcher. B. immobilize him to a long backboard and use the four-person carry to move him. C. apply a vest-style immobilization device and move him using a stair chair device. D. immobilize him with a short backboard and place him on the ambulance stretcher.

A. immobilize his spine with a long backboard and place him in a basket stretcher.

Which of the following would cause the greatest increase in cardiac output? A. increased heart rate and increased stroke volume B. decreased stroke volume and increased heart rate C. decreased heart rate and increased stroke volume D. decreased stroke volume and decreased heart rate

A. increased heart rate and increased stroke volume

Shivering is a mechanism in which the body generates heat by: A. increasing the metabolic rate. B. decreasing the use of oxygen. C. decreasing the metabolic rate. D. retaining excess carbon dioxide.

A. increasing the metabolic rate.

In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is: A. infection. B. hypothermia. C. nerve damage. D. vessel damage.

A. infection.

The diaphragm and intercostal muscles contract during: A. inhalation. B. exhalation. C. respiration. D. ventilation.

A. inhalation.

What is the function of platelets? A. initial formation of a blood clot B. transport of oxygen and nutrients C. defense against invading organisms D. transport of cellular waste materials

A. initial formation of a blood clot

The dorsal respiratory group (DRG) is a part of the brain stem and is responsible for: A. initiating inspiration. B. inhibiting deep inspiration. C. controlling expiration. D. decreasing respiratory depth.

A. initiating inspiration.

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the: A. intercostal muscles are not well developed. B. rib cage is rigid and provides little flexibility. C. abdominal organs force the diaphragm upward. D. upper airway is smaller and easily collapsible.

A. intercostal muscles are not well developed.

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer: A. into the patient's rectum. B. under the patient's tongue. C. behind the patient's knee. D. under the patient's armpit.

A. into the patient's rectum.

A mucosal atomizer device (MAD) is used to deliver certain medications via the: A. intranasal route. B. inhalation route. C. sublingual route. D. transdermal route.

A. intranasal route.

Which of the following medication routes would be the MOST appropriate to use in an unconscious patient when intravenous access cannot be obtained? A. intraosseous (IO) B. intramuscular C. subcutaneous D. transcutaneous

A. intraosseous (IO)

In contrast to simple access, complex access: A. involves forcible entry into a vehicle. B. is a skill commonly taught to EMTs. C. does not involve the breaking of glass. D. often involves simply unlocking a door.

A. involves forcible entry into a vehicle.

A 22-year-old male was walking on the beach and had sand blown into his eyes. He complains of pain and decreased vision to his right eye. Treatment should include: A. irrigating his right eye laterally. B. flushing his eye starting laterally. C. irrigating both eyes simultaneously. D. covering both eyes and transporting.

A. irrigating his right eye laterally.

A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes: A. irrigating the wound with vinegar and immersing his leg in hot water. B. pulling the nematocysts out with tweezers and bandaging the wound. C. immersing his leg in fresh cold water and scraping away the stingers. D. applying a chemical ice pack to the wound and encouraging movement.

A. irrigating the wound with vinegar and immersing his leg in hot water.

The scene size-up at a motor vehicle crash or other incident: A. is an ongoing process until the incident is terminated. B. should be performed by the most experienced EMT. C. is a quick visual assessment of the scene prior to entry. D. determines who is allowed to safely enter the hot zone.

A. is an ongoing process until the incident is terminated.

In contrast to viral hepatitis, toxin-induced hepatitis: A. is not a communicable disease. B. typically does not cause yellow skin. C. is a far more transmittable disease. D. can be prevented with a vaccination.

A. is not a communicable disease.

In contrast to delirium, dementia: A. is usually considered irreversible. B. is the result of an acute condition. C. is reversible with certain treatment. D. often develops over a period of days.

A. is usually considered irreversible.

A tight-fitting motorcycle helmet should be left in place unless: A. it interferes with your assessment of the airway. B. the patient must be placed onto a long backboard. C. the patient complains of severe neck or back pain. D. the helmet is equipped with a full face shield or visor.

A. it interferes with your assessment of the airway.

If an action or procedure that was performed on a patient is not recorded on the written report: A. it was not performed in the eyes of the law. B. it can be qualified by the EMT in charge. C. it cannot be used in establishing negligence. D. it was performed haphazardly by the EMT.

A. it was not performed in the eyes of the law.

A critical aspect of the rapid extrication technique is to: A. maintain stabilization of the spine at all times. B. move the patient as quickly as you possibly can. C. extricate the patient with one coordinated move. D. apply a vest-style device before moving the patient.

A. maintain stabilization of the spine at all times.

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should: A. keep him warm and provide ventilatory assistance. B. begin chest compressions and reassess in 30 seconds. C. clamp and cut the umbilical cord and keep him warm. D. assess his skin color and give free-flow oxygen as needed.

A. keep him warm and provide ventilatory assistance.

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, EXCEPT: A. keeping bystanders at a safe distance. B. assigning all patients a triage category. C. preparing all patients for transportation. D. continual assessment of critical patients.

A. keeping bystanders at a safe distance.

Which of the following organs is NOT part of the digestive system? A. kidney B. pancreas C. stomach D. gallbladder

A. kidney

When using a body drag to pull a patient who is on the ground, you should: A. kneel to minimize the distance that you will have to lean over. B. extend your elbows as far beyond your anterior torso as possible. C. bend your back laterally to maximize your amount of pulling power. D. avoid situations involving strenuous effort lasting more than 5 minutes.

A. kneel to minimize the distance that you will have to lean over.

The stooped posture of some older people, which gives them a humpback appearance, is called: A. kyphosis. B. arthritis. C. scoliosis. D. miosis.

A. kyphosis.

The vocal cords are located in the: A. larynx. B. pharynx. C. oropharynx. D. nasopharynx

A. larynx.

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes: A. leaning him forward and pinching his nostrils together. B. packing the nasopharynx with moist, sterile dressings. C. applying a gauze pad in between his lower lip and gum. D. placing him supine and pinching his nostrils together.

A. leaning him forward and pinching his nostrils together.

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying high-flow oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should: A. leave him in a sitting position, keep him warm, and prepare for immediate transport. B. place him in a supine position, elevate his lower extremities, and transport at once. C. treat for shock and request a paramedic unit to respond to the scene and assist you. D. perform a detailed secondary assessment and then transport him to a dialysis center.

A. leave him in a sitting position, keep him warm, and prepare for immediate transport.

Most patients with abdominal pain prefer to: A. lie on their side with their knees drawn into the abdomen. B. sit in a semi-Fowler position with their knees slightly bent. C. lie in a supine position with their knees in a flexed position. D. sit fully upright because it helps relax the abdominal muscles.

A. lie on their side with their knees drawn into the abdomen.

The proper technique for using the power grip is to: A. lift with your palms up. B. rotate your palms down. C. hold the handle with your fingers. D. position your hands about 6″ apart.

A. lift with your palms up.

When caring for a patient with an altered mental status and signs of circulatory compromise, you should: A. limit your time at the scene to 10 minutes or less, if possible. B. perform a detailed secondary assessment prior to transporting the patient. C. transport immediately and begin all emergency treatment en route to the hospital. D. have a paramedic unit respond to the scene if it is less than 15 minutes away.

A. limit your time at the scene to 10 minutes or less, if possible.

Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs? A. linear B. basilar C. open D. compressed

A. linear

All of the following body structures are lined with mucous membranes, EXCEPT for the: A. lips. B. nose. C. anus. D. mouth.

A. lips.

The __________ fills the entire anteroposterior depth of the right upper quadrant (RUQ) of the abdomen. A. liver B. spleen C. pancreas D. stomach

A. liver

Which of the following organs would MOST likely bleed profusely if injured? A. liver B. stomach C. appendix D. gallbladder

A. liver

Which of the following is an early sign of pit viper envenomation? A. local swelling and ecchymosis B. general weakness and diaphoresis C. syncope and bleeding at distal sites D. signs and symptoms of hypoperfusion

A. local swelling and ecchymosis

Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury? A. long backboard B. scoop stretcher C. portable stretcher D. wheeled stretcher

A. long backboard

You are dispatched to the scene of a crash involving a large tanker truck. While you are en route, dispatch advises you that there are multiple patients and that the fire department is en route as well. As you approach the scene, you should: A. maintain a safe distance and try to read the placard with binoculars. B. cordon off the area and quickly remove all of the injured patients. C. immediately begin evacuating residents that live near the crash site. D. don PPE and quickly triage all patients.

A. maintain a safe distance and try to read the placard with binoculars.

A 50-year-old female is entrapped in her passenger car after it struck a tree. As the rescue team is preparing to extricate her, you quickly assess her and determine that she is breathing shallowly and that her radial pulse is absent. You should: A. maintain spinal stabilization as she is extricated. B. secure her with a short backboard or vest device. C. stabilize her condition before extrication begins. D. begin CPR as the rescue team begins extrication.

A. maintain spinal stabilization as she is extricated.

As you assess the head of a patient with a suspected spinal injury, your partner should: A. maintain stabilization of the head. B. look in the ears for gross bleeding. C. prepare the immobilization equipment. D. assess the rest of the body for bleeding.

A. maintain stabilization of the head.

End-tidal carbon dioxide (ETCO2) is defined as the: A. maximal concentration of CO2 at the end of an exhaled breath. B. maximum amount of CO2 that remains in the lungs at all times. C. total amount of CO2 that remains in the lungs between breaths. D. amount of CO2 that a person breathes in during a single inhalation.

A. maximal concentration of CO2 at the end of an exhaled breath.

As an EMT, it is important to remember that the signs and symptoms of cumulative stress: A. may not be obvious or present all the time. B. usually manifest suddenly and without warning. C. cannot be identified and can cause health problems. D. are most effectively treated with medications.

A. may not be obvious or present all the time.

The EMT's scope of practice within his or her local response area is defined by the: A. medical director. B. state EMS office. C. EMS supervisor. D. local health district.

A. medical director.

The nose, chin, umbilicus (navel), and spine are examples of ___________ anatomic structures. A. midline B. proximal C. superior D. midaxillary

A. midline

If an average-sized patient's chest barely moves during inhalation, even if his or her respiratory rate is normal, you should suspect that: A. minute volume is decreased. B. inspiratory reserve is increased. C. overall tidal volume is increased. D. expiratory reserve volume is decreased.

A. minute volume is decreased.

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should: A. move him as a unit to a supine position. B. begin ventilations with a barrier device. C. immediately secure him to a longboard. D. perform a jaw-thrust maneuver to open his airway.

A. move him as a unit to a supine position.

Which of the following organs or tissues can survive the longest without oxygen? A. muscle B. heart C. liver D. kidneys

A. muscle

An acute myocardial infarction (AMI) occurs when: A. myocardial tissue dies secondary to an absence of oxygen. B. the heart muscle progressively weakens and dysfunctions. C. coronary artery dilation decreases blood flow to the heart. D. the entire left ventricle is damaged and cannot pump blood.

A. myocardial tissue dies secondary to an absence of oxygen.

Which of the following medications would the EMT LEAST likely administer to a patient with a medical complaint? A. naloxone (Narcan) B. aspirin C. albuterol D. oral glucose

A. naloxone (Narcan)

The first month of life after birth is referred to as the: A. neonatal period. B. toddler period. C. start of infancy. D. premature phase.

A. neonatal period.

The MOST common and significant complication associated with fractures or dislocations of the knee is: A. neurovascular compromise. B. internal bleeding and shock. C. ligament and cartilage damage. D. total depletion of synovial fluid.

A. neurovascular compromise.

When approaching a helicopter, whether the rotor blades are moving or not, you should: A. never duck under the body or the tail boom because the pilot cannot see you in these areas. B. remember that the main rotor blade is flexible and can dip as low as 5′ to 6′ from the ground. C. carefully approach the aircraft from the rear unless a crew member instructs you to do otherwise. D. approach the aircraft from the side because this will make it easier for you to access the aircraft doors.

A. never duck under the body or the tail boom because the pilot cannot see you in these areas.

Of the following musculoskeletal injuries, which is considered to be the LEAST severe? A. nondisplaced pelvic fracture B. open fractures of a long bone C. an amputation of an extremity D. multiple closed long bone fractures

A. nondisplaced pelvic fracture

Facial injuries should be identified and treated as soon as possible because: A. of the risk for airway problems. B. bleeding must be controlled early. C. the spine may be injured as well. D. swelling may mask hidden injuries.

A. of the risk for airway problems.

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: A. older than 8 to 10 years. B. complaining of severe back pain. C. immobilized on a long backboard. D. experiencing cardiopulmonary arrest.

A. older than 8 to 10 years.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: A. open his airway and assess his breathing status. B. perform an immediate head-to-toe assessment. C. assess his pulse for rate, regularity, and quality. D. apply high-flow oxygen and assess his injuries.

A. open his airway and assess his breathing status.

Which of the following medication routes has the slowest rate of absorption? A. oral B. rectal C. inhalation D. sublingual

A. oral

The ___________ is made up of the maxilla and zygoma, as well as the frontal bone of the cranium. A. orbit B. occiput C. mastoid D. sphenoid

A. orbit

Fractures of the pelvis in older patients often occur as the result of a combination of: A. osteoporosis and low-energy trauma. B. increased bone density and car crashes. C. arthritic joints and high-energy trauma. D. acetabular separation and severe falls.

A. osteoporosis and low-energy trauma.

When assessing an elderly patient who fell, it is important to remember that: A. osteoporosis can cause a fracture that may have resulted in the fall. B. any fall in the elderly is considered to be high-energy trauma. C. elderly patients who fall usually have a secondary head injury. D. bilateral hip fractures usually occur when an elderly person falls.

A. osteoporosis can cause a fracture that may have resulted in the fall.

The greatest danger in displaying a personal bias or "labeling" a patient who frequently calls EMS is: A. overlooking a potentially serious medical condition. B. making the entire EMS system look unprofessional. C. demeaning or humiliating the patient and his family. D. discouraging the patient from calling EMS in the future.

A. overlooking a potentially serious medical condition.

You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include: A. oxygen via a nonrebreathing mask, left lateral recumbent position, and transport. B. assisted ventilation with a bag-mask device, right lateral recumbent position, and transport. C. an oral airway, assisted ventilation with a bag-mask device, Fowler's position, and transport. D. oxygen via a nonrebreathing mask, supine position with legs elevated 6″ to 12″, and transport.

A. oxygen via a nonrebreathing mask, left lateral recumbent position, and transport.

When assessing a patient with abdominal pain, you should: A. palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

A. palpate the abdomen in a clockwise direction beginning with the quadrant after the one the patient indicates is painful.

Abnormalities in metabolism are MOST likely caused by dysfunction of the: A. pancreas. B. thyroid gland. C. adrenal gland. D. parathyroid gland.

A. pancreas.

An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n): A. pathologic fracture. B. idiopathic fracture. C. compression fracture. D. comminuted fracture.

A. pathologic fracture.

In ___________ administration, you are administering medication to yourself or your partner. A. peer-assisted B. patient-assisted C. EMT-administered D. paramedic-administered

A. peer-assisted

You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, is in obvious respiratory distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate livesaving treatment, you should: A. perform a rapid scan of her entire body and prepare for immediate transport. B. assess her vital signs, secure her to a backboard, and transport her immediately. C. fully immobilize her spine, load her into the ambulance, and assess her vital signs. D. identify the specific areas of her injuries and focus your assessment on those areas.

A. perform a rapid scan of her entire body and prepare for immediate transport.

A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: A. perform abdominal thrusts. B. visualize the child's airway. C. perform a blind finger sweep. D. give oxygen and transport at once.

A. perform abdominal thrusts.

The MOST common and significant complication associated with an acute abdomen is: A. peritonitis. B. high fever. C. severe pain. D. internal bleeding.

A. peritonitis.

An absence seizure is also referred to as a: A. petit mal seizure. B. grand mal seizure. C. total body seizure. D. generalized motor seizure.

A. petit mal seizure.

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse. A. physical B. financial C. emotional D. psychological

A. physical

Normal skin color, temperature, and condition should be: A. pink, warm, and dry. B. pale, cool, and moist. C. pink, warm, and moist. D. flushed, cool, and dry.

A. pink, warm, and dry.

When transporting a patient who is secured to a backboard, it is important to: A. place deceleration straps over the patient's shoulders. B. routinely elevate the head of the backboard 12″. C. use at least eight straps to secure the patient to the board. D. place a folded towel or blanket under his or her head.

A. place deceleration straps over the patient's shoulders.

A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should: A. place her in a left lateral recumbent position. B. position her supine and elevate her legs 12″. C. carefully place sterile gauze into her vagina. D. assist her ventilations with a bag-mask device.

A. place her in a left lateral recumbent position.

When administering oxygen to a frightened child, it would be MOST appropriate to: A. place oxygen tubing through a hole in a paper cup. B. tightly secure the oxygen mask straps to the face. C. have a parent restrain the child as you give oxygen. D. use a nasal cannula instead of a nonrebreathing mask.

A. place oxygen tubing through a hole in a paper cup.

Which of the following are noticeable characteristics of a 9-month-old infant? A. places objects in the mouth, pulls himself or herself up B. knows his or her name, can walk without any assistance C. responds to his or her name, crawls around efficiently D. walks without help, becomes frustrated with restrictions

A. places objects in the mouth, pulls himself or herself up

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: A. placing the mother supine with her head down and pelvis elevated. B. gently pulling on the infant's leg in an attempt to facilitate delivery. C. placing the mother in a recumbent position and rapidly transporting. D. carefully attempting to push the infant's leg off of the umbilical cord.

A. placing the mother supine with her head down and pelvis elevated.

The primary purpose for splinting a musculoskeletal injury is to: A. prevent further injury. B. maximize distal circulation. C. make the patient comfortable. D. facilitate ambulance transport.

A. prevent further injury.

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are: A. proportionately larger and situated more anteriorly. B. more vascular despite the fact that they are proportionately smaller. C. spaced further apart, which causes them to shift following trauma. D. lower in the abdominal cavity, where the muscles are not as strong.

A. proportionately larger and situated more anteriorly.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: A. protect her airway from aspiration. B. keep her supine and elevate her legs. C. rapidly transport her to the hospital. D. give her high-flow supplemental oxygen.

A. protect her airway from aspiration.

An important aspect in the treatment of a patient with severe abdominal pain is to: A. provide emotional support en route to the hospital. B. administer analgesic medications to alleviate pain. C. encourage the patient to remain in a supine position. D. give 100% oxygen only if signs of shock are present.

A. provide emotional support en route to the hospital.

You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert, but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should: A. provide treatment up to your level of training and transport the child at once. B. recognize that you cannot begin treatment without expressed parental consent. C. transport the child to the closest hospital and let them provide any treatment. D. administer oxygen only until you receive parental consent for further treatment.

A. provide treatment up to your level of training and transport the child at once.

An infant or small toddler would MOST likely gain trust in an individual who: A. provides an organized, routine environment. B. maintains eye contact, even if the person is a stranger. C. frequently changes the infant or toddler's regular routine. D. does not tower over him or her and avoids painful procedures.

A. provides an organized, routine environment.

The left side of the heart receives oxygenated blood from the lungs through the: A. pulmonary veins. B. pulmonary arteries. C. inferior venae cavae. D. superior venae cavae.

A. pulmonary veins.

The opening in the center of the iris, which allows light to move to the back of the eye, is called the: A. pupil. B. sclera. C. cornea. D. conjunctiva.

A. pupil.

When activated, the sympathetic nervous system produces all of the following effects, EXCEPT: A. pupillary constriction. B. increase in heart rate. C. shunting of blood to vital organs. D. dilation of the bronchiole smooth muscle.

A. pupillary constriction.

In responsive patients that are older than 1 year of age, you should palpate the pulse at the ________ artery. A. radial B. carotid C. brachial D. femoral

A. radial

Pain that moves from its point of origin to another body location is said to be: A. radiating. B. referred. C. palliating. D. provoking.

A. radiating.

High air temperature reduces the body's ability to lose heat by: A. radiation. B. convection. C. conduction. D. evaporation.

A. radiation.

The bones of the forearm are called the: A. radius and ulna. B. tibia and radius. C. humerus and ulna. D. radius and humerus.

A. radius and ulna.

Which of the following does NOT usually contribute to or cause obesity? A. rapid metabolism B. high caloric intake C. low metabolic rate D. genetic predisposition

A. rapid metabolism

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20′ and is lying unconscious on the ground; the power line is lying across his chest. You should: A. rapidly assess the patient after ensuring that the power line is not live. B. apply insulated gloves and assume manual control of his c-spine. C. quickly but carefully move the patient away from the power line. D. manually stabilize his head as your partner assesses for breathing.

A. rapidly assess the patient after ensuring that the power line is not live.

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to: A. recall that the patient is at risk for negative medication interactions. B. ask the patient to explain what each of the medications is used for. C. look up all of the medications before providing care to the patient. D. contact each of the physicians whose names are on the medications.

A. recall that the patient is at risk for negative medication interactions.

The primary function of the right atrium is to: A. receive blood from the vena cava. B. pump blood to the pulmonary artery. C. receive blood from the pulmonary veins. D. pump blood to the lungs for reoxygenation.

A. receive blood from the vena cava.

In addition to obtaining a SAMPLE history and asking questions related to the chief complaint, what else should you inquire about when assessing a patient with a potentially infectious disease? A. recent travel B. HIV status C. sexual practices D. drug allergies

A. recent travel

You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should: A. reevaluate the rate and volume of your ventilations. B. perform a head-to-toe assessment to look for bleeding. C. increase the volume of your ventilations and reassess his blood pressure. D. ensure that you are delivering one breath every 3 to 5 seconds.

A. reevaluate the rate and volume of your ventilations.

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: A. referred pain. B. radiating pain. C. visceral pain. D. remote pain.

A. referred pain.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker: A. regulates the patient's heart rate if it falls below a preset value. B. delivers a shock to the heart if the rate becomes exceedingly fast. C. is implanted under the skin in the left upper abdominal quadrant. D. will only activate if it detects rhythms such as ventricular fibrillation.

A. regulates the patient's heart rate if it falls below a preset value.

When given to patients with cardiac-related chest pain, nitroglycerin: A. relaxes the walls of the coronary arteries. B. increases myocardial contraction force. C. increases blood return to the right atrium. D. constricts the veins throughout the body.

A. relaxes the walls of the coronary arteries.

You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight-fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: A. remove her dentures, resume ventilations, and assess for adequate chest rise. B. attempt to replace her dentures so that they fit tightly and resume ventilations. C. leave her dentures in place, but carefully monitor her for an airway obstruction. D. remove her dentures at once and increase the rate and volume of your ventilations.

A. remove her dentures, resume ventilations, and assess for adequate chest rise.

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. B. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly.

A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

Disentanglement involves: A. removing a patient from a dangerous position. B. the use of simple access tools such as a pry bar. C. extrication techniques that EMTs are trained in. D. gaining access to a patient in a crashed vehicle.

A. removing a patient from a dangerous position.

When interviewing a patient, you can show him or her that you understand the situation by: A. repeating statements back to him or her. B. using medical terminology whenever possible. C. maintaining constant eye contact with him or her. D. interrupting him or her as needed for clarification.

A. repeating statements back to him or her.

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to: A. report exactly what the patient signs and not to add any commentary. B. voice what he or she is signing while communicating with the patient. C. document the answers to the questions that the patient has responded to. D. avoid any kind of lip movement while he or she is signing with the patient.

A. report exactly what the patient signs and not to add any commentary.

Quid pro quo, a type of sexual harassment, occurs when the harasser: A. requests sexual favors in exchange for something else. B. touches another person without his or her consent. C. stares at certain parts of another person's anatomy. D. makes rude remarks about a person's body parts.

A. requests sexual favors in exchange for something else.

In contrast to monophasic defibrillation, biphasic defibrillation: A. requires a lower energy setting. B. delivers all shocks at 360 joules. C. begins with 300 joules and escalates. D. is only effective for ventricular tachycardia.

A. requires a lower energy setting.

An unconscious patient found in a prone position must be placed in a supine position in case he or she: A. requires cardiopulmonary resuscitation (CPR). B. begins to vomit. C. regains consciousness. D. has increased tidal volume.

A. requires cardiopulmonary resuscitation (CPR).

The optic nerve endings are located within the: A. retina. B. sclera. C. pupil. D. cornea.

A. retina.

A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should: A. retreat and notify law enforcement personnel. B. tell the family member that it is not your fault. C. subdue the family member until the police arrive. D. ignore the family member and assess the patient.

A. retreat and notify law enforcement personnel.

A patient who cannot remember the events that preceded his or her head injury is experiencing: A. retrograde amnesia. B. anterograde amnesia. C. perigrade amnesia. D. posttraumatic amnesia.

A. retrograde amnesia.

Deoxygenated blood from the body returns to the: A. right atrium. B. right ventricle. C. left atrium. D. left ventricle.

A. right atrium.

The part of the brain that controls the left side of the body is the: A. right side cerebrum. B. left side cerebrum. C. left parietal lobe. D. right temporal lobe.

A. right side cerebrum.

When working at the scene of a motor vehicle crash at night, you should NOT use: A. road flares. B. reflective vests. C. portable floodlights. D. intermittent flashing devices.

A. road flares.

The ___________ portion of the spinal column is joined to the iliac bones of the pelvis. A. sacrum B. coccyx C. lumbar D. thoracic

A. sacrum

The pectoral girdle consists of the: A. scapulae and clavicles. B. clavicles and rib cage. C. sternum and scapulae. D. acromion and clavicles.

A. scapulae and clavicles.

Because a tracheostomy tube bypasses the nose and mouth: A. secretions can build up in and around the tube. B. the risk of a local infection is significantly high. C. bleeding or air leakage may occur around the tube. D. severe swelling of the trachea and bronchi can occur.

A. secretions can build up in and around the tube.

Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? A. seesaw breathing B. rapid respirations C. pursed-lip breathing D. accessory muscle use

A. seesaw breathing

Which of the following signs of respiratory distress is typically unique to infants and children? A. seesaw respirations B. unequal breath sounds C. unequal chest expansion D. irregular breathing pattern

A. seesaw respirations

A generalized seizure is characterized by: A. severe twitching of all the body's muscles. B. a blank stare and brief lapse of consciousness. C. unconsciousness for greater than 30 minutes. D. a core body temperature of greater than 103°F (40°C).

A. severe twitching of all the body's muscles.

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient? A. sexual activity B. past medical history C. change in bladder habits D. duration of symptoms

A. sexual activity

Which of the following factors will cause a decreased minute volume in an adult? A. shallow breathing B. increased tidal volume C. respirations of 20 breaths/min D. slight decrease in respiratory rate

A. shallow breathing

Clinical signs of labored breathing include all of the following, EXCEPT: A. shallow chest movement. B. use of accessory muscles. C. supraclavicular retractions. D. gasping attempts to breathe.

A. shallow chest movement.

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if: A. she became dizzy or fainted before falling. B. she attempted to catch herself before falling. C. a family member regularly checks up on her. D. she takes medications for Alzheimer disease.

A. she became dizzy or fainted before falling.

Bruising to the _________ is LEAST suggestive of child abuse. A. shins B. back C. face D. buttocks

A. shins

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a: A. shunt. B. G-tube. C. CS tube. D. cerebral bypass.

A. shunt.

After taking diphendydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n): A. side effect. B. untoward effect. C. therapeutic effect. D. unpredictable effect.

A. side effect.

The use of lights and siren on an ambulance: A. signifies a request for other drivers to yield the right of way. B. legally gives the emergency vehicle operator the right of way. C. allows other drivers to hear and see you from a great distance. D. is required any time a patient is being transported to the hospital.

A. signifies a request for other drivers to yield the right of way.

The electrical impulse of the heart normally begins at the: A. sinoatrial node. B. bundle of His. C. Purkinje fibers. D. atrioventricular node.

A. sinoatrial node.

Which of the following joints allows no motion? A. skull sutures B. sacroiliac joint C. shoulder joint D. sternoclavicular joint

A. skull sutures

The diaphragm functions as an involuntary muscle when a person: A. sleeps. B. coughs. C. takes a deep breath. D. holds his or her breath.

A. sleeps.

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: A. slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid. B. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid. C. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid. D. increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.

A. slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

When being tailgated by another vehicle while responding to an emergency call, you should: A. slow down and allow the driver to pass you. B. increase your speed to create more distance. C. slam on the brakes to frighten the tailgater. D. stop the ambulance and confront the driver.

A. slow down and allow the driver to pass you.

You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that: A. small infants are nose breathers and require clear nasal passages at all times. B. assisted ventilations in infants often need to be forceful to inflate their lungs. C. the infant's proportionately small tongue often causes an airway obstruction. D. an infant's head should be placed in a flexed position to prevent obstruction.

A. small infants are nose breathers and require clear nasal passages at all times.

The spinal cord is encased in and protected by the: A. spinal canal. B. vertebral body. C. vertebral arch. D. intervertebral disc.

A. spinal canal.

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should: A. splint the elbow in the position found and transport. B. gently manipulate the elbow to improve circulation. C. gently straighten the elbow and apply an air splint. D. apply a heat pack to the elbow to reduce swelling.

A. splint the elbow in the position found and transport.

A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to: A. stabilize her entire spine. B. obtain baseline vital signs. C. inspect the helmet for cracks. D. leave her bicycle helmet on.

A. stabilize her entire spine.

You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should: A. start CPR and attach the AED as soon as possible. B. ask the family if the patient has a terminal disease. C. perform CPR and transport the patient immediately. D. notify dispatch and request a paramedic ambulance.

A. start CPR and attach the AED as soon as possible.

The purpose of defibrillation is to: A. stop the chaotic, disorganized contraction of the cardiac cells. B. cause a rapid decrease in the heart rate of an unstable patient. C. improve the chance of cardiopulmonary resuscitation (CPR) being successful in resuscitation. D. prevent asystole from deteriorating into ventricular fibrillation.

A. stop the chaotic, disorganized contraction of the cardiac cells.

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: A. stridor. B. rhonchi. C. grunting. D. wheezing.

A. stridor.

When assessing a patient's abdomen, you will typically evaluate for all of the following, EXCEPT: A. subcutaneous emphysema. B. open wounds or eviscerations. C. gross bleeding and tenderness. D. rigidity and obvious bleeding.

A. subcutaneous emphysema.

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should: A. suction her oropharynx and apply 100% oxygen. B. insert an oral airway, apply oxygen, and transport. C. use a bag-mask device to assist her ventilations. D. place her on her side and prepare for rapid transport.

A. suction her oropharynx and apply 100% oxygen.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: A. suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility. B. place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department. C. suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber. D. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bagmask device, and contact medical control for further guidance.

A. suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility.

During delivery of the baby's head, you should suction the mouth before the nose because: A. suctioning the nose first may cause the baby to gasp and aspirate fluid. B. it is easier to suction larger volumes of fluid from the baby's oropharynx. C. babies are primarily mouth breathers and do not breathe through their nose. D. the mucosa of the nose is fragile and is easily damaged by vigorous suctioning.

A. suctioning the nose first may cause the baby to gasp and aspirate fluid.

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: A. sunken fontanelles. B. headache and fever. C. a stiff or painful neck. D. an altered mental status.

A. sunken fontanelles.

Burns associated with lightning strikes are typically: A. superficial. B. third-degree. C. full-thickness. D. partial-thickness.

A. superficial.

If one or more occupants in the same vehicle are killed in a crash, the EMT should: A. suspect that all living occupants experienced the same serious trauma. B. transport the survivors only if they have injuries or complain of pain. C. allow the survivors to refuse transport if they have no obvious injuries. D. rapidly assess only the survivors who have experienced obvious trauma.

A. suspect that all living occupants experienced the same serious trauma.

Activated charcoal is an example of a(n): A. suspension. B. solution. C. elixir. D. gel.

A. suspension.

Deformity caused by a fracture would MOST likely be masked by: A. swelling. B. guarding. C. crepitus. D. ecchymosis.

A. swelling.

Airway management can be challenging in patients with Down syndrome because their: A. teeth are misaligned and they have a large tongue. B. occiput is round, which causes flexion of the neck. C. tongue is relatively small and falls back in the throat. D. mandible is large, which inhibits a mask-to-face seal.

A. teeth are misaligned and they have a large tongue.

In the eyes of the court, an incomplete or untidy patient care form indicates: A. that inadequate patient care was administered. B. potential falsification of the patient care form. C. that thorough documentation was not required. D. that the EMT was too busy providing patient care.

A. that inadequate patient care was administered.

With increasing age, the heart must work harder to move the blood effectively because: A. the blood vessels become stiff. B. the arteries dilate significantly. C. diastolic blood pressure decreases. D. the blood thickens as a person ages.

A. the blood vessels become stiff.

The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if: A. the car seat is visibly damaged. B. he or she has no visible injuries. C. his or her vital signs are stable. D. he or she even has a minor injury.

A. the car seat is visibly damaged.

During delivery, it is MOST important to position your partner at the mother's head because: A. the mother may become nauseated and vomit. B. the mother needs to be apprised of the situation. C. she may need emotional support during the delivery. D. mothers often need assisted ventilation during delivery.

A. the mother may become nauseated and vomit.

EMTs arrive at the scene of an ill person. The EMR, who arrived before the EMTs, advises that the patient had a syncopal episode. The patient is conscious and alert and remains so throughout transport. When transferring patient care to the emergency department nurse, the EMT should advise the nurse that: A. the patient had a reported syncopal episode. B. she should contact the EMR about the incident. C. the EMR was probably mistaken about the episode. D. there is no evidence to support the syncopal episode.

A. the patient had a reported syncopal episode.

Prompt transport of a patient with a suspected AMI is important because: A. the patient may be eligible to receive thrombolytic therapy. B. 90% of the cardiac cells will die within the first 30 minutes. C. nitroglycerin can only be given in the emergency department. D. many patients with an AMI die within 6 hours.

A. the patient may be eligible to receive thrombolytic therapy.

The "Golden Period" begins when an injury occurs and ends when: A. the patient receives definitive care. B. the patient is admitted to the ICU. C. you depart the scene for the hospital. D. you arrive at the emergency department.

A. the patient receives definitive care.

Abruptio placenta occurs when: A. the placenta prematurely separates from the uterine wall. B. a tear in the placenta causes severe internal hemorrhage. C. the placenta affixes itself to the outer layer of the uterus. D. the placenta develops over and covers the cervical opening.

A. the placenta prematurely separates from the uterine wall.

Reassessment is performed to determine all of the following, EXCEPT: A. the reason why the patient called EMS. B. the patient's response to your treatment. C. whether or not the patient is deteriorating. D. the nature of any newly identified problems.

A. the reason why the patient called EMS.

The term "bloody show" is defined as: A. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug. B. mild vaginal bleeding that occurs within the first 30 minutes after the onset of the second stage of the labor process. C. the normal amount of vaginal bleeding that occurs within the first 24 hours following delivery of the baby and placenta. D. any volume of blood that is expelled from the vagina after the amniotic sac has ruptured and contractions have begun.

A. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT: A. the speed of the fall. B. the surface struck. C. the height of the fall. D. the primary impact point.

A. the speed of the fall.

The Adam's apple is: A. the upper part of the larynx that is formed by the thyroid cartilage. B. the lower part of the larynx that is formed by the cricoid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. below the thyroid cartilage and forms the upper part of the trachea.

A. the upper part of the larynx that is formed by the thyroid cartilage.

When the shoulder girdle is aligned over the pelvis during lifting: A. the weight is exerted straight down the vertebrae. B. the hands can be held further apart from the body. C. the muscles of the back experience increased strain. D. the risk of back injuries is significantly increased.

A. the weight is exerted straight down the vertebrae.

Infants are often referred to as "belly breathers" because: A. their rib cage is less rigid and the ribs sit horizontally. B. an infant's ribs are brittle and are less able to expand. C. their intercostal muscles are not functional. D. their diaphragm does not receive impulses from the brain.

A. their rib cage is less rigid and the ribs sit horizontally.

Vigorous suctioning of a newborn's airway is indicated if: A. there is meconium in the amniotic fluid. B. positive-pressure ventilations are indicated. C. the newborn presents with labored breathing. D. his or her heart rate is less than 60 beats/min.

A. there is meconium in the amniotic fluid.

When assessing or treating an adolescent patient, it is important to remember that: A. they usually do not wish to be observed during a procedure. B. it is generally not necessary to explain procedures in advance. C. they often request medication to help in the relief of severe pain. D. they cannot understand complex concepts and treatment options.

A. they usually do not wish to be observed during a procedure.

The act of pulling on a body structure in the direction of its normal alignment is called: A. traction. B. reduction. C. stabilization. D. immobilization.

A. traction.

When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: A. when the patient last appeared normal. B. if there is a family history of a stroke. C. if the patient has been hospitalized before. D. the patient's overall medication compliance.

A. when the patient last appeared normal.

According to the Association of Air Medical Services (AAMS), you should consider air medical transport of a trauma patient if: A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome. B. ground transport will take your ambulance out of service for an extended period of time, regardless of the severity of the patient's injuries. C. the patient requires advanced life support care and stabilization, and the nearest ALS-ground ambulance is more than 5 to 10 minutes away. D. he or she was involved in a motor vehicle crash in which another occupant in the same vehicle was killed, even if your patient's injuries are minor.

A. traffic conditions hamper the ability to get the patient to a trauma center by ground within the ideal time frame for the best clinical outcome.

The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include: A. transport to a trauma center. B. a focused exam of her forearm. C. transport to a community hospital. D. a secondary assessment at the scene.

A. transport to a trauma center.

After assessing your patient, you determine that his condition is stable. You provide the appropriate treatment and then load him into the ambulance. While en route to the hospital, you should: A. turn your emergency lights off and obey all traffic laws. B. keep your emergency lights on but avoid using the siren. C. use your lights and siren but drive slowly and defensively. D. drive slowly and remain in the far left-hand lane, if possible.

A. turn your emergency lights off and obey all traffic laws.

Upon arriving at the scene of a major motor vehicle crash at night, you find that the safest place to park your ambulance is in a direction that is facing oncoming traffic. You should: A. turn your headlights off. B. quickly access the patient. C. place a flare near the crash. D. turn all warning lights off.

A. turn your headlights off.

A properly sized blood pressure cuff should cover: A. two thirds the length from the armpit to the crease in the elbow. B. one half the length between the armpit to the crease in the elbow. C. one third the length from the armpit to the crease at the elbow. D. the entire upper arm between the armpit and the crease at the elbow.

A. two thirds the length from the armpit to the crease in the elbow.

When explaining the need for a particular procedure to an elderly patient, you should: A. use plain language and simple terms. B. use the appropriate medical terminology. C. be complex so the patient fully understands. D. realize that he or she will not understand you.

A. use plain language and simple terms.

If you do not have the appropriate size cervical collar, you should: A. use rolled towels to immobilize the patient's head. B. place sandbags on either side of the patient's head. C. ask the patient to keep his or her head in a neutral position. D. defer cervical immobilization and apply lateral head blocks.

A. use rolled towels to immobilize the patient's head.

The signs and symptoms of poisoning in children: A. vary widely, depending on the child's age and weight. B. are more obvious than in the adult population. C. usually present within the first 10 minutes of ingestion. D. are most severe if the child ingested a poisonous substance.

A. vary widely, depending on the child's age and weight.

The tip of a central venous catheter rests in the: A. vena cava. B. left atrium. C. right ventricle. D. pulmonary vein.

A. vena cava.

Heat loss from the body through respiration occurs when: A. warm air is exhaled into the atmosphere. B. the core body temperature is greater than 98°F (37°C). C. cool air is inhaled and displaces warm air. D. air temperature is greater than body temperature.

A. warm air is exhaled into the atmosphere.

The main objective of traffic control at the scene of a motor vehicle crash is to: A. warn oncoming traffic and prevent another crash. B. facilitate a route for the media to access the scene. C. prevent curious onlookers from observing the scene. D. get oncoming traffic past the scene as soon as possible.

A. warn oncoming traffic and prevent another crash.

If you use a waterless handwashing substitute in the field, it is important to: A. wash your hands with soap and water at the hospital. B. immediately dry your hands with a paper towel. C. wait at least 5 minutes before touching another patient. D. avoid donning another pair of gloves for at least 10 minutes.

A. wash your hands with soap and water at the hospital.

Capillary sphincter closure during internal or external bleeding is detrimental because: A. waste products are not removed and nutrients are not delivered to the cells. B. available blood is shunted off to another venule while still carrying oxygen. C. high levels of oxygen remain in the cell and can cause significant damage. D. carbon dioxide and other waste can enter the cell, but oxygen cannot enter.

A. waste products are not removed and nutrients are not delivered to the cells.

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: A. wheezing. B. a weak cough. C. a cough that resembles the bark of a seal. D. stridorous breathing.

A. wheezing.

During the transfer of patient care: A. when possible, the team member giving the patient care report should hand off lifesaving care. B. both the team members giving and receiving the patient care report should focus on their own priorities. C. any lifesaving care should be done first and then any patient care reports can be done after the patient is transported. D. any lifesaving care should be completed quickly and only the relevant documentation of care need be transferred.

A. when possible, the team member giving the patient care report should hand off lifesaving care.

The nasal cannula is MOST appropriately used in the prehospital setting: A. when the patient cannot tolerate a nonrebreathing mask. B. if the patient's nasopharynx is obstructed by secretions. C. if long-term supplemental oxygen administration is required. D. when the patient breathes primarily through his or her mouth.

A. when the patient cannot tolerate a nonrebreathing mask.

As soon as you leave the hospital and are en route back to your station, you should inform the dispatcher: A. whether you are back in service. B. that you are prepared for another call. C. of the name of the accepting physician. D. about the patient's clinical condition.

A. whether you are back in service.

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: A. wiggle his or her toes on command. B. feel you touching the extremity. C. note any changes in temperature. D. identify different types of stimuli.

A. wiggle his or her toes on command.

A nasopharyngeal airway is inserted: A. with the bevel facing the septum if inserted into the right nare. B. into the larger nostril with the tip pointing away from the septum. C. with the bevel pointing downward if inserted into the left nare. D. into the smaller nostril with the tip following the roof of the nose.

A. with the bevel facing the septum if inserted into the right nare.

Force acting over a distance defines the concept of: A. work. B. latent energy. C. kinetic energy. D. potential energy.

A. work.

While trying to make a family member feel better after a loved one has died, your partner uses trite statements. The family members may view this as: A. your partner's attempt to diminish their grief. B. a show of respect for the person who has died. C. coaching them through the grieving process. D. your partner's caring and supportive attitude.

A. your partner's attempt to diminish their grief.

If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:53. B. 7:57. C. 7:59. D. 8:00.

B. 7:57.

Which of the following clinical findings is MOST consistent with a chronic respiratory disease? A) An irregular pulse B) A barrel-shaped chest C) Altered mental status D) Use of accessory muscles

B) A barrel-shaped chest In certain lung diseases (eg, emphysema, asthma), air is gradually and continuously trapped in the lungs in increasing amounts; this increases the anteriorposterior (front to back) diameter of the chest, causing the chest to assume a barrel shape. A barrel-shaped chest indicates a chronic respiratory disease. Accessory muscle use and an altered mental status in a patient with respiratory distress should be assumed to be acute findings. An irregular pulse could be the result of a primary cardiac problem, or a cardiac problem secondary to chronic hypoxemia in patients with various respiratory diseases.

Assessment of an older man with respiratory distress reveals that his chest has a barrel-shaped appearance and he is exhaling through pursed lips. What is the pathophysiology of these findings? A) Decreased tidal volume B) Increased residual volume C) Increased vital capacity D) Widespread bronchodilation

B) Increased residual volume Pursed-lip breathing and a barrel-shaped chest are classic signs of emphysema, a type of chronic obstructive pulmonary disease (COPD). Emphysema is caused by destruction of the alveolar walls and a loss of pulmonary surfactant. As a result, the alveoli cannot easily expand and recoil and the process of pulmonary gas exchange is impaired. The patient with emphysema has chronic air trapping in the lungs due secondary to incomplete alveolar emptying; as a result, residual volume increases. Residual volume is the amount of air remaining in the lungs following a complete exhalation. Decreased tidal volume would manifest with shallow breathing; it would not explain the pursed-lip breathing and barrel-shaped chest. Vital capacity is the maximum amount of air one can exhale after a completion inhalation; in patients with emphysema, vital capacity would decrease, not increase. Widespread bronchospasm, such as what is seen in patients with asthma, would resu lt in wheezing; it would not explain the pursed-lip breathing and barrel-shaped chest.

A 65-year-old man with stroke-like symptoms is responsive only to deep painful stimuli and is making a snoring sound. His respiratory rate is 14 breaths/min and regular and his oxygen saturation is 97%. What should you do? A) Ventilate him with a bag-mask device and oxygen B) Insert a nasopharyngeal airway and keep him sitting up C) Suction his oropharynx and administer oxygen via nasal cannula D) Insert an oropharyngeal airway and position him on his left side

B) Insert a nasopharyngeal airway and keep him sitting up Due to the significant alteration in the patient's mental status, he is not able to maintain his own ai,way. However, because he is not completely unresponsive, he likely has an intact gag reflex; therefore, an oropharyngeal airway would not be an appropriate device. The nasopharyngeal airway is better tolerated in patients who have an intact gag reflex; this would be a more appropriate intervention. There is no evidence of hypoxemia (oxygen saturation is 97%), his breathing is adequate (14 breaths/min and regular), and there is no evidence of respiratory distress; therefore, neither oxygen nor assisted ventilation are indicated at this time. Oxygen is indicated if there is evidence of respiratory distress and/or the patient's oxygen saturation is less than 94% on room air. Keep the patient in a sitting position for further airway protection and transport him to the hospital.

Which of the following occurs during positive-pressure ventilation? A) The esophagus remains closed. B) Intrathoracic pressure increases. C) Blood is pulled back to the heart. D) Oxygen is pulled into the lungs.

B) Intrathoracic pressure increases. Negative-pressure ventilation, the act of normal breathing, occurs when the diaphragm and intercostal muscles contract and the intra thoracic cavity enlarges. This creates a vacuum (negative pressure), which pulls air into the lungs. The same vacuum that pulls air into the lungs assists in pulling blood back to the right side of the heart (venous return). During negative-pressure ventilation, the esophagus remains closed. In contrast, positive-pressure ventilation involves the pushing of air into the lungs, such as what occurs during bag-mask ventilation. Positive pressure ventilation increases intrathoracic pressure, which can impair venous return to the heart and decrease cardiac output, especially if excessive positive-pressure is used. Likewise, positive-pressure ventilation can force the esophagus open and allow air to enter the stomach (gastric distention); this could result in regurgitation and aspiration of gastric contents.

Assuming a dead space volume of 150 mL, which of the fo llowing would yield the lowest minute alveolar ventilation? A) Respiratory rate, 10 breaths/min; tidal volume, 500 mL B) Respiratory rate, 16 breaths/min; tidal volume, 300 mL C) Respiratory rate, 12 breaths/min; tidal volume, 400 mL D) Respiratory rate, 14 breaths/min; tidal volume, 350 mL

B) Respiratory rate, 16 breaths/min; tidal volume, 300 mL Minute alveolar venti lation is the amount of air that moves in and out of the alveoli each minute. In calculating minute alveolar ventilation, you must subtract the dead space volume from the tidal volume first, and then multiply that number by the respiratory rate. Of the options listed, a tidal volume of 300 mL and a respiratory rate of 16 breaths/min yields the lowest value (2 ,400 mL [2.4 L]).

What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position? A. 6 B. 8 C. 9 D. 10

B. 8

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is: A. 8. B. 9. C. 10. D. 11.

B. 9.

A 42-year-old man presents with a sudden onset of diffic ulty breathing. On assessment, he is cyanotic and is making a high-pitched sound on inhalation. Which of the following would MOST likely cause this type of presentation? A) Pulmonary embolism B) Swelling near the larynx C) Diffuse bronchiole inflammation D) Aspiration of fluid into the trachea

B) Swelling near the larynx A high-pitched sound heard during inhalation is called stridor and indicates narrowing or swelling near the larynx in the upper airway. This could be caused by a foreign body obstruction, angioedema, infectious processes such as epiglottitis, and severe allergic reactions (anaphylaxis). Aspiration of fluid into the trachea would be expected to present with harsh sounds over the trachea called rhonchi. Pulmonary embolism typically presents with acute dyspnea (with or without chest pain), tachycardia, and a low oxygen saturation; stridor is not commonly heard. Diffuse bronchiolar inflammation, such as what occurs with asthma, is a lower airway problem; it would be expected to cause wheezing in the lungs.

A 60-year-old woman has severe respiratory distress. She is conscious, but confused, and can only say two words at a time. Which of the following would be the MOST appropriate treatment for her? A) Insertion of a nasopharyngeal airway B) Ventilation with a bag-valve-mask device C) Oxygen via nasal cannula at 2 to 6 L/min D) Oxygen via nonrebreathing mask at 15 L/min

B) Ventilation with a bag-valve-mask device Because the patient is able to speak only in minimal-word sentences (two-word dyspnea), is experiencing severe respiratory distress, and is confused (a likely sign of hypoxemia), it is unlikely that she is ventilating adequately. Therefore, you should assist her ventilations with a bag-valve-mask (BVM) device. If her breathing continues as it is, she will become increasingly hypoxemic and may lose consciousness. Because this patient is conscious, you must explain to her that every time she takes in a breath, the BVM device will be squeezed so that an adequate volume of air can be delivered. Clearly, this can cause the patient great anxiety, so your reassurance during this procedure is important. If the patient will not tolerate your attempts to assist her ventilations, apply oxygen via a nonrebreathing mask and monitor her closely.

Occasional, irregular breaths that may be observed in a cardiac arrest patient are called: A) Biot respirations. B) agonal gasps. C) ataxic respirations. D) Cheyne-Stokes respirations.

B) agonal gasps. Occasional, irregular breaths, called agonal gasps, may be observed in some patients shortly after their heart stops beating. They occur when the respiratory center in the brain sends stray signals to the respiratory muscles. Agonal gasps are not adequate because they are infrequent and result in negligible tidal volume. Biot respirations are characterized by an irregular pattern, rate, and depth of breathing with intermittent periods of apnea; they are commonly associated with severe brain trauma. Ataxic respirations are ineffective, irregular breaths that may or may not have an identifiable pattern; they are also commonly associated with severe brain trauma. Cheyne-Stokes respirations are characterized by a crescendo-decrescendo pattern of breathing with a period of apnea between each cycle (fast, slow, apnea). Cheyne-Stokes respirations may occur in healthy people during certain phases of the sleep cycle; however, if they are grossly exaggerated or occur in a patient with a head injury, they are an ominous sign.

Patients with a hypoxic drive: A) may hypoventilate if given low concentrations of oxygen. B) are stimulated to breathe by low oxygen levels in the blood. C) rarely become cyanotic because of high blood oxygen levels. D) are accustomed to low levels of carbon dioxide in the blood.

B) are stimulated to breathe by low oxygen levels in the blood. Patients with chronic respiratory diseases (eg, emphysema) maintain decreased levels of oxygen and increased levels of carbon dioxide in the blood. The sensors in the brain become accustomed to this. Unlike in a healthy person, whose primary respiratory drive is influenced by increasing carbon dioxide levels in the blood, the primary respiratory drive of a patient with a chronic respiratory disease is influenced by low levels of oxygen in the blood (hypoxic drive). Cyanosis is common due to chronic hypoxemia. Some patients with a hypoxic drive may hypoventilate if given high concentrations of supplemental oxygen, although this is highly uncommon. High-flow supplemental oxygen may fool the brain into thinking the body has sufficient oxygen, causing it to send fewer signals to the diaphragm and intercostal muscles.

An unresponsive patient's respirations are 28 breaths/min and shallow. The MOST appropriate treatment includes: A) a nasal cannula set at 2 to 6 L/min. B) assisted ventilation with 100% oxygen. C) a simple face mask set at 10 to 12 L/min. D) a nonrebreathing mask set at 15 L/min.

B) assisted ventilation with 100% oxygen. Shallow respirations (reduced tidal volume) at a rate of 26 breaths/min will not provide adequate minute volume. Therefore, you should assist the patient's ventilations with a bag-valve-mask device and high-flow oxygen. Passive oxygenation devices (eg, nonrebreathing mask, simple face mask, nasal cannula) will be of little benefit to a patient with inadequate breathing. The patient must have adequate tidal volume to effectively breathe in oxygen from these devices.

You are performing abdominal thrusts on a 19-year-old male with a severe airway obstruction when he becomes unresponsive. After lowering him to the ground and placing him in a supine position, you should: A) open his airway and look inside his mouth. B) begin CPR, starting with chest compressions. C) continue abdominal thrusts until ALS responders arrive. D) assess for a carotid pulse for up to 10 seconds.

B) begin CPR, starting with chest compressions. A patient with a severe airway obstruction may initially be responsive and then become unresponsive during treatment. In th is case, you know that an airway obstruction is the cause of his or her problem. Therefore, after placing the patient in a supine position, you should begin CPR, starting with chest compressions. Do not check for a pulse before starting chest compressions. After performing 30 chest compressions (15 compressions in infants and children when two EMTs are present), open the airway and look in the mouth. Only remove an object that you can see; do not perform a blind finger sweep in any patient. If you cannot see the object, resume chest compressions. Attempt to ventilate only if you retrieve an object from the mouth.

Hypothermia occurs when the core body temperature falls below: A. 98°F (37°C). B. 95°F (35°C). C. 90°F (32°C). D. 88°F (31°C).

B. 95°F (35°C).

Which of the following statements regarding cervical collars is correct? A. Once a cervical collar is applied, you can cease manual head stabilization. B. A cervical collar is used in addition to, not instead of, manual immobilization. C. Cervical collars are contraindicated in patients with numbness to the extremities. D. The patient's head should be forced into a neutral position to apply a cervical collar.

B. A cervical collar is used in addition to, not instead of, manual immobilization.

A 66-year-old man with a history of COPD presents with respiratory distress. Assessment reveals that he is conscious, but is tired and fatigued. His breathing is labored and shallow, his pulse is rapid and weak, and his skin is cool and pale. The EMT should: A) apply high-flow oxygen via nonrebreathing mask. B) begin assisting his breathing with a bag-mask device. C) insert a nasal airway and reassess his breathing effort. D) give oxygen via nasal cannula and auscultate his lungs.

B) begin assisting his breathing with a bag-mask device Fatigue; labored, shallow breathing; and a rapid, weak pulse are clear signs of respiratory fai lure. If not treated immediately, the patient could develop cardiac arrest. The EMT should begin assisting the patient's ventilations with a bag-mask device and supplemental oxygen. Devices that deliver oxygen passively (ie, nasal cannula, nonrebreathing mask) would be of limi ted benefit to the patient with shallow breathing (reduced tidal volume). If the patient's level of consciousness deteriorates, he may lose the ability to protect his own airway; therefore, it may be necessary to insert an airway adjunct (ie, nasopharyngeal airway).

Intrapulmonary shunting occurs when: A) insufficient hemoglobin does not allow for adequate hemoglobin binding. B) blood flowing through the lungs returns to the left side of the heart in a deoxygenated state. C) blood from the right side of the heart is oxygenated without passing through the lungs. D) too much carbon dioxide is removed from the blood as it passes through the lungs.

B) blood flowing through the lungs returns to the left side of the heart in a deoxygenated state. Conditions that reduce the surface area for gas exchange also decrease the body's oxygen supply, leading to inadequate tissue perfusion. Medical conditions such as pneumonia, pulmonary edema, and COPD may also result in a disturbance of cellular metabolism. These conditons decrease the surface area of the alveoli either by damaging alveoli or by leading to an accumulation of fluid in the lungs. Nonfunctional alveoli, either because of widespead collapse (atelectasis) or inundation with fluid, inhibit the diffusion of oxygen and carbon dioxide. As a result, blood entering the lungs from the right side of the heart bypasses the alveoli and returns to the left side of the heart in a deoxygenated state; this is called intrapulmonary shunting. The greater the degree of shunting, the less oxygen will diffuse from the alveoli to the blood. Blood cannot be reoxygenated, nor can carbon dioxide be removed, without passing through the lungs. A decrease in hemoglobin levels, such as what occurs with severe blood loss, reduces the oxygen-carrying capacity of the blood because there are fewer hemoglobin molecules for oxygen to attach to.

All of the following would cause an increased level of carbon dioxide in the arterial blood, EXCEPT: A) reduced tidal volume. B) deep, rapid breathing. C) short exhalation phase. D) slow, shallow breathing.

B) deep, rapid breathing. Adequate oxygen intake and carbon dioxide elimination require a patent airway and adequate breathing. The level of carbon dioxide in arterial blood can rise for a number of reasons. Reduced tidal volume (shallow depth of breathing) results in insufficient oxygen intake and decreased carbon dioxide elimination. A patient who is breathing slowly (bradypnea) will also experience a decrease in oxygen intake and reduced carbon dioxide elimination. If exhalation is impaired, the body will not eliminate adequate carbon dioxide; therefore, it will accumulate in arterial blood. Deep, rapid breathing (hyperventilation), however, would likely increase carbon dioxide elimination from the body, thus lowering the carbon dioxide content of arterial blood.

After an adult cardiac arrest patient has been intubated by a paramedic, you are providing ventilations as your partner performs chest compressions. When ventilating the patient, you should: A) deliver 2 breaths during a brief pause in chest compressions. B) deliver each breath over 1 second at a rate of 10 breaths/min. C) hyperventilate the patient to maximize carbon dioxide elimination. D) deliver each breath over 2 seconds at a rate of15 breaths/min.

B) deliver each breath over 1 second at a rate of 10 breaths/min. When ventilating an adult cardiac arrest patient with an advanced airway in place (ie, ET tube, multilumen airway, supraglottic airway), you should deliver each breath over a period oft second--just enough to produce visible chest rise--at a rate of10 breaths/min (one breath every 6 seconds). Do not attempt to synchronize ventilations with chest compressions once the airway has been secured with an advanced device. Hyperventilation should be avoided, as it may result in increased intrathoracic pressure, decreased blood return to the heart, and, as a resu lt, less effective chest compressions.

Assessment of a 40-year-old patient reveals respiratory distress, tachycardia, audible expiratory wheezing, and an oxygen saturation of 88%. The EMT should suspect: A) fluid in the lower airways. B) diffuse bronchoconstriction. C) swelling in the laryngeal area. D) infection of the lower airway.

B) diffuse bronchoconstriction. Wheezing is a whistling sound that indicates constriction of the bronchioles in the lungs. It is commonly heard on exhalation, but may also occur during inhalation and exhalation. Wheezing occurs with asthma or bronchiolitis. Fluid in the lower airways produces breath sounds such as rales (crackles) or rhonchi. Laryngeal swelling would produce stridor, a high-pitched sound heard during inhalation. Infection of the lower airway, such as pneumonia, would be expected to present with a fever, productive cough, and diminished breath sounds over an isolated lung field.

A 70-year-old woman with severe respiratory distress is found lying supine in her bed. She is conscious, but confused, and her skin is pale and clammy. Her husband states that she has congestive heart failure and hypertension, and that her breathing difficulty began suddenly. The EMT should: A) assist the patient's ventilations with a bag-mask device. B) elevate the patient's upper body and administer oxygen. C) auscultate the patient's lungs and apply the pulse oximeter. D) suspect pulmonary edema and begin treatment with CPAP.

B) elevate the patient's upper body and administer oxygen. The patient's clinical presentation and medical history suggests acute pulmonary edema. The EMT should immediately sit the patient up in order to make it easier for her to breathe. If she continues to lie supine, she will become increasingly hypoxic and may stop breathing altogether. Administer high-flow oxygen and further assess the patient (ie, breath sounds, pulse oximetry, etc). If her breath sounds reveal crackles and she is able to follow verbal commands, treatment with continuous positive airway pressure (CPAP) should be considered. If she is not able to follow verbal commands, begin assisting her ventilations with a bag-mask device. Monitor her oxygen saturation, and if avai lable, end-tidal carbon dioxide (ETC02).

Syphilis is a: A. high-risk disease to the EMT, especially through a needlestick. B. bloodborne disease that can successfully be treated with penicillin. C. sexually transmitted disease that is only found in vaginal secretions. D. bacterial infection that is typically resistant to antibiotic medications.

B. bloodborne disease that can successfully be treated with penicillin.

The active, muscular part of breathing is called: A) expiration. B) inhalation. C) ventilation. D) respiration.

B) inhalation. The active, muscular part of breathing is called inhalation (inspiration). During inhalation, the diaphragm and intercostal muscles contract. When the diaphragm contracts, it descends and enlarges the thoracic cage from top to bottom. When the intercostal muscles contract, they lift the ribs up and out. As the thoracic cage expands, the air pressure within the thorax decreases, creating a slight vacuum. This pulls air through the trachea, causing the lungs to fil l. Exhalation (expiration) does not require muscular effort; it is a passive process. During exhalation, the diaphragm and intercostal muscles relax. In response, the thorax decreases in size, and the ribs and muscles assume a normal resting position. When the size of the thoracic cage decreases, air in the lungs is compressed into a smaller space. The air pressure within the thorax then becomes higher than the pressure outside and air is pushed out through the trachea. Respiration is defined as the exchange of gases between the body and its environment. Ventilation is defined as the movement of air into and out of the lungs.

A properly placed oropharyngeal airway: A) prevents aspiration if the patient regurgitates. B) keeps the tongue off of the posterior pharynx. C) eliminates the need to perform a head tilt-chin lift. D) will not stimulate a conscious patient's gag reflex.

B) keeps the tongue off of the posterior pharynx. The oropharyngeal (oral) airway is an artificial adjunct used to keep the tongue away from the posterior pharynx (back of the throat), thereby preventing it from blocking the upper airway. It is used in conjunction with, not in lieu of, the head tilt-chin lift or jaw-thrust maneuver to maintain patency of the airway. The oral airway will not prevent aspiration if the patient regurgitates because it does not occlude the esophagus or protect the trachea. The oral airway is contraindicated in conscious patients and in all patients, even those who are unconscious, who have an intact gag reflex. Stimulation of the gag reflex may cause vomiting and aspiration.

A 60-year-old female is found unresponsive. She is cyanotic, is making a snoring sound, and has a slow respiratory rate. You should: A) insert an airway adjunct. B) manually open her airway. C) thoroughly suction her airway. D) ventilate her with a bag-mask device.

B) manually open her airway. Before you can assess and manage a patient's breathing, you must first ensure that the airway is patent. Snoring respirations indicate partial obstruction of the airway by the tongue. Manually open her airway, using the head tilt-chin lift or jaw-thrust maneuver, and ensure that her airway is clear of secretions. Suction the oropharynx if needed. After manually opening her airway and removing any secretions with suction, insert an airway adjunct (eg, oral or nasal airway). Slow respirations and cyanosis in an unresponsive patient are obvious signs of inadequate breathing and significant hypoxemia; therefore, this patient would require assisted ventilation with a bag-mask device.

Ventilation is defined as the: A) el imination of carbon dioxide from the body. B) movement of air into and out of the lungs. C) volume of air inhaled into the lungs in a single breath. D) exchange of oxygen and carbon dioxide at the cell ular level.

B) movement of air into and out of the lungs. Ventilation is defined as the movement of air into and out of the lungs. During negative-pressure ventilation (normal breathing), the diaphragm and intercostal muscles contract, which increases the vertical and horizontal dimensions of the chest cavity. As a result, a vacuum is created in the chest and air is drawn into the lungs. Positive-pressure ventilation is the act of forcing air into the lungs (ie, bag-valve-mask ventilation). The volume of air inhaled or exhaled in a single breath is called tidal volume. The exchange of gases between the body and its environment is called respiration; therefore, the exchange of oxygen and carbon dioxide at the cell level is called cellular (internal) respiration. During pulmonary (external) respiration, oxygen and carbon dioxide are exchanged in the lungs; oxygenated blood returns to the left side of the heart and carbon dioxide is eliminated from the body during exhalation.

When attaching an oxygen regulator to a D cylinder and preparing it for use, you should recall that: A) the cylinder must remain in a standing position at all times or it will not deliver any oxygen. B) oxygen supports combustion and should not be used where sparks are easily generated. C) a pressure-compensated flowmeter should be used when laying the oxygen cylinder down. D) the cylinder should be taken out of service and refilled when it contains less than 750 psi.

B) oxygen supports combustion and should not be used where sparks are easily generated. Oxygen does not burn or explode; however, it does support combustion. A small spark, even a lit cigarette, can become a flame in an oxygen-rich atmosphere. Therefore, you must ensure that the environment in which you will use oxygen is adequately ventilated, especially in industrial settings where hazardous materials may be present and where sparks are easily generated. Never leave an oxygen cylinder standing unattended; the cylinder can be knocked over, injuring the patient or damaging the equipment. The D cylinder (small cylinder carried to the patient) should be taken out of service and refilled when the pressure inside it falls below 500 psi. The pressure-compensated flowmeter, which contains a ball and float that rises or falls according to the gas flow, can be used only when an oxygen cylinder is upright, which is why it is used with on-board oxygen (M cylinder). The Bourdon-gauge flowmeter does not require the oxygen cylinder to be upright, which is why it is used with D cylinders.

During your initial attempt to ventilate an unresponsive apneic patient, you meet resistance and do not see the patient's chest rise. You should: A) begin CPR, starting with chest compressions. B) reposition the airway and reattempt to ventilate. C) suction the oropharynx and reattempt to ventilate. D) assume that a foreign body is blocking the airway.

B) reposition the airway and reattempt to ventilate. If your initial attempt to ventilate a patient is met with resistance and/or does not make the chest visibly rise, you should reposition the patient's airway and reattempt to ventilate. In many cases, this simple action will enable you to ventilate the patient. However, If both of your breaths are met with resistance and/or do not make the chest visibly rise, you should assume that a foreign body is obstructing the airway and begin chest compressions. The airway should be suctioned if secretions are present in the mouth; if oral secretions are not present, do not uction.

Which of the following statements regarding a patient with a behavioral crisis is correct? A. Depression accounts for a very small percentage of violent attacks. B. A quiet patient is not as likely to attack you as one who is screaming. C. A past history of violence is an unreliable indicator of future violence. D. People who say that they are "hearing voices" are usually bluffing you.

B. A quiet patient is not as likely to attack you as one who is screaming.

While providing initial ventilations to an apneic adult with a bag-valve-mask device, you note minimal rise of the chest despite an adequate mask-to-face seal. You should: A) suction the airway and reattempt to ventilate. B) reposition the airway and reattempt to ventilate. C) switch to a smaller mask for the bag-valve-mask device. D) attach an oxygen reservoir to the bag-valve-mask device.

B) reposition the airway and reattempt to ventilate. You must deliver adequate tidal volume to the patient to cause sufficient chest rise. If initial ventilations cause minimal rise of the patient's chest despite an adequate mask-to-face seal, reposition the patient's airway and reattempt the ventilate. If needed, insert a simple airway adjunct (ie, oral and/or nasal airway). Squeeze the bag with just enough force to cause adequate chest rise. Do not routinely suction the patient's airway unless there are secretions in the mouth, as evidenced by a gurgling sound during ventilations. Switching to a smaller mask would likely be ineffective, as air would probably leak from around the mask. Attach the oxygen reservoir to the bag-valve-mask device as soon as possible; although this does not influence the volume of air delivered to the patient, it does allow you to deliver a higher concentration of oxygen.

A patient who is breathing with reduced tidal volume would MOST likely have: A) warm, moist skin. B) shallow respirations. C) a prolonged inhalation phase. D) a respiratory rate of14 breaths/min.

B) shallow respirations. Tidal volume, a measure of the depth of breathing, is the amount of air (in milliliters [mL]) that is moved into or out of the lungs during a single breath; in the average adult male, this is about 500 mL. Tidal volume cannot be quantified (that is, it cannot be assigned a numeric value) by the EMT; however, it can be estimated by observing the adequacy of chest rise during inhalation. A patient who is breathing with reduced tidal volume will have a shallow depth of breathing; his or her chest rises minimally during inhalation. If a patient is not breathing with adequate tidal volume, he or she will eventually become hypoxemic, which will cause the skin to become cool and clammy and pale or cyanotic. Conversely, a patient with a prolonged inhalation phase (eg, taking a deep breath) would experience an increase in tidal volume. Minute volume is the amount of air moved through the lungs each minute; it is calculated by multiplying tidal volume and respiratory rate. A respiratory rate of 14 breaths/min with adequate tidal volume would result in adequate minute volume. Minute volume is affected by tidal volume, respiratory rate, or both.

In order to avoid forcing air into the stomach during bag-mask ventilation, you should: A) ventilate the patient at a rate of at least 10 to 12/breaths/min. B) squeeze the bag slowly and release when you observe chest rise. C) apply manual pressure to the abdomen during bag-mask ventilation. D) ensure that you are also delivering a high oxygen concentration.

B) squeeze the bag slowly and release when you observe chest rise The esophagus opens at approximately 20 cmH20. High airway pressures, such as what occurs when the bag-mask device is squeezed to quickly and/or forcefully, may generate greater than 20 cmH20 and force air into the stomach. This is why it is critical to squeeze the bag slowly, just until you observe chest rise, and then release. Faster ventilation rates can hyperinflate the lungs, squeeze the heart, and impair venous return; however, the pressure used to squeeze the bag is more influential in opening the esophagus. Obviously, applying manual pressure to the abdomen is inviting the patient to vomit and is clearly inappropriate. The amount of delivered oxygen has no influence on esophageal opening pressure.

Continuous positive airway pressure (CPAP) therapy opens collapsed alveoli when: A) the patient's oxygen saturation increases. B) the patient exhales against positive pressure. C) the patient breathes in supplemental oxygen. D) the CPAP pressu re is set to less than 5 cmH20.

B) the patient exhales against positive pressure. The physiologic effects of CPAP, such as opening collapsed alveoli, pushing more oxygen across the alveolar membrane, and forcing interstitial fluid back into the pulmonary circulation, occur when the patient exhales against airflow that is being pushed into the lungs. This generates back pressure that is directed to the lower airway. The higher the CPAP setting, the more resistance the patient must breathe against. At a setting less than 5 cmH20, there is virtually no resistance to breathe against; as a result, the therapeutic benefit would be minimal. Supplemental oxygen does not open collapsed alveoli, pressure does. An increasing oxygen saturation occurs as a result of the effects of CPAP.

If the level of carbon dioxide in the arterial blood increases: A) a reduction in tidal volume will occur. B) the respiratory rate and depth increase. C) the respiratory rate slows significantly. D) the respiratory rate and depth decrease.

B) the respiratory rate and depth increase. Special receptors, called chemoreceptors, sense the levels of oxygen and carbon dioxide in the arterial blood. The central chemoreceptors are located in the brain; the peripheral chemoreceptors are located in the aorta and carotid arteries. The level of carbon dioxide in the arterial blood stimulates the healthy patient to breathe (primary respiratory drive). If the carbon dioxide level rises above normal, the chemoreceptors send messages to respiratory centers in the brain, resulting in an increase in respiratory rate and depth (tidal volume). Conversely, if the level of carbon dioxide is too low, respiratory rate and depth decrease accordingly.

A patient overdosed on several drugs and is unresponsive with shallow breathing and facial cyanosis. As you continue your assessment, the patient suddenly vomits. You should: A) suction his oropharynx at once. B) turn the patient onto his side. C) insert an oropharyngeal airway. D) begin assisting his ventilations.

B) turn the patient onto his side. The patient's airway must be clear of foreign bodies or secretions before it can be assessed or managed. If the patient begins to vomit, he must first be rolled onto his side to allow for drainage of the vomitus. Use suction to remove secretions after you have positioned him on his side. After the airway is clear, you should insert an appropriate airway adjunct (oral or nasal airway) and ensure adequate ventilation and oxygenation. In this patient, this involves assisting his ventilations with a bag-valve-mask device.

Snoring respirations in an unresponsive patient are MOST often the result of: A) foreign body airway obstruction. B) upper airway obstruction by the tongue. C) collapse of the trachea during breathing. D) swelling of the upper airway structures.

B) upper airway obstruction by the tongue. In an unresponsive patient, the muscles of the tongue, which attach to the mandible, relax and fall back over the posterior pharynx; this causes a snoring sound when the patient breathes. The tongue is the most common cause of airway obstruction in the unresponsive patient. Foreign body upper airway obstructions and upper airway swelling typically produce stridor, a high-pitched sound heard during inhalation. Collapsing of the trachea during breathing would present with marked respiratory distress and retractions.

A patient overdosed on heroin and is unresponsive. He is cyanotic; he has slow, shallow breathing; and his oxygen saturation is 80%. The primary cause of this patient's condition is inadequate: A) perfusion. B) ventilation. C) respiration. D) oxygenation.

B) ventilation. The patient overdosed on a narcotic, which has suppressed his respiratory system and is preventing him from ventilating adequately. This failure of ventilation causes a ripple effect. If ventilation is inadequate, oxygen is not effectively drawn into the lungs and carbon dioxide cannot be effectively eliminated. Therefore, pulmonary respiration is negatively affected. If oxygen cannot be drawn into the lungs, it cannot be delivered to the cells; therefore, cellular respiration is negatively affected, which results in inadequate perfusion.

Which of the following medical history questions would be of LEAST pertinence in an acute situation? A. "Does the pain stay in your chest?" B. "Does your mother have diabetes?" C. "Has this ever happened to you before?" D. "Are there medications that you cannot take?"

B. "Does your mother have diabetes?"

Which of the following statements is MOST consistent with the bargaining phase of the grieving process? A. "It is because of our lousy health care system that I developed this brain tumor." B. "I will be compliant with all my medications if I can just see my grandson graduate." C. "I understand that my death is inevitable and I am ready to die when the time comes." D. "The doctors must be wrong in their diagnosis because I have always been healthy."

B. "I will be compliant with all my medications if I can just see my grandson graduate."

Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT: A. "Am I going to die?" B. "What hospital am I going to?" C. "What are you doing to me?" D. "Will I be permanently disabled?"

B. "What hospital am I going to?"

At what age does separation anxiety typically peak in infants and small children? A. 6 to 8 months B. 10 to 18 months C. 18 to 24 months D. 24 to 36 months

B. 10 to 18 months

Trench collapses usually involve large areas of falling dirt that weigh approximately _______ per cubic foot. A. 50 lb B. 100 lb C. 150 lb D. 200 lb

B. 100 lb

When parking your ambulance at the scene of a motor vehicle crash, you should position the ambulance: A. 50′ past the scene on the opposite side of the road. B. 100′ past the scene on the same side of the road. C. 50′ before the scene on the same side of the road. D. alongside the scene to rapidly access the patient(s).

B. 100′ past the scene on the same side of the road.

The normal respiratory rate for an adult should range from: A. 10 to 15 breaths per minute. B. 12 to 20 breaths per minute. C. 18 to 24 breaths per minute. D. 24 to 28 breaths per minute.

B. 12 to 20 breaths per minute.

The human body should be functioning at its optimal level between the ages of: A. 18 and 22 years. B. 19 and 25 years. C. 21 and 30 years. D. 25 and 35 years.

B. 19 and 25 years.

When you assess capillary refill time (CRT) in an infant, normal color to the tested area should return within: A. 1 second. B. 2 seconds. C. 3 seconds. D. 4 seconds.

B. 2 seconds.

Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child? A. 12.5 g B. 20 g C. 25 g D. 50 g

B. 20 g

The air you breathe is _______ oxygen, and the air you exhale is _______ oxygen. A. 16%, 25% B. 21%, 16% C. 25%, 32% D. 21%, 35%

B. 21%, 16%

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response? A. 2 B. 3 C. 4 D. 5

B. 3

If a mask cannot be placed on a coughing patient, the Centers for Disease Control and Prevention (CDC) recommend that you maintain a distance of at least ________ feet if possible. A. 2 B. 3 C. 4 D. 5

B. 3

A portable oxygen cylinder should have a capacity of a minimum of ____ of oxygen. A. 250 L B. 500 L C. 750 L D. 1,000 L

B. 500 L

An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than: A. 200 psi. B. 500 psi. C. 1,000 psi. D. 1,500 psi.

B. 500 psi.

You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving? A. 45% B. 55% C. 65% D. 75%

B. 55%

Febrile seizures are MOST common in children between: A. 3 months and 4 years. B. 6 months and 6 years. C. 8 months and 8 years. D. 18 months and 10 years.

B. 6 months and 6 years.

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: A. 4 years. B. 6 years. C. 8 years. D. 10 years.

B. 6 years.

The normal respiratory rate for a newborn should not exceed ______ breaths/min. A. 50 B. 60 C. 70 D. 80

B. 60

The full-body scan of a patient that occurs following the primary assessment should take no longer than: A. 30 seconds. B. 60 to 90 seconds. C. 90 to 120 seconds. D. 120 to 180 seconds.

B. 60 to 90 seconds.

The average pulse rate of individuals between 19 and 60 years of age is typically: A. 60 beats/min. B. 70 beats/min. C. 80 beats/min. D. 90 beats/min.

B. 70 beats/min.

The pulse rate of a child from ages 6 to 12 years is approximately: A. 60 to 100 beats/min. B. 70 to 120 beats/min. C. 90 to 140 beats/min. D. 100 to 150 beats/min.

B. 70 to 120 beats/min.

During each heartbeat, ___________ of blood is ejected from the adult heart. This is called stroke volume (SV). A. 40 to 50 mL B. 70 to 80 mL C. 90 to 100 mL D. 100 to 120 mL

B. 70 to 80 mL

What occurs when a patient is breathing very rapidly and shallowly? A. Minute volume increases because of a marked increase in both tidal volume and respiratory rate. B. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange. C. Air is forcefully drawn into the lungs due to the negative pressure created by the rapid respirations. D. The majority of tidal volume reaches the lungs and diffuses across the alveolar-capillary membrane.

B. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange.

Causes of delirium in the older patient include all of the following, EXCEPT: A. acute hypovolemia. B. Alzheimer disease. C. low blood sugar level. D. decreased cerebral perfusion.

B. Alzheimer disease.

Which of the following scenarios MOST accurately depicts informed consent? A. A patient advises an EMT of why he or she is refusing care. B. An EMT advises a patient of the risks of receiving treatment. C. An EMT initiates immediate care for an unconscious adult. D. A patient is advised by an EMT of the risks of refusing care.

B. An EMT advises a patient of the risks of receiving treatment.

Which of the following statements regarding an emergency patient move is correct? A. The spine must be fully immobilized prior to performing an emergency move. B. An emergency move is performed before the primary assessment and treatment. C. The patient is dragged against the body's long axis during an emergency move. D. It is not possible to perform an emergency move without injuring the patient.

B. An emergency move is performed before the primary assessment and treatment.

Which of the following statements regarding an infant's vital signs is correct? A. An infant's heart rate generally ranges between 70 and 110 beats/min. B. An infant's normal body temperature is typically higher than a preschooler's. C. By 6 months of age, an infant's normal tidal volume is 2 to 4 mL/kg. D. An infant's normal heart rate increases by 10 beats/min each month.

B. An infant's normal body temperature is typically higher than a preschooler's.

Which of the following is an anatomic difference between children and adults? A. The ribcage of an infant is less flexible than an adult's. B. An infant's tongue is proportionately larger than an adult's. C. The trachea of an infant is proportionately longer than an adult's. D. An infant's head accounts for less body weight than an adult's.

B. An infant's tongue is proportionately larger than an adult's.

Which of the following statements regarding anaerobic metabolism is correct? A. Anaerobic metabolism can be supported in most of the body's cells for up to 10 minutes. B. Anaerobic metabolism produces lactic acid and occurs when cellular oxygen is limited. C. The body functions optimally and produces maximum ATP during anaerobic metabolism. D. Without anaerobic metabolism, perfusion to the body would suffer and cellular death would occur.

B. Anaerobic metabolism produces lactic acid and occurs when cellular oxygen is limited.

Which of the following is a major difference between angina pectoris and AMI? A. AMI is caused by myocardial ischemia. B. Anginal pain typically subsides with rest. C. Nitroglycerin has no effect on angina pectoris. D. Pain from an AMI subsides within 30 minutes.

B. Anginal pain typically subsides with rest.

Which of the following statements regarding gastrointestinal bleeding is correct? A. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself. C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome. D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder? A. vertical-position flowmeter B. Bourdon-gauge flowmeter C. ball-and-float flowmeter D. pressure-compensated flowmeter

B. Bourdon-gauge flowmeter

Minimum airway and ventilation equipment that should be carried on every ambulance include all of the following, EXCEPT: A. various sizes of oral and nasal airways. B. Combitubes or laryngeal mask airways. C. mounted and portable suctioning units. D. adult and pediatric bag-mask devices.

B. Combitubes or laryngeal mask airways.

Which of the following statements regarding crush syndrome is correct? A. With crush syndrome, massive blood vessel damage occurs following severe soft-tissue injuries, such as amputation of an extremity. B. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours. C. Tissue damage that occurs in crush syndrome is severe, but kidney injury is unlikely because toxins are quickly eliminated from the body. D. Provided that a patient with a crush injury is freed from entrapment within 6 hours, the amount of tissue damaged is generally minimal.

B. Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.

With regard to the legal implications of child abuse: A. child abuse must be reported only if it can be proven. B. EMTs must report all suspected cases of child abuse. C. you should document your perceptions on the run form. D. a supervisor can forbid you from reporting possible abuse.

B. EMTs must report all suspected cases of child abuse.

What should you do before attempting to access a patient trapped in a vehicle? A. Check for other patients. B. Ensure the vehicle is stable. C. Request another ambulance. D. Contact medical control.

B. Ensure the vehicle is stable.

Which of the following statements regarding glucose is correct? A. Glucose is a complex sugar that rapidly absorbs into the bloodstream. B. Glucose is a simple sugar that is readily absorbed by the bloodstream. C. Glucose is given to patients who are suspected of being hyperglycemic. D. Glucose is usually administered by the EMT via the intravenous route.

B. Glucose is a simple sugar that is readily absorbed by the bloodstream.

Which of the following statements regarding trench rescue is correct? A. Rescue vehicles should park at least 250′ from the scene. B. Ground vibration is a primary cause of secondary collapse. C. A trench deeper than 10′ should be shored prior to entry. D. Most deaths involving cave-ins are caused by head injury.

B. Ground vibration is a primary cause of secondary collapse.

You have two patients who were involved in a motor vehicle crash when their SUV struck a tree—one with neck and back pain, and the other with a deformed left femur. The patient with the deformed femur states that he does not want to be placed on a hard board, nor does he want a collar around his neck. What is the MOST appropriate and practical method of securing these patients and placing them into the ambulance? A. Immobilize both patients with a cervical collar and long backboard based on the mechanism of injury; place one on the wheeled stretcher and the other on the squad bench. B. Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench. C. Immobilize the patient with neck and back pain on a long backboard and place him on the squad bench; allow the patient with the deformed femur to sit on the wheeled stretcher. D. Apply a traction splint to the patient with the deformed femur and place him on the wheeled stretcher; place the patient with neck and back pain on the squad bench immobilized with a cervical collar and scoop stretcher.

B. Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench.

Which of the following statements regarding the vitreous humor is correct? A. It is a clear, watery fluid that cannot be replaced if it is lost during an eye injury. B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost. C. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost. D. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost.

B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.

What is the function of the left atrium? A. It ejects oxygenated blood into the aorta. B. It receives oxygenated blood from the lungs. C. It receives blood from the pulmonary arteries. D. It receives oxygenated blood from the vena cava.

B. It receives oxygenated blood from the lungs.

Which of the following statements regarding methicillin-resistant Staphylococcus aureus (MRSA) is correct? A. Most cases of MRSA transmission occur following an accidental needlestick. B. MRSA is a bacterium that causes infections and is resistant to most antibiotics. C. The communicable period for MRSA is 10 days to 2 weeks after being infected. D. Studies have shown that less than 1% of health care providers are MRSA carriers.

B. MRSA is a bacterium that causes infections and is resistant to most antibiotics.

When gathering a patient's medications, you find the following: Isordil, Lasix, Motrin, and Digoxin. Which of these medications can be obtained over-the-counter (OTC)? A. Lasix B. Motrin C. Isordil D. Digoxin

B. Motrin

Which of the following statements regarding the hepatitis B vaccine is correct? A. Vaccination against hepatitis B provides partial immunity for life. B. OSHA requires that your employer offer you the vaccine free of charge. C. The hepatitis B vaccine provides protection against the disease for 2 years. D. Vaccination with the hepatitis B vaccine confers immunity against hepatitis A.

B. OSHA requires that your employer offer you the vaccine free of charge.

Which of the following statements regarding normal gas exchange in the lungs is correct? A. The oxygen content in the alveoli is highest during the exhalation phase. B. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries. C. The actual exchange of oxygen and carbon dioxide occurs in the capillaries. D. Blood that returns to the lungs from the body has a low carbon dioxide content.

B. Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries.

Which of the following statements regarding parenteral medications is correct? A. Tylenol is an example of a parenteral medication because it is taken orally. B. Parenteral medications are absorbed more quickly than enteral medications. C. Compared to enteral medications, parenteral medications have fewer side effects. D. Parenteral medications are absorbed by the body through the digestive system.

B. Parenteral medications are absorbed more quickly than enteral medications.

Which of the following statements regarding patients with developmental disabilities is correct? A. Speaking with the patient's family is the least effective way to determine how much the patient understands. B. Patients with developmental disabilities are susceptible to the same disease processes as other patients. C. A developmental disability differs from mental retardation in that it is the result of a congenital abnormality. D. Most patients with developmental disabilities have normal cognitive function, but abnormal physical features.

B. Patients with developmental disabilities are susceptible to the same disease processes as other patients.

Which of the following is the MOST accurate guide to palpating a pulse? A. Avoid compressing the artery against a bone or solid structure. B. Place the tips of your index and long fingers over the pulse point. C. Use your thumb to increase the surface area that you are palpating. D. Apply firm pressure to the artery with your ring and little fingers.

B. Place the tips of your index and long fingers over the pulse point.

Which of the following patients would MOST likely require insertion of an oropharyngeal airway? A. a 33-year-old semiconscious patient with reduced tidal volume B. a 40-year-old unconscious patient with slow, shallow respirations C. a 51-year-old confused patient with severely labored respirations D. a 64-year-old conscious patient with rapid and deep respirations

B. a 40-year-old unconscious patient with slow, shallow respirations

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is MOST correct? A. You should contact the police and have the patients arrested. B. The 39-year-old female is at high risk for an infection. C. The patient struck in the mouth should be immobilized. D. The 44-year-old female is at high risk for an infection.

B. The 39-year-old female is at high risk for an infection.

In which of the following situations is an emergency patient move indicated? A. A patient has an altered mental status or is in shock. B. The EMT is unable to protect the patient from scene hazards. C. The EMT has to gain access to lesser-injured patients in a vehicle. D. A significant mechanism of injury is involved.

B. The EMT is unable to protect the patient from scene hazards.

Which of the following statements regarding the rule of nines is correct? A. A child's head is equal to 14% of his or her total BSA. B. The anterior trunk of an adult is equal to 18% of the BSA. C. The posterior of a child's leg is equal to 13.5% of the BSA. D. The anterior arm in the adult is equal to 9% of the total BSA.

B. The anterior trunk of an adult is equal to 18% of the BSA.

Which of the following MOST accurately describes hyperthermia? A. The core body temperature exceeds 99.5°F (37°C). B. The body is exposed to more heat than it can lose. C. Heat evaporates a significant amount of body water. D. The body eliminates more heat than it can generate.

B. The body is exposed to more heat than it can lose.

Which of the following statements regarding the dermis is correct? A. The dermis produces a substance that provides color to the skin. B. The dermis contains hair follicles, sweat glands, and nerve endings. C. The cells of the dermis are worn away and are constantly replaced. D. The dermis lies above the germinal layer and provides protection.

B. The dermis contains hair follicles, sweat glands, and nerve endings.

Which of the following statements regarding the medulla oblongata is correct? A. The medulla reduces the rate and depth of breathing if it detects an increase in carbon dioxide levels. B. The medulla is sensitive to pH changes and sends messages via the phrenic nerve to contract the diaphragm. C. The medulla's primary role is to increase your level of oxygen, not to decrease your level of carbon dioxide. D. The medulla is a portion of the cerebrum and primarily responds to an increase in the pH of CSF.

B. The medulla is sensitive to pH changes and sends messages via the phrenic nerve to contract the diaphragm.

Which of the following describes the Moro reflex? A. When something touches a neonate's cheek, he or she instinctively turns his or her head toward the touch. B. The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled. C. An infant's heart rate decreases secondary to hypoxia because he or she depends heavily on the heart rate to perfuse the body. D. When the sole of the foot is stroked with a blunt object, the big toe lifts upward and the other toes fan outward.

B. The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled.

Which of the following observations or statements represents the "E" in the GEMS diamond? A. Elderly patients present atypically and deserve your respect. B. The patient's residence is cold due to a malfunctioning heater. C. A patient is assisted with his or her activities of daily living. D. The patient's medications have not been filled in 2 months.

B. The patient's residence is cold due to a malfunctioning heater.

Which of the following statements regarding positive-pressure ventilation is correct? A. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body. B. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing. C. To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation. D. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure.

B. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever? A. a 3-month-old female who was born prematurely B. a 17-year-old male with depression and anxiety C. a 35-year-old female in the later stages of AIDS D. an 88-year-old male with chronic renal problems

B. a 17-year-old male with depression and anxiety

On which of the following patients would it be MOST appropriate to use the flow-restricted, oxygenpowered ventilation device? A. an 8-year-old female with respiratory failure B. a 21-year-old male with traumatic cardiac arrest C. a 38-year-old apneic female with blunt chest trauma D. a 59-year-old male with chronic obstructive pulmonary disease (COPD)

B. a 21-year-old male with traumatic cardiac arrest

In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway? A. a 24-year-old male who is found unconscious at the base of a tree B. a 37-year-old female who is found unconscious in her bed C. a 45-year-old male who is semiconscious after falling 20 feet D. a 50-year-old male who is unconscious following head trauma

B. a 37-year-old female who is found unconscious in her bed

Spina bifida is MOST accurately defined as: A. congenital inflammation of the spinal cord, usually in the neck. B. a birth defect caused by incomplete closure of the spinal column. C. a birth defect in which the child is born without spinal vertebrae. D. chronic pressure on the brain caused by excess cerebrospinal fluid.

B. a birth defect caused by incomplete closure of the spinal column.

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient's clinical presentation is MOST consistent with: A. a lacerated globe. B. a blowout fracture. C. a ruptured eyeball. D. optic vessel compression.

B. a blowout fracture.

In order for electricity to flow through the body and cause damage: A. an insulator must exist between the electrical source and the patient. B. a complete circuit must exist between the electrical source and the ground. C. the part of the body that is in contact with the electrical source must be dry. D. the person must make direct physical contact with the source of electricity.

B. a complete circuit must exist between the electrical source and the ground.

Age-related changes in the renal system result in: A. a significant increase in filtration, which causes the excretion of large amounts of water from the body. B. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. C. the formation of large amounts of urine secondary to an increase in kidney mass of up to 20%. D. dilation of the blood vessels that supply the nephrons, which allows the kidneys to maintain their function.

B. a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed.

The MOST reliable sign of a head injury is: A. a pulse that is rapid and thready. B. a decreased level of consciousness. C. an abnormally low blood pressure. D. decreased sensation in the extremities.

B. a decreased level of consciousness.

A ventilation/perfusion (V/Q ratio) mismatch occurs when: A. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange. B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen. C. ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body. D. a traumatic injury or medical condition impairs the body's ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.

B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.

Negative pressure breathing involves: A. relaxing the respiratory muscles. B. a drop in pressure within the chest cavity. C. pushing or forcing air into the lungs. D. increasing airway resistance during breathing.

B. a drop in pressure within the chest cavity.

Acute coronary syndrome (ACS) is a term used to describe: A. the warning signs that occur shortly before a heart attack. B. a group of symptoms that are caused by myocardial ischemia. C. a severe decrease in perfusion caused by changes in heart rate. D. the exact moment that a coronary artery is completely occluded.

B. a group of symptoms that are caused by myocardial ischemia.

Characteristics of a safe ambulance operator include: A. the ability to operate an ambulance at a high rate of speed. B. a positive attitude about the ability to tolerate other drivers. C. realizing that lights and siren will be effective traffic tools. D. an offensive attitude about driving during an emergency call.

B. a positive attitude about the ability to tolerate other drivers.

The EMT should be MOST concerned when a child presents with fever and: A. chills. B. a rash. C. ear pain. D. a headache.

B. a rash.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: A. a decreased ability to shiver. B. a relatively small surface area. C. a smaller amount of body fat. D. a smaller overall muscle mass.

B. a relatively small surface area.

In which of the following situations does the EMT NOT have a legal duty to act? A. a response to the residence of a patient who fell B. a response to a motor vehicle crash while off duty C. a response to an injured patient while off duty D. Local policy requires you to assist in any emergency.

B. a response to a motor vehicle crash while off duty

Characteristic anatomic features of Down syndrome include: A. a proportionately small tongue. B. a round head with a flat occiput. C. bulging eyes and a large face. D. long hands with wide fingers.

B. a round head with a flat occiput.

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: A. acute hypoglycemia. B. a ruptured cerebral artery. C. a complex partial seizure. D. an occluded cerebral artery.

B. a ruptured cerebral artery.

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient's injuries because: A. they must make arrangements for an ICU bed. B. a specialist may need to be called. C. it saves time on repeat assessments at the hospital. D. most patients with facial trauma will need surgery.

B. a specialist may need to be called.

Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? A. anxiety or severe stress B. beta-blocker medications C. internal bleeding from trauma D. lack of a regular exercise routine

B. beta-blocker medications

Subcutaneous injections deliver the medication: A. directly into the muscle tissue. B. between the skin and the muscle. C. below the first layer of muscle. D. in the mucosa under the tongue.

B. between the skin and the muscle.

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.

Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss? A. avulsion B. abrasion C. incision D. laceration

B. abrasion

Equipment and supplies that are carried on an ambulance should be stored: A. as directed by the EMS system's medical director. B. according to the urgency and frequency of their use. C. based on recommendations of the health department. D. in locked or secured cabinets in order to prevent theft.

B. according to the urgency and frequency of their use.

When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT: A. factually document all findings. B. accuse a caregiver of physical abuse. C. ask the patient how the bruises occurred. D. review the patient's activities of daily living.

B. accuse a caregiver of physical abuse.

You are transporting an elderly woman who has possibly experienced a stroke. She is obviously scared but is unable to talk and cannot move the entire right side of her body. In addition to providing the medical care that she needs, you should: A. reassure her that after proper treatment in the hospital, she will regain her speech in time. B. acknowledge that she is scared and tell her that you are going to take good care of her. C. maintain eye contact at all times and tell her that there is no need for her to be scared. D. tell her that you understand why she is scared and that everything will likely be okay.

B. acknowledge that she is scared and tell her that you are going to take good care of her.

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal layer, function by: A. regenerating brain cells after they have been damaged. B. acting as a shock absorber for the brain and spinal cord. C. delivering oxygen directly to the CNS. D. producing leukocytes that protect the brain from infection.

B. acting as a shock absorber for the brain and spinal cord.

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.

While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to: A. give the patient nitroglycerin to increase his blood pressure. B. administer drugs via the IV route to achieve the fastest effect. C. give the patient activated charcoal to rule out a drug overdose. D. withhold drug therapy until an intraosseous catheter is in place.

B. administer drugs via the IV route to achieve the fastest effect.

You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient high-flow oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should: A. notify dispatch and request that a paramedic unit respond to the scene so they can administer epinephrine to the patient. B. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital. C. elevate the patient's legs 6″ to 12″, keep her warm, begin transport to the hospital, and request a paramedic intercept en route. D. immediately load the patient into the ambulance, begin transport, and reattempt to contact medical control when you receive a cell signal.

B. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital.

A 59-year-old male presents with a sudden onset of severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should: A. vigorously palpate the abdomen to establish pain severity. B. administer oxygen and prepare for immediate transport. C. place the patient in a sitting position and transport at once. D. request a paramedic unit to give the patient pain medication.

B. administer oxygen and prepare for immediate transport.

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should: A. perform a focused physical exam of his abdomen. B. administer oxygen and prepare for rapid transport. C. place him in a sitting position and give him oxygen. D. conclude that he is experiencing intracranial bleeding.

B. administer oxygen and prepare for rapid transport.

You have just delivered a major trauma patient to the hospital. Shortly after departing the hospital, dispatch advises you of another call. The back of the ambulance is contaminated with bloody dressings and is in disarray, and you are in need of airway equipment and numerous other supplies. You should: A. proceed to the call, functioning only as an emergency medical responder. B. advise the dispatcher that you are out of service and to send another unit. C. have your partner quickly clean the ambulance as you proceed to the call. D. quickly proceed to the call and clean and restock the ambulance afterwards.

B. advise the dispatcher that you are out of service and to send another unit.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made: A. once the patient's baseline vital signs are known. B. after the primary assessment has been completed. C. upon completion of a detailed secondary assessment. D. as soon as the patient voices his or her chief complaint.

B. after the primary assessment has been completed.

Bone marrow produces: A. platelets. B. blood cells. C. lymphocytes. D. electrolytes.

B. blood cells.

When assessing an 80-year-old patient in shock, it is important to remember that: A. it is common to see a more significant increase in heart rate than what would be expected in younger adults. B. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion. C. the patient's cardiac output is able to increase by nearly 200% in response to the decrease in perfusion. D. in older adults, it is especially common to observe a significant decrease in heart rate in response to shock.

B. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion.

The MOST significant complication associated with facial injuries is: A. damage to the eyes. B. airway compromise. C. cervical spine injury. D. mandibular immobility.

B. airway compromise.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. B. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. C. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. D. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.

B. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

Palliating factors regarding a patient's pain involve those that: A. worsen the pain. B. alleviate the pain. C. initiate the pain. D. change the pain.

B. alleviate the pain.

Braxton-Hicks contractions are characterized by: A. regular contractions of progressively increasing intensity. B. alleviation of pain with movement or changing positions. C. pink or red bloody show in conjunction with the contractions. D. a rupture of the amniotic sac just before the contractions begin.

B. alleviation of pain with movement or changing positions.

During the attempted resuscitation of an infant with suspected SIDS: A. discourage the family from observing. B. allow the family to observe if they wish. C. a law enforcement officer must be present. D. give detailed updates to the infant's parents.

B. allow the family to observe if they wish.

The purpose of the pediatric assessment triangle (PAT) is to: A. determine if the child's vital signs are within the age-appropriate limits. B. allow you to rapidly and visually form a general impression of the child. C. facilitate a rapid head-to-toe assessment of the child by visualization only. D. gather critical data by performing a rapid hands-on assessment of the child.

B. allow you to rapidly and visually form a general impression of the child.

The actual exchange of oxygen and carbon dioxide occurs in the: A. bronchioles. B. alveolar sacs. C. apex of the lung. D. pulmonary capillaries.

B. alveolar sacs.

As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the: A. pleura. B. alveoli. C. bronchi. D. capillaries.

B. alveoli.

Any unresponsive trauma patient should be assumed to have: A. a history of diabetes mellitus. B. an accompanying spinal injury. C. a severe intracranial hemorrhage. D. internal bleeding in the abdomen.

B. an accompanying spinal injury.

An area of swelling or enlargement in a weakened arterial wall is called: A. a thrombus. B. an aneurysm. C. an embolism. D. atherosclerosis.

B. an aneurysm.

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of: A. acute pancreatitis. B. an aortic aneurysm. C. a kidney infection. D. acute appendicitis.

B. an aortic aneurysm.

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: A. ileus. B. an ulcer. C. appendicitis. D. cholecystitis.

B. an ulcer.

You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the health care system caused his disease. What stage of the grieving process is this patient's behavior consistent with? A. denial B. anger C. bargaining D. depression

B. anger

Which of the following is a severe burn in a 2-year-old child? A. superficial burn that covers 25% of the BSA B. any full-thickness burn, regardless of its location on the body C. partial-thickness burn that covers 10% of the BSA D. any burn that involves the arms, legs, or posterior part of the body

B. any full-thickness burn, regardless of its location on the body

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? A. flail chest B. aortic rupture C. extremity fractures D. forehead lacerations

B. aortic rupture

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.

An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should: A. slide a scoop stretcher under his buttocks and rotate him laterally. B. apply a cervical collar and immobilize him with a vest-style device. C. perform a detailed head-to-toe assessment and apply a cervical collar. D. maintain manual stabilization of his head and grasp him by the clothes.

B. apply a cervical collar and immobilize him with a vest-style device.

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A. ensure that his airway is patent. B. apply direct pressure to the wound. C. elevate his legs and keep him warm. D. administer 100% supplemental oxygen.

B. apply direct pressure to the wound.

Which of the following would NOT cause a decrease in tidal volume? A. shallow breathing B. deep respirations C. irregular breathing D. agonal respirations

B. deep respirations

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should: A. splint the elbow in the position of deformity and transport immediately. B. apply gentle manual traction in line with the limb and reassess for a pulse. C. carefully straighten the injured arm and secure it with padded board splints. D. make two or three attempts to restore distal circulation by manipulating the elbow.

B. apply gentle manual traction in line with the limb and reassess for a pulse.

When a helicopter must land on a grade (uneven ground), you should: A. approach the aircraft from the uphill side. B. approach the aircraft from the downhill side. C. attempt to approach the aircraft from behind. D. move the patient to the aircraft as soon as it lands.

B. approach the aircraft from the downhill side.

When evaluating the mechanism of injury of a car versus pedestrian collision, you should first: A. determine if the patient was propelled away from the vehicle. B. approximate the speed of the vehicle that struck the pedestrian. C. evaluate the vehicle that struck the patient for structural damage. D. determine if the patient was struck and pulled under the vehicle.

B. approximate the speed of the vehicle that struck the pedestrian.

A short backboard or vest-style immobilization device is indicated for patients who: A. are found supine and have stable vital signs. B. are in a sitting position and are clinically stable. C. require prompt extrication from an automobile. D. are sitting in their car and are clinically unstable.

B. are in a sitting position and are clinically stable.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: A. are elderly. B. are in denial. C. cannot afford it. D. do not trust EMTs.

B. are in denial.

The kidneys and pancreas are called retroperitoneal organs because they: A. are protected by the anterior rib cage. B. are located behind the abdominal cavity. C. sit in front of the liver, spleen, and stomach. D. lie just anterior to the costovertebral angle.

B. are located behind the abdominal cavity.

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: A. have minor abrasions to the head area. B. are taking blood-thinning medications. C. do not have deformities to the skull. D. have a history of Alzheimer disease.

B. are taking blood-thinning medications.

Under what circumstances is a left ventricular assist device used? A. to permanently replace the function of one or both of the ventricles B. as a bridge to heart transplantation while a donor heart is being located C. to reduce ventricular pumping force in patients with aortic aneurysms D. to ensure that the ventricles contract at an adequate and consistent rate

B. as a bridge to heart transplantation while a donor heart is being located

Poor peripheral circulation will cause the skin to appear: A. pink. B. ashen. C. flushed. D. cyanotic.

B. ashen.

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should: A. avoid giving him nitroglycerin and transport him at once. B. ask him what he takes, how much, and when he last took it. C. recall that erectile dysfunction drugs can cause hypertension if given with nitroglycerin. D. administer his nitroglycerin and then reassess his blood pressure.

B. ask him what he takes, how much, and when he last took it.

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should: A. break the window and unlock the door. B. ask the patient if he can unlock the door. C. request the rescue team to extricate him. D. use a pry bar to attempt to open the door.

B. ask the patient if he can unlock the door.

Which of the following will MOST reliably allow you to determine the nature of a patient's illness? A. trending of the patient's vital signs over time B. asking questions related to the chief complaint C. refraining from asking open-ended questions D. focusing solely on how the call is dispatched

B. asking questions related to the chief complaint

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? A. furosemide (Lasix) B. aspirin C. oxygen D. digoxin (Lanoxin)

B. aspirin

Acting in such a way as to make another person fear immediate bodily harm is called: A. libel. B. assault. C. battery. D. negligence.

B. assault.

After your partner assumes manual in-line stabilization of the patient's head, you should: A. apply an appropriately sized rigid cervical collar. B. assess distal neurovascular status in the extremities. C. thoroughly palpate the patient's head for deformities. D. use four people to log roll the patient onto a backboard.

B. assess distal neurovascular status in the extremities.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should: A. apply an AED and assess his cardiac rhythm. B. assess for a carotid pulse for up to 45 seconds. C. open his airway and give two rescue breaths. D. apply chemical heat packs to his groin and axillae.

B. assess for a carotid pulse for up to 45 seconds.

Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children? A. heart rate B. blood pressure C. skin condition D. capillary refill

B. blood pressure

The anterior aspect of the cerebrum controls: A. touch. B. emotion. C. movement. D. vision.

B. emotion.

A 62-year-old male presents with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering 100% oxygen and contacting medical control, you should: A. begin immediate transport and request a rendezvous with a paramedic unit. B. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg. C. administer up to three doses of nitroglycerin before assessing his blood pressure. D. administer the nitroglycerin unless he has taken Viagra within the past 72 hours.

B. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg.

You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. You should: A. attempt to insert an oropharyngeal airway. B. assist his ventilations with a bag-mask device. C. apply a continuous positive airway pressure (CPAP) device and monitor his breathing. D. apply high-flow oxygen via nonrebreathing mask.

B. assist his ventilations with a bag-mask device.

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: A. allow the mother to drive her daughter to the hospital. B. attempt cooling measures, offer oxygen, and transport. C. place the child in cold water to attempt to reduce her fever. D. suspect that the child has meningitis and transport at once.

B. attempt cooling measures, offer oxygen, and transport.

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should: A. try to locate the documentation. B. attempt to resuscitate the patient. C. allow the patient to die in peace. D. contact medical control for advice.

B. attempt to resuscitate the patient.

Both areas of the pons are used to: A. provide forced inspiration or expiration as needed. B. augment respirations during emotional or physical stress. C. ensure that the lungs do not overinflate during breathing. D. set the base rate and depth of breathing in a healthy person.

B. augment respirations during emotional or physical stress.

An EMT may administer aspirin to a patient if: A. the patient is currently experiencing hypotension. B. authorization from medical control has been obtained. C. transport time to the hospital is greater than 30 minutes. D. the patient is believed to be experiencing an acute stroke.

B. authorization from medical control has been obtained.

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: A. carefully examine her eye and remove any foreign objects if needed. B. avoid applying pressure to the globe when you are covering the eye. C. ask her to move the injured eye to assess the integrity of the optic nerve. D. apply firm direct pressure to the injured eye and cover the opposite eye.

B. avoid applying pressure to the globe when you are covering the eye.

To avoid injury when pushing a patient or other object, you should: A. push the patient from an overhead position if possible. B. avoid pushing the patient with your elbows fully extended. C. push from the area of your body between the knees and hips. D. kneel if you are pushing an object that is above waist level.

B. avoid pushing the patient with your elbows fully extended.

An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n): A. incision. B. avulsion. C. laceration. D. amputation.

B. avulsion.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: A. transport him in a supine position. B. be alert for signs and symptoms of shock. C. assess his blood pressure to determine perfusion adequacy. D. determine the exact location and cause of his pain.

B. be alert for signs and symptoms of shock.

When assessing or providing care to a patient with a developmental disability, you should: A. explain procedures while in the process of performing them. B. be observant for signs of fear or reluctance from the patient. C. move swiftly and deliberately to quickly accomplish the task. D. frequently reassure him or her that everything will be okay.

B. be observant for signs of fear or reluctance from the patient.

You have been tasked by your medical director to assist in the development of your EMS agency's institutional standards. When developing these standards, it is important to: A. require personnel to transport all patients to the closest hospital. B. be reasonable and realistic to avoid overburdening your personnel. C. demand that all personnel consistently exceed the standard of care. D. expect personnel to function beyond their scope of practice if needed.

B. be reasonable and realistic to avoid overburdening your personnel.

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: A. obtain baseline vital signs. B. begin ventilatory assistance. C. attach the automated external defibrillator (AED) immediately. D. apply a nonrebreathing mask.

B. begin ventilatory assistance.

The central nervous system (CNS) is composed of the: A. cerebellum and brain. B. brain and spinal cord. C. cerebrum and meninges. D. meninges and spinal cord.

B. brain and spinal cord.

A fracture is MOST accurately defined as a(n): A. total loss of function in a bone. B. break in the continuity of the bone. C. disruption in the midshaft of a bone. D. abnormality in the structure of a bone.

B. break in the continuity of the bone.

When performing a full-body scan on a trauma patient, you note the presence of Battle's sign. This is defined as: A. unequal pupils. B. bruising behind the ear. C. swelling to the orbital area. D. fluid drainage from the nose.

B. bruising behind the ear.

A person's bones would become brittle if he or she was deficient in: A. sodium. B. calcium. C. potassium. D. magnesium.

B. calcium.

Hazards that are associated with a structural fire include all of the following, EXCEPT: A. smoke and toxic gases. B. carbon dioxide deficiency. C. high ambient temperatures. D. the risk of building collapse.

B. carbon dioxide deficiency.

When assessing an elderly male who complains of nausea and generalized weakness, you find that he takes simvastatin (Vytorin) and clopidogrel (Plavix). This medication regimen suggests a history of: A. bacterial infection. B. cardiovascular disease. C. reactive airway disease. D. non-insulin-dependent diabetes.

B. cardiovascular disease.

Clouding of the lenses of the eyes is called: A. retinitis. B. cataracts. C. glaucoma. D. conjunctivitis.

B. cataracts.

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may: A. depress the gag reflex. B. cause the child to vomit. C. result in airway swelling. D. result in a soft-tissue injury.

B. cause the child to vomit.

The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as: A. capitation. B. cavitation. C. congruent. D. conversion.

B. cavitation.

Which part of the central nervous system is responsible for coordinating bodily movements such as writing or sewing? A. cerebrum B. cerebellum C. brain stem D. hypothalamus

B. cerebellum

Muscle control and body coordination are controlled by the: A. cerebrum. B. cerebellum. C. brain stem. D. cerebral cortex.

B. cerebellum.

A temporary loss or alteration of part or all of the brain's abilities to function without physical damage to the brain MOST accurately describes a(n): A. cerebral contusion. B. cerebral concussion. C. intracranial hemorrhage. D. intracerebral hematoma.

B. cerebral concussion.

The MOST common and serious complication of a significant head injury is: A. a skull fracture. B. cerebral edema. C. a hypoxic seizure. D. acute hypotension.

B. cerebral edema.

The five sections of the spinal column, in descending order, are the: A. thoracic, cervical, lumbar, coccygeal, and sacral. B. cervical, thoracic, lumbar, sacral, and coccygeal. C. coccygeal, sacral, lumbar, thoracic, and cervical. D. cervical, coccygeal, thoracic, sacral, and lumbar.

B. cervical, thoracic, lumbar, sacral, and coccygeal.

Select the areas of the spinal column in descending order. A. cervical, thoracic, sacral, lumbar, coccyx B. cervical, thoracic, lumbar, sacral, coccyx C. cervical, thoracic, coccyx, lumbar, sacral D. cervical, lumbar, thoracic, sacral, coccyx

B. cervical, thoracic, lumbar, sacral, coccyx

If a technical rescue team is required at the scene, but is not present when you arrive, you should: A. don personal protective equipment and begin the rescue process. B. check with the incident commander to ensure that the team is en route. C. remain with your ambulance until the rescue team arrives at the scene. D. have fire personnel initiate the rescue process if they are at the scene.

B. check with the incident commander to ensure that the team is en route.

Common signs and symptoms of an airway burn include all of the following, EXCEPT: A. hoarseness. B. chest pressure. C. singed nasal hair. D. soot around the mouth.

B. chest pressure.

If it is not possible to adequately clean your ambulance at the hospital following a call, you should: A. quickly wipe down all high contact surfaces with an antibacterial solution. B. clean the ambulance at your station in a designated area that is well ventilated. C. wait until the end of your shift and then disinfect the entire patient compartment. D. thoroughly wash the back of the ambulance at a local car wash or similar facility.

B. clean the ambulance at your station in a designated area that is well ventilated.

In order for a do not resuscitate (DNR) order to be valid, it must: A. be dated within the previous 24 months. B. clearly state the patient's medical problem. C. be updated a minimum of every 6 months. D. be signed by the local justice of the peace.

B. clearly state the patient's medical problem.

The most distal four spinal vertebrae, which are fused together, form the: A. ilium. B. coccyx. C. sacrum. D. ischium.

B. coccyx.

When assessing a patient with a possible fracture of the leg, the EMT should: A. assess proximal circulation. B. compare it to the uninjured leg. C. carefully move it to elicit crepitus. D. ask the patient to move the injured leg.

B. compare it to the uninjured leg.

A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has: A. internal hemorrhage. B. compartment syndrome. C. a severe closed fracture. D. damage to the radial nerve.

B. compartment syndrome.

The frontal and parietal bones of the skull are especially susceptible to: A. basilar skull fractures. B. compressed skull fractures. C. linear skull fractures. D. nondisplaced skull fractures.

B. compressed skull fractures.

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called: A. radiation. B. conduction. C. convection. D. evaporation.

B. conduction.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: A. a cardiac arrhythmia. B. congestive heart failure. C. significant hypotension. D. right ventricular failure.

B. congestive heart failure.

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing: A. acute retinitis. B. conjunctivitis. C. a detached retina. D. a corneal abrasion.

B. conjunctivitis.

Which of the following nerves allow sensory and motor impulses to be sent from one nerve directly to another? A. somatic B. connecting C. peripheral D. autonomic

B. connecting

Which of the following is NOT a function of the sympathetic nervous system? A. dilation of blood vessels in the muscles B. constriction of blood vessels in the muscles C. increases in the heart and respiratory rates D. constriction of blood vessels in the digestive system

B. constriction of blood vessels in the muscles

You are dispatched to a movie theater for a 39-year-old female with signs and symptoms of an allergic reaction. As you are assessing her, she pulls an epinephrine auto-injector out of her purse and hands it to you. After administering 100% oxygen, you should: A. administer the drug. B. contact medical control. C. verify the medication name. D. check the drug's expiration date.

B. contact medical control.

A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n): A. abrasion. B. contusion. C. hematoma. D. crush injury.

B. contusion.

Signs of a pulmonary blast injury include: A. vomiting blood. B. coughing up blood. C. an irregular pulse. D. multiple rib fractures.

B. coughing up blood.

The firm cartilaginous ring that forms the inferior portion of the larynx is called the: A. costal cartilage. B. cricoid cartilage. C. thyroid cartilage. D. laryngo cartilage.

B. cricoid cartilage.

Which of the following is an indication of imminent birth? A. rupture of the amniotic sac B. crowning of the baby's head C. irregular contractions lasting 10 minutes D. expulsion of the mucus plug from the vagina

B. crowning of the baby's head

What type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years? A. acute stress reaction B. cumulative stress reaction C. posttraumatic stress reaction D. critical incident stress reaction

B. cumulative stress reaction

Which of the following is a late sign of hypoxia? A. anxiety B. cyanosis C. tachycardia D. restlessness

B. cyanosis

Drowning is MOST accurately defined as: A. temporary survival after submersion in water. B. death from suffocation after submersion in water. C. water in the lungs following submersion in water. D. death beyond 24 hours after submersion in water.

B. death from suffocation after submersion in water.

It is essential that you ____________ your equipment to prevent the spread of disease. A. throw out B. decontaminate C. burn D. store

B. decontaminate

Ischemic heart disease is MOST accurately defined as: A. absent myocardial blood flow due to a blocked coronary artery. B. decreased blood flow to one or more portions of the myocardium. C. death of a portion of the heart muscle due to a decrease in oxygen. D. decreased blood flow to the heart muscle due to coronary dilation.

B. decreased blood flow to one or more portions of the myocardium.

Why does the incidence of diabetes mellitus increase with age? A. decreased food intake, decreased weight gain, and decreased blood sugar levels B. decreased physical activity, increased weight gain, and decreased insulin production C. increased physical activity, increased food intake, and increased insulin production D. decreased physical activity, increased weight gain, and decreased blood sugar levels

B. decreased physical activity, increased weight gain, and decreased insulin production

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? A. collapsed dashboard B. deformed steering wheel C. caved-in passenger door D. intrathoracic hemorrhage

B. deformed steering wheel

Common signs and symptoms of a sprain include all of the following, EXCEPT: A. swelling. B. deformity. C. ecchymosis. D. point tenderness.

B. deformity.

A common cause of shock in an infant is: A. a cardiac arrhythmia. B. dehydration from vomiting and diarrhea. C. excessive tachycardia. D. cardiovascular disease.

B. dehydration from vomiting and diarrhea.

It is especially important for EMS personnel to develop nonadversarial relationships with their coworkers because they: A. are highly prone to stress and burnout. B. depend on each other for their safety. C. must work together every third day. D. may have to bunk in the same room.

B. depend on each other for their safety.

Which of the following signs is commonly observed in patients with right-sided heart failure? A. labored breathing B. dependent edema C. pulmonary edema D. flat jugular veins

B. dependent edema

When evaluating a patient with multiple complaints, the EMT's responsibility is to: A. direct his or her attention to the most obvious signs and symptoms. B. determine which complaint poses the greatest threat to the patient's life. C. definitively rule out serious causes of each of the patient's complaints. D. assess each complaint based on the patient's perception of its seriousness.

B. determine which complaint poses the greatest threat to the patient's life.

Which of the following MOST accurately defines negligence? A. transport of a mentally incompetent patient against his or her will B. deviation from the standard of care that may result in further injury C. transferring patient care to a provider with a lower level of training D. providing care that is consistent with care provided by other EMTs

B. deviation from the standard of care that may result in further injury

The ____________ is a muscular dome that forms the inferior boundary of the thorax, separating the thorax from the abdomen. A. costal arch B. diaphragm C. mediastinum D. costovertebral angle

B. diaphragm

The phase of the cardiac cycle in which the ventricles fill with blood is called: A. systole. B. diastole. C. cardiac output. D. stroke volume.

B. diastole.

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should: A. attempt to troubleshoot the ventilator problem. B. disconnect the ventilator and use a bag-mask device. C. place a call to the home health agency treating this patient. D. reset the ventilator by unplugging it for 30 to 60 seconds.

B. disconnect the ventilator and use a bag-mask device.

If a problem with a team member is not directly or immediately impacting patient care, the team leader should: A. engage the team member at once. B. discuss the problem after the call. C. contact the medical director at once. D. ignore the problem to avoid conflict.

B. discuss the problem after the call.

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of? A. unstable angina B. dissecting aortic aneurysm C. AMI D. hypertensive emergency

B. dissecting aortic aneurysm

A supracondylar or intercondylar fracture is also known as a fracture of the: A. radial head. B. distal humerus. C. proximal radius. D. olecranon process.

B. distal humerus.

A Colles fracture involves a fracture of the: A. distal ulna. B. distal radius. C. proximal radius. D. radius and ulna.

B. distal radius.

An older patient with significant dehydration would MOST likely present with: A. an increase in blood pressure upon standing. B. dizziness or fainting upon standing. C. weakness to one side of the body. D. a drop in heart rate upon standing.

B. dizziness or fainting upon standing.

The artery that can be palpated on the anterior surface of the foot is the: A. ventral pedis. B. dorsalis pedis. C. anterior tibial. D. posterior tibial.

B. dorsalis pedis.

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: A. extreme restlessness. B. drooling or congestion. C. skin that is cool and dry. D. acute respiratory distress.

B. drooling or congestion.

Prior to attaching the AED to a cardiac arrest patient, the EMT should: A. contact medical control. B. dry the chest off if it is wet. C. perform CPR for 30 seconds. D. assess for a pulse for 20 seconds.

B. dry the chest off if it is wet.

A patient whose speech is slurred and difficult to understand is experiencing: A. aphasia. B. dysarthria. C. dysphagia. D. paraplegia.

B. dysarthria.

The pulse oximeter is an assessment tool used to evaluate the: A. percentage of red blood cells. B. effectiveness of oxygenation. C. saturation level of venous blood. D. amount of exhaled carbon dioxide.

B. effectiveness of oxygenation.

If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then: A. tilt the board 30° to the right to prevent hypotension. B. elevate the right side of the board with rolled towels or blankets. C. raise the foot of the board 12″ in order to maintain blood pressure. D. elevate the head of the board 6″ to prevent breathing impairment.

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

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should: A. carefully look into his mouth and remove the object if you see it. B. encourage him to cough, give oxygen as tolerated, and transport. C. deliver a series of five back blows and then reassess his condition. D. place the child in a supine position and perform abdominal thrusts.

B. encourage him to cough, give oxygen as tolerated, and transport.

A 12-year-old male jumped approximately 12′ from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain? A. lateral impact to the spine B. energy transmission to the spine C. direct trauma to the spinal column D. secondary fall after the initial impact

B. energy transmission to the spine

When inserting an oropharyngeal airway in an infant or child, you should: A. place padding under the child's head. B. ensure that his or her neck is hyperextended. C. insert it until the flange rests on the teeth. D. depress the tongue with a tongue depressor.

B. ensure that his or her neck is hyperextended.

Before assessing the respiratory adequacy of an semiconscious infant or child, you must: A. routinely suction the mouth to remove oral secretions. B. ensure that the airway is patent and clear of obstructions. C. insert a nasopharyngeal or oropharyngeal airway adjunct. D. ensure that his or her head is in a hyperextended position.

B. ensure that the airway is patent and clear of obstructions.

Which of the following is the BEST example of gaining simple access to a patient? A. using a pry bar to open a damaged door B. entering a vehicle through an open window C. breaking glass to gain access to the patient D. removing the roof to access a critical patient

B. entering a vehicle through an open window

What layer of the skin forms a watertight, protective seal for the body? A. dermis B. epidermis C. muscular layer D. subcutaneous layer

B. epidermis

The leaf-shaped flap of tissue that prevents food and liquid from entering the trachea during swallowing is called the: A. uvula. B. epiglottis. C. vallecula. D. pharynx.

B. epiglottis.

Key hormones of the sympathetic nervous system include: A. acetylcholine and insulin. B. epinephrine and norepinephrine. C. glucagon and noradrenaline. D. norepinephrine and acetylcholine.

B. epinephrine and norepinephrine.

Hemoglobin is a molecule that attaches to ___________ and carries oxygen. A. monocytes B. erythrocytes C. leukocytes D. thrombocytes

B. erythrocytes

A 56-year-old female is found supine in a narrow hallway of her mobile home. She complains of severe weakness and dizziness, and states that she is unable to walk. There is no evidence of trauma and the patient states that she did not fall. How should you and your partner move this patient to a more spacious area? A. direct carry B. extremity lift C. scoop stretcher D. emergency move

B. extremity lift

Which of the following groups of people is associated with the lowest risk of meningitis? A. newborns B. females C. geriatrics D. children with shunts

B. females

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: A. elevate her legs 6″ to 8″ and cover her with a blanket. B. firmly massage the uterine fundus with a circular motion. C. carefully insert a sterile trauma dressing into her vagina. D. place her legs together and position her on her left side.

B. firmly massage the uterine fundus with a circular motion.

A burn that is characterized by redness and pain is classified as a: A. third-degree burn. B. first-degree burn. C. second-degree burn D. partial-thickness burn

B. first-degree burn.

Blood that is ejected from the right ventricle: A. enters the systemic circulation. B. flows into the pulmonary arteries. C. has a high concentration of oxygen. D. was received directly from the aorta.

B. flows into the pulmonary arteries.

Peritonitis may result in shock because: A. intra-abdominal hemorrhage is typically present. B. fluid shifts from the bloodstream into body tissues. C. abdominal distention impairs cardiac contractions. D. severe pain causes systemic dilation of the vasculature.

B. fluid shifts from the bloodstream into body tissues.

The __________ of a medication usually dictates the route by which it will be administered. A. type B. form C. class D. name

B. form

You should not attempt to lift a patient who weighs more than 250 lb with fewer than _______ rescuers, regardless of individual strength. A. three B. four C. five D. six

B. four

All of the following terms are used to describe a cold body part that is not frozen, EXCEPT: A. frostnip. B. frostbite. C. chilblains. D. trench foot.

B. frostbite.

The eyeball itself is referred to as the: A. orbit. B. globe. C. sclera. D. cornea.

B. globe.

If hydroplaning of the ambulance occurs, the driver should: A. slowly move the steering wheel back and forth. B. gradually slow down without jamming on the brakes. C. slowly pump the brakes until he or she regains vehicle control. D. quickly jerk the steering wheel.

B. gradually slow down without jamming on the brakes.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he: A. is allergic to any medications. B. has a history of eye surgeries. C. regularly sees a family physician. D. noticed the change during a meal.

B. has a history of eye surgeries.

When caring for a female child who has possibly been sexually abused, you should: A. encourage the child to urinate and take a shower. B. have a female EMT remain with her if possible. C. carefully examine the genitalia for signs of injury. D. immediately report your suspicions to the parents.

B. have a female EMT remain with her if possible.

In contrast to a Level III trauma center, a Level I trauma center must: A. be involved in trauma prevention programs. B. have general surgeons that are in-house 24 hours a day. C. have access to an emergency physician within 30 minutes. D. be able to stabilize patients before transferring to a higher level facility.

B. have general surgeons that are in-house 24 hours a day.

To minimize distractions and confusion when assessing an older patient, you should: A. dismiss the family members from the room or area. B. have only one EMT speak to the patient at a time. C. elevate your voice and speak directly to the patient. D. perform a physical exam and then talk to the patient.

B. have only one EMT speak to the patient at a time.

Common safety equipment carried on the ambulance includes all of the following, EXCEPT: A. face shields. B. hazardous materials gear. C. safety goggles. D. turnout gear.

B. hazardous materials gear.

Which of the following is an example of a symptom? A. cyanosis B. headache C. tachycardia D. hypertension

B. headache

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: A. an oral airway has been inserted. B. his or her tidal volume is adequate. C. his or her respirations are shallow. D. he or she is breathing inadequately.

B. his or her tidal volume is adequate.

The supporting bone of the arm is the: A. ulna. B. humerus. C. radius. D. clavicle.

B. humerus.

For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt? A. heart failure B. hydrocephalus C. cerebral palsy D. subdural hematoma

B. hydrocephalus

Which of the following medications is NOT used to treat patients with a history of seizures? A. phenytoin (Dilantin) B. hydromorphone (Dilaudid) C. carbamazepine (Tegretol) D. phenobarbital

B. hydromorphone (Dilaudid)

Common causes of seizures in children include all of the following, EXCEPT: A. infection. B. hyperglycemia. C. electrolyte imbalances. D. poisonings or ingestion.

B. hyperglycemia.

Common side effects of nitroglycerin include all of the following, EXCEPT: A. bradycardia. B. hypertension. C. hypotension. D. severe headache.

B. hypertension.

The MOST significant risk factor for a hemorrhagic stroke is: A. severe stress. B. hypertension. C. heavy exertion. D. diabetes mellitus.

B. hypertension.

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure? A. hypertension and tachycardia B. hypotension and flat jugular veins C. the presence of rales in the lungs D. trouble breathing while lying down

B. hypotension and flat jugular veins

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? A. hypoglycemia B. hypovolemia C. a postictal state D. intracranial bleeding

B. hypovolemia

The MOST significant complication associated with oropharyngeal suctioning is: A. oral abrasions from vigorous suctioning. B. hypoxia due to prolonged suction attempts. C. clogging of the catheter with thick secretions. D. vomiting from stimulating the anterior airway.

B. hypoxia due to prolonged suction attempts.

After performing a primary assessment, a rapid scan of the body should be performed in order to: A. determine the need for spinal motion restriction precautions. B. identify less obvious injuries that require immediate treatment. C. look specifically for signs and symptoms of inadequate perfusion. D. find and treat injuries or conditions that do not pose a threat to life.

B. identify less obvious injuries that require immediate treatment.

Each pelvic bone is formed by the fusion of the: A. sacrum and ischium. B. ilium, ischium, and pubis. C. pubis and acetabulum. D. ilium, pubis, and sacrum.

B. ilium, ischium, and pubis.

If you cannot palpate a pulse in an unresponsive patient, you should: A. attach an automated external defibrillator (AED) at once. B. immediately begin cardiopulmonary resuscitation (CPR). C. palpate at another pulse site. D. assess for adequate breathing.

B. immediately begin cardiopulmonary resuscitation (CPR).

After the AED has delivered a shock, the EMT should: A. assess for a carotid pulse. B. immediately resume CPR. C. reanalyze the cardiac rhythm. D. transport the patient at once.

B. immediately resume CPR.

A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain. The vehicle is stable and no hazards are present. When removing this patient from his vehicle, you should: A. use the rapid extrication technique. B. immobilize him with a vest-style device. C. maintain slight traction to his neck area. D. adequately secure him to a long backboard.

B. immobilize him with a vest-style device.

A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: A. acute pancreatitis. B. liver dysfunction. C. gallbladder disease. D. renal insufficiency.

B. liver dysfunction.

A 45-year-old male was working on his roof when he fell approximately 12′,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should: A. obtain a Glasgow Coma Score value and give him oxygen. B. immobilize his spine and perform a focused secondary exam. C. allow him to refuse transport if his vital signs remain stable. D. perform a rapid head-to-toe exam and immobilize his spine.

B. immobilize his spine and perform a focused secondary exam.

During your rapid secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The MOST appropriate treatment for this patient includes: A. applying and inflating the pneumatic antishock garment (PASG) and transporting. B. immobilizing her to a backboard and rapidly transporting. C. applying a traction splint to immobilize her femur. D. carefully splinting each of her deformed extremities.

B. immobilizing her to a backboard and rapidly transporting.

Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated? A. actual B. implied C. informed D. expressed

B. implied

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy? A. decreased respiratory rate and increased minute volume B. increased respiratory rate and decreased respiratory reserve C. increased respiratory reserve and decreased oxygen demand D. increased respiratory depth and decreased respiratory rate

B. increased respiratory rate and decreased respiratory reserve

While providing care to a patient, blood got onto the ambulance stretcher. Because the stretcher was not properly cleaned afterward, a virus was transmitted to another emergency medical technician (EMT) several days later. What route of transmission does this scenario describe? A. direct contact B. indirect contact C. airborne transmission D. vector-borne transmission

B. indirect contact

You are at a mass-casualty scene and in the process of organizing a group to be responsible for ongoing patient care. In order for the group to be successful: A. individual goals are accomplished. B. individuals have an understanding of how the group will accomplish its goals. C. individuals see this as a one-time exercise and that the group may change. D. all individuals have the same roles.

B. individuals have an understanding of how the group will accomplish its goals.

The topographic term used to describe the part of the body that is nearer to the feet is: A. dorsal. B. inferior. C. internal. D. superior.

B. inferior.

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: A. assess the patient for a facial droop and hemiparesis. B. initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible. C. obtain a blood glucose sample to rule out hypoglycemia. D. perform CPR for 5 minutes before applying the AED.

B. initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.

The MOST serious consequence of a poorly planned or rushed patient move is: A. unnecessarily wasting time. B. injury to you or your patient. C. causing patient anxiety or fear. D. confusion among team members.

B. injury to you or your patient.

A 16-year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should: A. obtain the majority of your information from one of her parents. B. inquire about the possibility of pregnancy in private, if possible. C. avoid asking questions that she will feel uncomfortable answering. D. recall that patients in this age group prefer not to be treated as adults.

B. inquire about the possibility of pregnancy in private, if possible.

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should: A. perform a focused secondary assessment of the patient's head and neck. B. instruct him to assist her ventilations while you perform a rapid assessment. C. apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs. D. immediately place her on a long backboard and prepare for rapid transport.

B. instruct him to assist her ventilations while you perform a rapid assessment.

The amniotic fluid serves to: A. transfer oxygen to the fetus. B. insulate and protect the fetus. C. remove viruses from the fetus. D. assist in fetal development.

B. insulate and protect the fetus.

Bleeding within the brain tissue itself is called a(n): A. epidural hematoma. B. intracerebral hematoma. C. subdural hematoma. D. intracranial hematoma.

B. intracerebral hematoma.

Which of the following is the MOST rapidly acting medication administration route? A. sublingual (SL) B. intravenous (IV) C. subcutaneous (SC) D. intramuscular (IM)

B. intravenous (IV)

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should: A. flush both eyes with an alcohol-based solution and transport. B. irrigate both eyes continuously for 20 minutes with plain water. C. neutralize the acid chemical in his eye with an alkaline chemical. D. mix baking soda with water and irrigate his eyes with the solution.

B. irrigate both eyes continuously for 20 minutes with plain water.

In contrast to inhalation, exhalation: A. requires muscular effort to effectively expel air from the lungs. B. is a passive process caused by increased intrathoracic pressure. C. occurs when the diaphragm lowers and expels air from the lungs. D. is an active process caused by decreased intrathoracic pressure.

B. is a passive process caused by increased intrathoracic pressure.

Angina pectoris occurs when: A. a coronary artery is totally occluded by plaque. B. myocardial oxygen demand exceeds the supply. C. one or more coronary arteries suddenly spasm. D. myocardial oxygen supply exceeds the demand.

B. myocardial oxygen demand exceeds the supply.

In contrast to the assessment of a trauma patient, assessment of a medical patient: A. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem. B. is focused on the nature of illness, the patient's chief complaint, and his or her symptoms. C. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems. D. is not as complex for the EMT because most patients typically present with classic symptoms.

B. is focused on the nature of illness, the patient's chief complaint, and his or her symptoms.

In contrast to the brown recluse spider, the black widow spider: A. is very small and has a violin-shaped marking on its back. B. is large and has a red-orange hourglass mark on its abdomen. C. has a bite that is typically painless until a blister develops. D. has a bite that usually produces local pain but no systemic signs or symptoms.

B. is large and has a red-orange hourglass mark on its abdomen.

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearingimpaired patient if he or she: A. is hurt. B. is sick. C. needs help. D. is nauseated.

B. is sick.

The cricoid cartilage: A. lies superior to the thyroid cartilage in the neck. B. is the only complete circular cartilage of the trachea. C. is easier to see and palpate than the thyroid cartilage. D. lies superior to the cricothyroid membrane in the neck.

B. is the only complete circular cartilage of the trachea.

A nuchal cord is defined as an umbilical cord that: A. has separated from the placenta. B. is wrapped around the baby's neck. C. is lacerated due to a traumatic delivery. D. has abnormally developed blood vessels.

B. is wrapped around the baby's neck.

Which of the following signs would indicate that your partner is experiencing significant stress? A. increased interest in daily activities B. isolation from the rest of the crew C. hyperactivity during an EMS call D. acute increase in his or her appetite

B. isolation from the rest of the crew

The AED is MOST advantageous to the EMT because: A. it is lightweight, easy to use, and safe for the EMT who is using it. B. it delivers prompt defibrillation to patients with ventricular fibrillation. C. its use does not require the presence of ALS personnel. D. it delivers an unlimited number of shocks with the same amount of energy

B. it delivers prompt defibrillation to patients with ventricular fibrillation.

In order for sweating to be an effective cooling mechanism: A. several layers of clothing must be worn. B. it must be able to evaporate from the body. C. the relative humidity must be above 90%. D. the body must produce at least 1 L per hour.

B. it must be able to evaporate from the body.

When a light is shone into the pupil: A. the opposite pupil should dilate. B. it should become smaller in size. C. it should become larger in size. D. both pupils should dilate together.

B. it should become smaller in size.

Which of the following assessment findings is MOST indicative of a cardiovascular problem? A. unequal breath sounds B. jugular venous distention C. use of the accessory muscles D. palpable pain to the epigastrium

B. jugular venous distention

When carrying a patient on a backboard up or down stairs: A. keep your palms facing down. B. keep the head end elevated. C. carry the patient headfirst. D. keep the foot end elevated.

B. keep the head end elevated.

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? A. liver B. kidney C. pancreas D. gallbladder

B. kidney

Which of the following organs or structures lies within the retroperitoneal space? A. spleen B. kidneys C. gallbladder D. abdominal aorta

B. kidneys

Upon returning to your station following a run, you should disinfect the ambulance as needed. Disinfection is MOST accurately defined as: A. using heat as a means of removing all microbial contaminants. B. killing pathogenic agents with a chemical made for that purpose. C. removing dirt, dust, blood, or other grossly visible contaminants. D. destroying pathogenic agents by using potent disinfection means.

B. killing pathogenic agents with a chemical made for that purpose.

The energy of a moving object is called: A. latent energy. B. kinetic energy. C. potential energy. D. converted energy.

B. kinetic energy.

A hematoma develops when: A. small amounts of blood leak into the epidermis. B. large blood vessels beneath the skin are damaged. C. severe swelling compromises arterial circulation. D. cells and small vessels in the dermis are damaged.

B. large blood vessels beneath the skin are damaged.

Approximately 25% of severe injuries to the aorta occur during: A. frontal collisions. B. lateral collisions. C. rollover collisions. D. rear-end collisions.

B. lateral collisions.

When splinting a possible fracture of the foot, it is MOST important for the EMT to: A. use a pillow as a splint. B. leave the toes exposed. C. apply a pneumatic splint. D. observe for tissue swelling.

B. leave the toes exposed.

Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered: A. legal and ethical. B. legal but unethical. C. illegal but ethical. D. illegal and unethical.

B. legal but unethical.

You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to: A. palpate for the presence of a carotid pulse. B. log roll him as a unit to a supine position. C. assess the rate and quality of his breathing. D. open his airway with a jaw-thrust maneuver.

B. log roll him as a unit to a supine position.

The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases— is influenced by: A. high blood oxygen levels. B. low blood oxygen levels. C. low blood carbon dioxide levels. D. high blood carbon dioxide levels.

B. low blood oxygen levels.

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would MOST likely experience an accompanying fracture of the: A. thoracic spine. B. lumbar spine. C. coccygeal spine. D. symphysis pubis.

B. lumbar spine.

A patient with atherosclerotic heart disease experiences chest pain during exertion because the: A. coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. B. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. C. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. D. ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.

B. lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: A. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. C. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible. D. load him into the ambulance, begin transport, and perform all treatment en route to the hospital.

B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.

A drug is contraindicated for a patient when it: A. is used to treat a multitude of conditions. B. may cause harm or have no positive effect. C. produces actions other than the desired ones. D. is used to treat a specific medical condition.

B. may cause harm or have no positive effect.

Talking about an elderly patient in front of him or her to other members of the family: A. often causes the patient to become paranoid and untrusting of your help. B. may cause the patient to think that he or she has no say in making decisions. C. will anger the patient and result in his or her refusal to accept care or transport. D. is usually beneficial because the patient's cognitive skills are typically impaired.

B. may cause the patient to think that he or she has no say in making decisions.

At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you: A. should transport the donor patient before critical patients. B. may have to assign the donor patient a lower triage priority. C. should use a separate ambulance to transport the donor patient. D. must assign the donor the highest priority regardless of injuries.

B. may have to assign the donor patient a lower triage priority.

When a patient experiences a severe spinal injury, he or she: A. will likely be paralyzed from the neck down. B. may lose sensation below the level of the injury. C. most commonly has a palpable spinal deformity. D. often loses motor function on one side of the body.

B. may lose sensation below the level of the injury.

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding the: A. index of suspicion. B. mechanism of injury. C. kinetic energy. D. potential energy.

B. mechanism of injury.

The distal aspect of the tibia forms the: A. lateral condyle. B. medial malleolus. C. Achilles tendon. D. lateral malleolus.

B. medial malleolus.

The topographic term used to describe the location of body parts that are closer toward the midline or center of the body is: A. lateral. B. medial. C. midaxillary. D. midclavicular.

B. medial.

The six-pointed Star of Life® emblem identifies vehicles that: A. are staffed by a minimum of one certified advanced EMT (AEMT). B. meet federal specifications as licensed or certified ambulances. C. are equipped with supplies to manage a mass-casualty situation. D. have complied with state regulations for ambulance certification.

B. meet federal specifications as licensed or certified ambulances.

A patient who presents with a headache, fever, confusion, and red blotches on his or her skin should be suspected of having: A. hepatitis. B. meningitis. C. hantavirus. D. tuberculosis.

B. meningitis.

The diastolic pressure represents the: A. average pressure against the arterial walls during a cardiac cycle. B. minimum amount of pressure that is always present in the arteries. C. increased arterial pressure that occurs during ventricular contraction. D. difference in pressure between ventricular contraction and relaxation.

B. minimum amount of pressure that is always present in the arteries.

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect: A. mild dehydration. B. moderate dehydration. C. severe dehydration. D. hypovolemic shock.

B. moderate dehydration.

A 4-year-old 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. give 12.5 to 25 g of activated charcoal.

B. monitor her airway and give oxygen.

Tidal volume is defined as the volume of air that: A. is moved through the lungs in a single minute. B. moves into or out of the lungs in a single breath. C. remains in the lungs following a complete exhalation. D. is forced into the lungs as a result of positive pressure.

B. moves into or out of the lungs in a single breath.

While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the air bag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced: A. open abdominal trauma. B. neck and facial injuries. C. blunt trauma to the head. D. lower extremity fractures.

B. neck and facial injuries.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A. barotrauma. B. nerve damage. C. earwax accumulation. D. eardrum perforation.

B. nerve damage.

The venom of a black widow spider is toxic to the: A. renal system. B. nervous system. C. respiratory system. D. cardiovascular system.

B. nervous system.

A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a: A. nasal cannula. B. nonrebreathing mask. C. bag-mask device. D. mouth-to-mask device.

B. nonrebreathing mask.

After determining that an infant or child has strong central pulses, you should: A. assume the child is hypertensive. B. not rule out compensated shock. C. conclude that the child is stable. D. assess his or her respiratory effort.

B. not rule out compensated shock.

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should: A. immediately seek out a family member or other caregiver. B. observe for conditions that may make the residence unsafe. C. begin his or her assessment after gathering any medication bottles. D. talk to the patient after performing his or her primary assessment.

B. observe for conditions that may make the residence unsafe.

Immediately upon arriving at the scene of an emergency call involving a traumatic injury, you should notify the dispatcher of your arrival and then: A. quickly gain access to the patient. B. observe the scene for safety hazards. C. determine if additional units are needed. D. carefully assess the mechanism of injury.

B. observe the scene for safety hazards.

Typical methods of assessing a patient's breathing include all of the following, EXCEPT: A. listening to breath sounds with a stethoscope. B. observing for nasal flaring during inhalation. C. observing the chest for adequate rise and fall. D. quickly scanning the chest for obvious movement.

B. observing for nasal flaring during inhalation.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: A. determine if the patient is a known alcohol abuser. B. obtain a description of how the seizure developed. C. determine when he was last seen by his physician. D. ask her how long the patient has been taking his medication.

B. obtain a description of how the seizure developed.

Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: A. ensure the medication is in tablet form. B. obtain authorization from medical control. C. determine who prescribed the nitroglycerin. D. wait at least 5 minutes after assessing the blood pressure.

B. obtain authorization from medical control.

According to Occupational Safety and Health Administration (OSHA) regulations, an employer must: A. guarantee a 100% risk-free environment prior to employment. B. offer a workplace environment that reduces the risk for exposure. C. provide gloves and other personal protective equipment (PPE) to full-time paid employees only. D. screen all prospective employees for bloodborne pathogens.

B. offer a workplace environment that reduces the risk for exposure.

In contrast to AMI, a dissecting aortic aneurysm: A. is more commonly associated with pressure in the chest. B. often presents with pain that is maximal from the onset. C. usually presents gradually, often over a period of hours. D. is typically preceded by other symptoms, such as nausea.

B. often presents with pain that is maximal from the onset.

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: A. apply a cervical collar and suction his airway. B. open his airway with the jaw-thrust maneuver. C. apply a pressure dressing to the patient's arm. D. tilt the patient's head back and lift up on his chin.

B. open his airway with the jaw-thrust maneuver.

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes: A. applying a tight pressure dressing. B. padding between the ear and the scalp. C. packing the ear with sterile gauze pads. D. covering the wound with a moist dressing.

B. padding between the ear and the scalp.

Signs and symptoms of an air embolism include all of the following, EXCEPT: A. dysphasia. B. pale skin. C. dizziness. D. joint pain.

B. pale skin.

In infants and small children, skin color should be assessed on the: A. forehead. B. palms and soles. C. chest and abdomen. D. underside of the arms.

B. palms and soles.

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

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

Anterior to the knee is a specialized bone called the: A. tibia. B. patella. C. femur. D. calcaneus.

B. patella.

A fracture caused by minimal force that is associated with diseases such as cancer and osteoporosis is called a __________ fracture. A. greenstick B. pathologic C. transverse D. comminuted

B. pathologic

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should: A. reanalyze the patient's cardiac rhythm. B. perform CPR for 2 minutes and reassess. C. determine if a palpable pulse is present. D. immediately assess the patient's airway.

B. perform CPR for 2 minutes and reassess.

In order to evaluate hazards present at the scene and determine the number of patients, you should: A. request the fire department at all scenes. B. perform a 360° walk-around of the scene. C. use the information provided by dispatch. D. interview bystanders present at the scene.

B. perform a 360° walk-around of the scene.

Once entrance and access to the patient have been provided, you should: A. allow extrication to commence. B. perform a primary assessment. C. administer high-flow oxygen. D. begin treating his or her injuries.

B. perform a primary assessment.

A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face and his respirations are slow and shallow. The EMT must immediately: A. insert a nasopharyngeal airway. B. perform oropharyngeal suctioning. C. apply oxygen via a nonrebreathing mask. D. assist the patient's ventilations with a bag-mask device.

B. perform oropharyngeal suctioning.

The circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called: A. respiration. B. perfusion. C. metabolism. D. cardiac output.

B. perfusion.

Relative to the adult's airway, the child's: A. tongue takes up less space in the pharynx. B. pharynx is smaller and less deeply curved. C. trachea is smaller, softer, and less flexible. D. mouth and nose are proportionately larger.

B. pharynx is smaller and less deeply curved.

Which of the following glands regulates the function of all other endocrine glands in the body? A. thyroid B. pituitary C. adrenal D. parathyroid

B. pituitary

To ensure that the airway of an infant or small child is correctly positioned, you may have to: A. place bulky padding behind his or her occiput. B. place a towel or folded sheet behind the shoulders. C. slightly flex the neck to prevent tracheal kinking. D. hyperextend the neck to ensure adequate alignment.

B. place a towel or folded sheet behind the shoulders.

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: A. force the head into a neutral alignment. B. place blankets behind the patient's head. C. secure the patient's head before the torso. D. use a scoop stretcher instead of a log roll.

B. place blankets behind the patient's head.

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should: A. apply the AED in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully. B. place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling. C. cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature. D. sit her up and give her small sips of warm water to drink, place heat packs to her axillae and groin, and cover her with blankets.

B. place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

When moving a conscious, weak patient down a flight of stairs, you should: A. secure the patient to a scoop stretcher and carry him or her headfirst down the stairs to the awaiting stretcher. B. place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair. C. collapse the undercarriage of the wheeled stretcher and carefully carry the patient down the stairs on the stretcher. D. assist the patient in walking down the stairs and place him or her on the wheeled stretcher at the bottom of the stairs.

B. place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair.

A young male jumped from a tree and landed feet first. What aspect of his body has sustained the initial injury? A. palmar B. plantar C. dorsal D. ventral

B. plantar

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

B. polypharmacy.

Effective methods for providing pain relief to a child with an extremity injury include: A. separating the child from his or her parents. B. positioning, ice packs, and emotional support. C. avoiding the placement of a splint, if possible. D. heat compresses and lowering the injured extremity.

B. positioning, ice packs, and emotional support.

When performing a full-body scan on a supine patient, what part of the body is typically assessed last? A. abdomen B. posterior C. extremities D. anterior chest

B. posterior

Which of the following anatomic terms is synonymous with the word "dorsal"? A. medial B. posterior C. palmar D. anterior

B. posterior

When the myocardium requires more oxygen: A. the heart contracts with less force. B. the arteries supplying the heart dilate. C. the heart rate decreases significantly. D. the AV node conducts fewer impulses.

B. the arteries supplying the heart dilate.

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert, but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger's side of the vehicle. In addition to fractures or dislocations of the knees, you should be MOST suspicious for: A. anterior hip dislocation. B. posterior hip dislocation. C. a thoracic spine fracture. D. fracture of the tibia or fibula.

B. posterior hip dislocation.

A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: A. injury to the cervical spine. B. potential airway compromise. C. damage to internal structures. D. alterations in his mental status.

B. potential airway compromise.

You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should: A. continue with your secondary assessment. B. prepare the patient for immediate transport. C. insert a nasal airway and assist his breathing. D. request an ALS unit to respond to the scene.

B. prepare the patient for immediate transport.

Functions of the liver include: A. storage of bile, which is produced in the gallbladder. B. production of substances necessary for blood clotting. C. production of hormones that regulate blood sugar levels. D. release of amylase, which breaks down starches into sugar.

B. production of substances necessary for blood clotting.

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT: A. low birth weight. B. profound tachycardia. C. premature delivery. D. respiratory depression.

B. profound tachycardia.

What section of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel? A. controlling insurance cost B. protecting patient privacy C. preventing insurance fraud D. ensuring access to insurance

B. protecting patient privacy

To minimize the risk of litigation, the EMT should always: A. transport patients to the hospital of their choice. B. provide competent care that meets current standards. C. use universal precautions with every patient encounter. D. utilize at least four personnel when moving a patient.

B. provide competent care that meets current standards.

You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to: A. notify medical control for advice. B. provide immediate patient care. C. wait for law enforcement to arrive. D. determine why the patient was injured

B. provide immediate patient care.

The PASG is absolutely contraindicated in patients who have: A. pelvic fractures. B. pulmonary edema. C. bilateral femur fractures. D. any trauma below the pelvis.

B. pulmonary edema.

During the primary assessment, circulation is evaluated by assessing: A. skin quality, blood pressure, and capillary refill. B. pulse quality, external bleeding, and skin condition. C. blood pressure, pulse rate, and external bleeding. D. external bleeding, skin condition, and capillary refill.

B. pulse quality, external bleeding, and skin condition.

Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should: A. give the mother 100% oxygen and transport at once. B. puncture the sac and suction the baby's mouth and nose. C. leave the amniotic sac intact until arrival at the hospital. D. note the color of the amniotic fluid before breaking the sac.

B. puncture the sac and suction the baby's mouth and nose.

When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear: A. latex gloves with thick leather gloves underneath. B. puncture-proof leather gloves over your latex gloves. C. fire fighter gloves only, to preserve manual dexterity. D. thick fire fighter gloves over two pairs of latex gloves.

B. puncture-proof leather gloves over your latex gloves.

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should: A. carefully push the cord back into the vagina. B. push the infant's head away from the cord. C. cover the umbilical cord with a dry dressing. D. gently pull on the cord to facilitate delivery.

B. push the infant's head away from the cord.

In most instances, you should move a patient on a wheeled ambulance stretcher by: A. pushing the foot of the stretcher while your partner guides the head. B. pushing the head of the stretcher while your partner guides the foot. C. slightly lifting the stretcher to prevent unnecessary patient movement. D. retracting the undercarriage and carrying the stretcher to the ambulance.

B. pushing the head of the stretcher while your partner guides the foot.

You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should: A. obtain permission from law enforcement before moving anything. B. quickly move the coffee table so you can access and treat the patient. C. treat the patient where he is so that you do not destroy any evidence. D. drag the patient into a larger area so that you can begin treatment.

B. quickly move the coffee table so you can access and treat the patient.

A patient with a core body temperature of 95°F (35°C) will MOST likely experience: A. a slow pulse. B. rapid breathing. C. muscle stiffness. D. loss of consciousness.

B. rapid breathing.

When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is: A. slow. B. rapid. C. irregular. D. thready.

B. rapid.

Nitroglycerin is contraindicated in patients: A. who have taken up to two doses. B. who have experienced a head injury. C. with a history of an ischemic stroke. D. with a systolic blood pressure less than 120 mm Hg.

B. who have experienced a head injury.

After assisting your patient with his or her nitroglycerin, you should: A. place the patient in a recumbent position in case he or she faints. B. reassess the blood pressure within 5 minutes to detect hypotension. C. avoid further dosing if the patient complains of a severe headache. D. perform a secondary assessment before administering further doses.

B. reassess the blood pressure within 5 minutes to detect hypotension.

When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: A. recumbent position with the paralyzed side up. B. recumbent position with the paralyzed side down. C. sitting position with the head at a 45° to 90° angle. D. supine position with the legs elevated 6″ to 12″.

B. recumbent position with the paralyzed side down.

Applying ice to and elevating an injured extremity are performed in order to: A. prevent further injury. B. reduce pain and swelling. C. enhance tissue circulation. D. maintain extremity perfusion.

B. reduce pain and swelling.

When driving an ambulance on a multilane highway in emergency mode, you should: A. pass other drivers on the right side. B. remain in the extreme left-hand lane. C. remain in the extreme right-hand lane. D. drive in the center lane of the highway.

B. remain in the extreme left-hand lane.

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state "We have located a victim" over the radio. You should: A. notify the hospital that you will be transporting a burn patient to their facility. B. remain with the ambulance and wait for fire personnel to bring the victim to you. C. immediately locate the incident commander and ask where the victim is located. D. locate the victim and provide initial care while your partner stays with the ambulance.

B. remain with the ambulance and wait for fire personnel to bring the victim to you.

When a motor vehicle strikes a tree while traveling at 40 mph, the unrestrained occupant: A. will most likely be thrown over the steering column. B. remains in motion until acted upon by an external force. C. will decelerate at the same rate as the motor vehicle. D. is thrust under the steering column onto the floorboard.

B. remains in motion until acted upon by an external force.

When caring for an occupant inside a motor vehicle equipped with an air bag that did not deploy upon impact, it is MOST important to: A. realize that the air bag malfunctioned at the time of impact. B. remember that it could still deploy and seriously injure you. C. suspect that the patient may have experienced serious injuries. D. recognize that the force of impact was most likely not severe.

B. remember that it could still deploy and seriously injure you.

A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: A. continue to insert the airway as you suction her oropharynx. B. remove the airway and be prepared to suction her oropharynx. C. insert the airway no further but leave it in place as a bite block. D. select a smaller oropharyngeal airway and attempt to insert it.

B. remove the airway and be prepared to suction her oropharynx.

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: A. ensuring adequate oxygenation and ventilation at all times. B. removing the tube if the area around it appears to be infected. C. suctioning the tube as needed to clear a thick mucous plug. D. maintaining the patient in a position of comfort when possible.

B. removing the tube if the area around it appears to be infected.

Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: A. pancreatic failure. B. renal insufficiency. C. intentional overdose. D. splenic dysfunction.

B. renal insufficiency.

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: A. repeat the arm drift test and ensure that her palms are facing downward. B. repeat the arm drift test, but move the patient's arms into position yourself. C. instruct the patient to keep her eyes open and then repeat the arm drift test. D. defer this part of the test and assess her for facial droop and slurred speech.

B. repeat the arm drift test, but move the patient's arms into position yourself.

While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should: A. immerse your wound in an alcohol-based solution. B. report the incident to your supervisor after the call. C. get immunized against hepatitis as soon as possible. D. discontinue patient care and seek medical attention.

B. report the incident to your supervisor after the call.

Upon arriving at the scene of a law enforcement tactical situation, you should ensure your own safety and then: A. begin immediate triage of any injured personnel. B. report to the incident commander for instructions. C. locate all injured personnel and begin treatment. D. apprise medical control of the tactical situation.

B. report to the incident commander for instructions.

You have been working at the scene of a major building collapse for 8 hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is MOST effectively managed by: A. providing large amounts of caffeine to the rescue workers. B. requesting a CISM team to provide on-scene peer support. C. conducting a critical incident stress debriefing the next day. D. allowing each worker to sleep in 15- to 30-minute increments.

B. requesting a CISM team to provide on-scene peer support.

The amount of air that remains in the lungs simply to keep them open is called: A. tidal volume. B. residual volume. C. inspiratory reserve volume. D. expiratory reserve volume.

B. residual volume.

Cardiac arrest in the pediatric population is MOST commonly the result of: A. a complete airway obstruction. B. respiratory or circulatory failure. C. a congenital cardiovascular defect. D. lethal cardiac rhythm disturbances.

B. respiratory or circulatory failure.

Heatstroke occurs when: A. a person's core body temperature rises above 103°F (39°C). B. the body's heat-eliminating mechanisms are overwhelmed. C. a person becomes dehydrated secondary to excess water loss. D. the ambient temperature exceeds 90°F (32°C) and the humidity is high.

B. the body's heat-eliminating mechanisms are overwhelmed.

You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she: A. is unable to track your movements with her eyes. B. responds to her name but is fearful of your presence. C. will readily allow you to separate her from her mother. D. has bulging fontanelles secondary to severe dehydration.

B. responds to her name but is fearful of your presence.

Drawing in of the muscles between the ribs or of the sternum during inspiration is called: A. tenting. B. retracting. C. hyperpnea. D. accessory muscle use.

B. retracting.

The right coronary artery supplies blood to the: A. left ventricle and inferior wall of the right atrium. B. right ventricle and inferior wall of the left ventricle. C. right atrium and posterior wall of the right ventricle. D. left ventricle and posterior wall of the right ventricle.

B. right ventricle and inferior wall of the left ventricle.

The _________ is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle. A. coccyx B. sacrum C. thorax D. ischium

B. sacrum

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should: A. thrust the jaw forward. B. seal the mouth and nose. C. ventilate with less pressure. D. thoroughly suction the stoma.

B. seal the mouth and nose.

Which of the following situations or conditions warrants immediate transport? A. mild pain in the lower abdomen B. severe chest pain and cool, pale skin C. decreased ability to move an extremity D. responsiveness and ability to follow commands

B. severe chest pain and cool, pale skin

Which of the following conditions is NOT a common cause of seizures? A. poisoning or overdose B. severe hypovolemia C. acute hypoglycemia D. acute alcohol withdrawal

B. severe hypovolemia

During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a: A. handgun. B. shotgun. C. .22-caliber pistol. D. .357 magnum.

B. shotgun.

When a child is struck by a car, the area of greatest injury depends MOSTLY on the: A. speed at which the car was traveling when impact occurred. B. size of the child and the height of the bumper upon impact. C. age of the child and the size of the car that struck him or her. D. height of the child and the speed at which the car was traveling.

B. size of the child and the height of the bumper upon impact.

Which of the following types of muscle is under direct voluntary control of the brain? A. cardiac B. skeletal C. smooth D. autonomic

B. skeletal

Signs of severe dehydration in an infant include all of the following, EXCEPT: A. profound tachycardia. B. slowed level of activity. C. delayed capillary refill. D. dry mucous membranes.

B. slowed level of activity.

Moderate elevation in intracranial pressure with middle brain stem involvement is characterized by: A. increased blood pressure, bradycardia, reactive pupils, and rapid respirations. B. sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing. C. ataxic respirations, unequal pupils, no response to pain, and an irregular pulse. D. fixed and dilated pupils, decreased blood pressure, and irregular respirations.

B. sluggishly reactive pupils, widened pulse pressure, bradycardia, and posturing.

When the EMT assists a paramedic with an advanced intervention, he or she should recall that the focus of the intervention is on: A. following local protocol. B. solving a clinical problem. C. completing the procedure. D. learning to perform the skill.

B. solving a clinical problem.

Activities such as walking, talking, and writing are regulated exclusively by the: A. central nervous system. B. somatic nervous system. C. autonomic nervous system. D. involuntary nervous system.

B. somatic nervous system.

Common associated conditions in patients with spina bifida include all of the following, EXCEPT: A. hydrocephalus. B. spastic limb movement. C. extreme latex allergy. D. loss of bladder control.

B. spastic limb movement.

Solid abdominal organs include the: A. stomach and small intestine. B. spleen, kidneys, and pancreas. C. gallbladder and large intestine. D. urinary bladder, colon, and ureters.

B. spleen, kidneys, and pancreas.

Worn out blood cells, foreign substances, and bacteria are filtered from the blood by the: A. liver. B. spleen. C. kidney. D. pancreas.

B. spleen.

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments. A. strain B. sprain C. fracture D. dislocation

B. sprain

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should: A. begin immediate rescue breathing. B. stabilize his head and check for a pulse. C. perform a head tilt-chin lift maneuver. D. open his airway and look in his mouth.

B. stabilize his head and check for a pulse.

The concept of consistent care across the entire health care team from first patient contact to patient discharge is called: A. the standard of care. B. the continuum of care. C. patient care advocacy. D. the scope of practice

B. the continuum of care.

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: A. defibrillate with the AED while continuing transport to the hospital. B. stop the ambulance, begin CPR, and attach the AED as soon as possible. C. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. D. alert the receiving hospital and perform CPR for the duration of the transport.

B. stop the ambulance, begin CPR, and attach the AED as soon as possible.

As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden, sharp pain in your lower back. You should: A. reposition your hands and continue to move the patient. B. stop the move and request additional lifting assistance. C. guide your partner while moving the chair backwards. D. stop the move and have the patient walk down the stairs.

B. stop the move and request additional lifting assistance.

The Hering-Breuer reflex is stimulated when: A. excess carbon dioxide needs to be eliminated from the body. B. stretch receptors in the chest wall detect that the lungs are too full. C. the DRG stops and the process of expiration begins. D. the brain stem senses that there is a low amount of oxygen in the blood.

B. stretch receptors in the chest wall detect that the lungs are too full.

Skeletal muscle is also referred to as __________ muscle. A. smooth B. striated C. connective D. involuntary

B. striated

Which of the following abnormal breath sounds indicates obstruction of the upper airway? A. rales B. stridor C. crackles D. rhonchi

B. stridor

What layer of the skin is composed of fatty tissue and serves as an insulator for the body? A. epidermis B. subcutaneous C. dermal D. sebaceous

B. subcutaneous

Frequent reassessments of the patient with face or neck injuries are MOST important because: A. they lend credibility to your documentation. B. such injuries can affect the respiratory system. C. hospital staff require frequent patient updates. D. rapid facial swelling may mask hidden injuries.

B. such injuries can affect the respiratory system.

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: A. assist his ventilations with a bag-mask device. B. suction his oropharynx for up to 15 seconds. C. immobilize his spine and transport immediately. D. pack his nostrils to stop the drainage of blood.

B. suction his oropharynx for up to 15 seconds.

Proper technique for suctioning the oropharynx of an adult patient includes: A. continuously suctioning patients with copious oral secretions. B. suctioning while withdrawing the catheter from the oropharynx. C. removing large, solid objects with a tonsil-tip suction catheter. D. suctioning for up to 1 minute if the patient is well oxygenated.

B. suctioning while withdrawing the catheter from the oropharynx.

It is 10:30 pm and you have requested air medical transport for a critically injured patient. When you arrive at the designated landing zone, you should: A. mark the proposed landing area with road flares. B. survey the area for power lines or other hazards. C. provide the flight crew with a patient status update. D. mark the landing site using personnel with flashlights.

B. survey the area for power lines or other hazards.

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. pulse pressure. B. systolic blood pressure. C. diastolic blood pressure. D. cardiac output pressure.

B. systolic blood pressure.

The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. blood pressure. B. systolic pressure. C. diastolic pressure. D. pulse pressure.

B. systolic pressure.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with: A. fever and a cough that produces green sputum. B. tachypnea and paroxysmal nocturnal dyspnea. C. jugular venous distention and peripheral edema. D. swelling of the lower extremities and weakness.

B. tachypnea and paroxysmal nocturnal dyspnea.

When caring for a patient who takes numerous medications, it is best to: A. document the medications on your patient care report, but leave them at home so they do not get misplaced. B. take all of the patient's medications with you to the hospital and document them on your patient care report. C. send the patient's medications to the hospital with a family member or other person who will safeguard them. D. let the hospital staff retrieve the patient's medical records, which should show a list of his or her current medications.

B. take all of the patient's medications with you to the hospital and document them on your patient care report.

After sizing up the scene of a patient with a possible infectious disease, your next priority should be to: A. contact medical control. B. take standard precautions. C. quickly access the patient. D. notify law enforcement.

B. take standard precautions.

When assessing an 8-year-old child, you should: A. refrain from taking a blood pressure. B. talk to the child, not just the caregiver. C. use a toe-to-head assessment approach. D. rely solely on the parent for information.

B. talk to the child, not just the caregiver.

Skeletal muscle is attached to the bone by tough, ropelike fibrous structures called: A. fascia. B. tendons. C. cartilage. D. ligaments.

B. tendons.

The presence of thick meconium in the amniotic fluid indicates: A. an expected finding in full-term infants. B. that the baby's airway may be obstructed. C. that the fetus is at least 4 weeks premature. D. that full newborn resuscitation will be needed.

B. that the baby's airway may be obstructed.

Situational awareness is MOST accurately defined as: A. an ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics. B. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact. C. predicting the presence of certain hazards at the scene after receiving initial information from the dispatcher. D. performing an initial scan of the scene in order to identify hazards that will pose an immediate threat to you and your crew.

B. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.

An air embolism associated with diving occurs when: A. the diver hyperventilates prior to entering the water. B. the diver holds his or her breath during a rapid ascent. C. the alveoli completely collapse due to high pressure. D. high water pressure forces air into the mediastinum.

B. the diver holds his or her breath during a rapid ascent.

When a child experiences a blunt chest injury: A. the flexible rib cage protects the vital thoracic organs. B. the flexible ribs can be compressed without breaking. C. the sudden force against the ribs causes them to fracture. D. there is usually obvious injury to the external chest wall.

B. the flexible ribs can be compressed without breaking.

The ideal procedure for moving an injured patient from the ground to a backboard is: A. the clothes drag. B. the four-person log roll. C. to use a scoop stretcher. D. the direct patient carry.

B. the four-person log roll.

When the parasympathetic nervous system is activated: A. blood is shunted away from the digestive organs. B. the heart rate decreases and the blood vessels dilate. C. hormones are released that prepare the body for stress. D. heart rate and blood pressure increase.

B. the heart rate decreases and the blood vessels dilate.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when: A. the patient has a terminal illness. B. the patient develops cardiac arrest. C. the patient is in a health care setting. D. it is signed by three or more physicians.

B. the patient develops cardiac arrest.

You should gently palpate a patient's pelvis only if: A. you note gross deformity to the pelvic area. B. the patient does not complain of pelvic pain. C. the MOI suggests pelvic trauma. D. the possibility of a pelvic fracture has been ruled out.

B. the patient does not complain of pelvic pain.

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: A. distal circulation. B. the patient history. C. bruising to the shoulder. D. the presence of deformity.

B. the patient history.

In general, musculoskeletal injuries should be splinted before moving the patient unless: A. the patient is in severe pain. B. the patient is clinically unstable. C. deformity and swelling are present. D. transport time is less than 15 minutes.

B. the patient is clinically unstable.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that: A. because of her age and medical history, you should suspect Alzheimer disease. B. the patient is experiencing delirious behavior, which suggests a new health problem. C. her mental status is likely the result of hypoglycemia and you should give her sugar. D. dementia typically presents as an acute onset of deterioration of cognitive function.

B. the patient is experiencing delirious behavior, which suggests a new health problem.

Supine hypotensive syndrome occurs when: A. a supine position kinks the ascending aorta. B. the pregnant uterus compresses the inferior vena cava. C. the superior vena cava is compressed by the uterus. D. blood pressure decreases as a result of hypovolemia.

B. the pregnant uterus compresses the inferior vena cava.

What is the MOST common cause of airway obstruction in an unconscious patient? A. vomitus B. the tongue C. blood clots D. aspirated fluid

B. the tongue

The main advantage of the Venturi mask is: A. the ability to adjust the percentage of inspired oxygen when caring for a critically ill or injured patient. B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients. C. that it does not contain an oxygen reservoir, so the same percentage of oxygen can consistently be administered. D. the ability to adjust the amount of oxygen administered to the patient by increasing the flow rate on the regulator.

B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.

A "silent" heart attack occurs when: A. sweating is the only presentation. B. the usual chest pain is not present. C. a sudden dysrhythmia causes death. D. the patient minimizes the chest pain.

B. the usual chest pain is not present.

When caring for patients with cerebral palsy, it is important to remember that: A. they are unable to walk and are totally dependent upon you. B. their limbs are often underdeveloped and are prone to injury. C. hearing aids are usually ineffective for patients with hearing loss. D. most patients have the ability to walk, but have an unsteady gait.

B. their limbs are often underdeveloped and are prone to injury.

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. A. two B. three C. four D. five

B. three

When a patient's respirations are shallow: A. chest rise will be easily noticeable. B. tidal volume is markedly reduced. C. oxygenation occurs more efficiently. D. carbon dioxide elimination is increased.

B. tidal volume is markedly reduced.

When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. In addition to administering oxygen, you should: A. apply a cardiac monitor and observe her cardiac rhythm. B. transport at once and consider requesting a paramedic unit. C. document your findings and perform a detailed assessment. D. conclude that the irregular pulse is normal based on her age.

B. transport at once and consider requesting a paramedic unit.

When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to: A. allow at least two family members to accompany the patient. B. transport him or her to a hospital that he or she is familiar with. C. avoid the use of a long backboard, even if trauma is suspected. D. perform frequent detailed assessments to gain the patient's trust.

B. transport him or her to a hospital that he or she is familiar with.

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: A. cover the child with wet towels and give oxygen via nasal cannula. B. transport the child to the hospital and reassure the mother en route. C. advise the mother to take her child to the doctor the following day. D. call medical control and request permission to give the child aspirin.

B. transport the child to the hospital and reassure the mother en route.

General treatment guidelines when caring for a woman with traumatic vaginal bleeding include: A. carefully removing impaled objects. B. transporting to an appropriate facility. C. packing the vagina with sterile dressings. D. cleaning external wounds with sterile water.

B. transporting to an appropriate facility.

You suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child's mother appears and refuses to allow you to continue treatment. You should: A. use your authority under the implied consent law. B. try to persuade the mother that treatment is needed. C. ask the mother to sign a refusal form and then leave. D. tell the mother that her refusal is a form of child abuse.

B. try to persuade the mother that treatment is needed.

You are dispatched to a residence for a patient with chest pain; however, you are unfamiliar with the address and cannot find the location in your map book. A nearby police officer radios you and tells you that he knows how to get to the scene. You should: A. ask the dispatcher to call the residence and obtain driving directions. B. turn off your lights and carefully follow the police officer to the scene. C. follow the police officer in emergency mode until you get near the scene. D. keep your lights on and ask the police officer to guide you to the scene.

B. turn off your lights and carefully follow the police officer to the scene.

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should: A. quickly suction his oropharynx. B. turn the backboard onto its side. C. reassess his breathing adequacy. D. alert the hospital of the situation.

B. turn the backboard onto its side.

The descending aorta divides into the two iliac arteries at the level of the: A. nipple line. B. umbilicus. C. iliac crest. D. pubic symphysis.

B. umbilicus.

Urine is transported from the kidneys to the urinary bladder via the: A. prostate. B. ureters. C. urethra. D. renal duct.

B. ureters.

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.

In order to facilitate a safe and coordinated move, the team leader should: A. be positioned at the feet so the team can hear. B. use preparatory commands to initiate any moves. C. speak softly but clearly to avoid startling the patient. D. never become involved in the move, just direct the move.

B. use preparatory commands to initiate any moves.

When documenting a patient's description of his or her chest pain or discomfort, the EMT should: A. use medical terminology. B. use the patient's own words. C. underline the patient's quotes. D. document his or her own perception.

B. use the patient's own words.

Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located? A. attempting to use body language to determine the problem B. using a piece of paper and writing utensil to ask questions C. using a high-pitched voice while speaking directly into the ear D. contacting dispatch and requesting a sign language interpreter

B. using a piece of paper and writing utensil to ask questions

From what internal female organ is the fetus expelled during delivery? A. vagina B. uterus C. cervix D. perineum

B. uterus

Common causes of syncope in older patients include all of the following, EXCEPT: A. venous pooling. B. vasoconstriction. C. acute hypotension. D. blood volume loss.

B. vasoconstriction.

Assisting with endotracheal intubation may include: A. visualization of the vocal cords. B. ventilation and preoxygenation. C. inserting a supraglottic airway should the intubation attempt be unsuccessful. D. providing deep suctioning via the ET tube.

B. ventilation and preoxygenation.

The physical act of moving air into and out of the lungs is called: A. diffusion. B. ventilation. C. respiration. D. oxygenation.

B. ventilation.

Rough handling of a hypothermic patient with a pulse may cause: A. profound bradycardia. B. ventricular fibrillation. C. ventricular tachycardia. D. pulseless electrical activity.

B. ventricular fibrillation.

In the presence of ileus, the only way the stomach can empty itself is by: A. diarrhea. B. vomiting. C. muscular contraction. D. spontaneous rupture.

B. vomiting.

Signs of vasoconstriction in the infant or child include: A. warm, dry skin. B. weak distal pulses. C. a rapid heart rate. D. brisk capillary refill.

B. weak distal pulses.

If you properly assess and stabilize a patient at the scene, driving to the hospital with excessive speed: A. is allowable according to state law. B. will decrease the driver's reaction time. C. is often necessary if the patient is critical. D. increases the patient's chance for survival.

B. will decrease the driver's reaction time.

The extremity lift would NOT be appropriate to use on a patient: A. without a spinal injury. B. with a deformed humerus. C. who complains of nausea. D. with forearm lacerations.

B. with a deformed humerus.

The inferior cartilaginous tip of the sternum is called the: A. sternal notch. B. xiphoid process. C. angle of Louis. D. jugular notch.

B. xiphoid process.

Burn patients without airway compromise and patients with multiple bone or joint injuries should be marked with a __________ triage at a mass-casualty incident. A. red B. yellow C. green D. black

B. yellow

A positive TB skin test indicates that: A. you have never been exposed to TB. B. you have been exposed to the disease. C. you are actively infected with the disease. D. the disease is dormant and may become active.

B. you have been exposed to the disease.

An index of suspicion is MOST accurately defined as: A. the EMT's prediction of the type of illness a patient has based on how the call is dispatched. B. your awareness and concern for potentially serious underlying and unseen injuries or illness. C. ruling out specific medical conditions based on the absence of certain signs and symptoms. D. determining the underlying cause of a patient's medical condition based on signs and symptoms.

B. your awareness and concern for potentially serious underlying and unseen injuries or illness.

After assuming care of a cardiac arrest patient from an EMT, the paramedic should remember that:

BLS efforts must continue throughout the patient care continuum.

When pulling a patient, you should extend your arms no more than ________ in front of your torso. A. 5″ to 10″ B. 10″ to 15″ C. 15″ to 20″ D. 20″ to 30″

C. 15″ to 20″

A person is said to be obese when he or she is ________ over his or her ideal weight. A. 5% to 10% B. 10% to 15% C. 20% to 30% D. 40% to 50%

C. 20% to 30%

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock. A. 5% B. 15% C. 25% D. 35%

C. 25%

You are administering oxygen at 15 L/min to a patient with res piratory distress. If you are using a D cylinder (cylinder constant, 0.16), which reads 1500 psi, how long will it take before you need to replace the oxygen cylinder? A) 9 minutes B) 11 minutes C) 14 minutes D) 18 minutes

C) 14 minutes The length of time you can use an oxygen cylinder depends on the type of cylinder you are using, the pressure in the cylinder, and the oxygen flow rate. AD cylinder is a small oxygen cylinder that is usually carried in the jump kit to the patient; it has a cylinder constant of 0.16. The fo llowing method can be used to calculate cylinder duration: gauge pressure (in psi) - the safe residual pressure (200 psi) x the cylinder constant/ flow rate in L/min. Using th is formula, your D cylinder will become depleted in about 14 minutes, as fo llows: 1500 (psi) - 200 (safe residual pressure) x 0.16 (cylinder constant)/ 15 (flow rate in L/min) ; 13.86 (14 minutes). A full oxygen cylinder should contain 2000 psi. The safe residual pressure is the lowest acceptable cylinder pressure before it should be replaced; it is usually 200 psi, although some EMS systems use 500 psi as a safe residual pressure. Although you will switch to your on-board oxygen (M cylinder) source when you load the patient into the ambulance, you should always have at least one backup portable cylinder (preferably two) when administering oxygen to a patient at the scene, especially if you are giving high-flow (12 to 15 L/min) oxygen and/or your on-scene time will be delayed (eg. lengthy extrication, moving a patient from the second floor).

An unresponsive man is found lying supine in his bed. Which of the fo llowing assessment findings would indicate that his gag reflex is depressed or absent? A) gurgling sound during breathing B) High-pitched inspiratory strider C) Breathing that is slow and shallow D) Cyanosis to the face, neck, and chest

C) Breathing that is slow and shallow Secretions in the upper airway of a patient with an intact gag reflex would normally stimulate coughing, gagging, or some other mechanism to clear the airway. If the unresponsive patient is gurgling, fluids are pooling in the airway and such a mechanism is absent; this clearly indicates a severely depressed or absent gag reflex. Stridor indicates narrowing or swelling of the upper airway; it tells you nothing as to the status of the patient's gag reflex. Slow, shallow breathing indicates that the patient's respiratory effort is inadequate; it does not give any indication as to the status of the gag reflex. Cyanosis is a clinical sign of significant hypoxia; it does not indicate the presence or absence of a gag reflex.

Which of the following patients would be the BEST candidate for treatment with continuous positive airway pressure (CPAP)? A) Conscious; respiratory distress; fever; and hypotension B) Unresponsive; labored breathing; cyanosis; and tachycardia C) Conscious; labored breathing; anxiety; and coarse crackles D) Semiconscious; shallow breathing; and audible wheezing

C) Conscious; labored breathing; anxiety; and coarse crackles Continuous positive airway pres ure (CPAP) therapy can effectively improve oxygenation and ventilation in patients with respiratory distress secondary to pulmonary edema (for example, CHF with coarse crackles heard during auscultation), or in patients with respiratory distress secondary to bronchospasm (as evidenced by wheezing). However, in order for the patient to benefit from CPAP therapy, he or she must be alert enough to follow verbal commands and should have relatively adequate tidal volume. If the patient is unable to follow verbal commands and/or his or her baseline breathing is so poor that respiratory arrest is imminent, you should assist his or her ventilations with a bag-mask device. CPAP is a form of non-invasive positive-pressure ventilation; as such, it can have a negative effect on cardiac output. If the patient is already hypotensive, CPAP could be more detrimental than beneficial.

Which of the following signs or symptoms is MOST indicative of cerebral hypoxia? A) Chief complaint of dyspnea B) Diffuse wheezing on exhalation C) Decreased level of consciousness D) Heart rate greater than 120 beats/min

C) Decreased level of consciousness Dyspnea, a feeling of shortness of breath, is a symptom of a condition that can cause cerebral hypoxia (eg, CHF, COPD); however, dyspnea itself does not indicate cerebral hypoxia. Wheezing, a whistling sound that indicates bronchospasm, is a sign; like dyspnea, it indicates the presence of a condition that can cause cerebral hypoxia (eg, asthma). Tachycardia can occur for many reasons; cerebral hypoxia is but one. Of the choices listed, a decreased level of consciousness is most indicative of cerebral hypoxia. As oxygen levels in the brain decrease and carbon dioxide levels increase, the patient's mental status deteriorates.

In which position would you expect a patient with severe dyspnea to be found? A) Prone B) Supine C) Fowler's D) Lateral recumbent

C) Fowler's The preferred position of comfort for most patients with respiratory distress is Fowler's position (sitting up). A prone, supine, or lateral recumbent position would make it more difficult for the patient to breathe. If a patient with severe dyspnea is willing to lie flat, the EMT should take this as an ominous sign and should be prepared to assist the patient's ventilations.

What is the function of pulmonary surfactant? A) It carries fresh oxygen from the lungs to the left side of the heart. B) It dilates the bronchioles in the lungs and enhances the flow of air. C) It lubricates the alveolar walls and allows them to expand and recoil. D) It facilitates the production of mucus, which is expelled during coughing.

C) It lubricates the alveolar walls and allows them to expand and recoil. Surfactant is a compound that lines the inside of the alveoli. It reduces surface tension on the alveolar wall, which allows the alveoli to expand and recoil easily; this faci li tates the exchange of oxygen and carbon dioxide in the lungs (pulmonary respiration). Diseases such as emphysema cause destruction of the alveolar walls and a decrease in pulmonary surfactant, which impairs pulmonary respiration. Mucus-producing cells, called goblet cells, line the trachea and larger bronchi. Provided the patient has an effective cough reflex, bacteria and other pathogens can be expelled from the body via the mucus produced by the goblet cell s.

Which of the following would MOST likely occur if an adult patient is breathing at a rate of 45 breaths/min with shallow depth? A) The volume of air that reaches the alveoli would increase significantly. B) Minute alveolar volume would increase due to the rapid respiratory rate. C) Most of his or her inhaled air will not go beyond the anatomic dead space. D) The lungs would become hyperinflated, potentially causing a pneumothorax.

C) Most of his or her inhaled air will not go beyond the anatomic dead space. Minute alveolar volume, the amount of air that reaches the alveoli per minute and participates in pulmonary respiration, is affected by tidal volume, respiratory rate, or both. If the respiratory rate decreases, tidal volume must increase to maintain adequate minute alveolar volume. Conversely, if tidal volume decreases, the respiratory rate must increase accordingly. However, if the respiratory rate is extremely fast, especially if the depth of breathing is shallow (reduced tidal volume), most of the inhaled air will only make it to the anatomic dead space (ie, trachea, larger bronchi) before it is promptly exhaled. As a result, minute alveolar volume will decrease, resulting in inadequate pulmonary respiration and hypoxia. For this reason, patients with rapid, shallow breathing often require ventilation assistance. Pulmonary hyperinflation would not be an issue in a patient with exceedingly fast breathing and reduced tidal volume because very little air is actually reaching the lungs.

What does pulse oximetry measure? A) Carbon monoxide levels B) Oxygen levels in the tissues C) Percentage of bound hemoglobin D) Oxygen levels in the lungs

C) Percentage of bound hemoglobin Pulse oximetry is an assessment tool that measures the percentage of bound hemoglobin. However, it does not tell you what is bound to the hemoglobin. If the patient is conscious and alert; has normal skin color, condition, and temperature; and is not in respiratory distress, then the pulse oximetry reading is likely reflective of oxygen-hemoglobin binding. However, if an unresponsive patient was just pulled from a structural fire (in which case they were breathing carbon monoxide [CO] and other noxious gases, not oxygen), then the pulse oximetry reading should be questioned if it is high. The pulse oximeter cannot differentiate CO and oxygen, and CO will bind to hemoglobin 250 times more readily than oxygen. A special device called a CO-oximeter can specifically tell you the percentage of CO that is bound to hemoglobin. The concentration of oxygen in the lungs and tissues requires arterial blood gas (ABG) monitoring; the pulse oximeter will not provide this information. The levels of CO in the tissues would also require ABG monitoring.

An obese 56-year-old woman experienced a sudden onset of dyspnea and chest pain while reading a book. Her breathing is labored and her heart rate is 130 beats/min. Despite supplemental oxygen, her oxygen saturation remains low. What should the EMT suspect? A) Acute asthma attack B) Bacterial pneumonia C) Pulmonary embolism D) Spontaneous pneumothorax

C) Pulmonary embolism Acute dyspnea (with or without chest pain), tachycardia, and refractory hypoxemia (oxygen saturation remains low, despite supplemental oxygen) are classic signs of acute pulmonary embolism. Risk factors for pulmonary embolism include obesity, immobility or sedentary lifestyle, and contraception use, among others. An acute asthma attack is unlikely because there was no apparent trigger (asthma attacks typically have a trigger, such as stress, exercise, or temperature changes); furthermore, there is no mention of wheezing in the patient's clinical presentation. Spontaneous pneumothorax can also present with acute dyspnea and chest pain; however, this is more common in young, tall, thin males, especially with a recent history of air travel. Pneumonia typically presents with flu-like symptoms, followed by progressive (not acute) respiratory difficulty. In fact, many patients with pneumonia do not develop respiratory distress.

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head and anterior trunk. What percentage of her body surface area has been burned? A. 18% B. 27% C. 30% D. 36%

C. 30%

Portable and mounted suction units must be powerful enough to generate a vacuum of at least ____ mm Hg when the tubing is clamped. A. 100 B. 200 C. 300 D. 400

C. 300

When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than: A. 100 mm Hg. B. 200 mm Hg. C. 300 mm Hg. D. 400 mm Hg.

C. 300 mm Hg.

In which of the following situations would you MOST likely encounter agonal gasps? A) Any patient who is unresponsive due to hypoxia B) Occlusion of the posterior pharynx by the tongue C) Shortly after the patient becomes unresponsive and pulseless D) Significant hypoxemia, regardless of the cause

C) Shortly after the patient becomes unresponsive and pulseless Agonal gasps are occasional, irregular, and ineffective breaths. They are commonly observed in patients shortly after they become unresponsive and pulseless (cardiac arrest). Agonal gasps may also be observed in patients with a severe brain injury or cerebral anoxia (complete absence of oxygen). Patients with agonal gasps require some form of positive-pressure ventilation. Hypoxemic and hypoxic patients typically present with tachypnea (increased respirations) in an attempt to eliminate carbon dioxide and bring in more oxygen. However, as the hypoxic patient begins to decompensate, his or her respirations often become slow (bradypnea). If the tongue is occluding the posterior pharynx, a characteristic snoring sound is typically heard.

Which of the followi ng processes occurs during cellular/capillary gas exchange? A) The cells give up oxygen to the capillaries. B) The cells receive carbon dioxide from the capillaries. C) The capillaries give up oxygen to the cells. D) The capillaries give up carbon dioxide to the cells.

C) The capillaries give up oxygen to the cells. At the cellular level, oxygen passes across the capillary bed from the arterioles and into the cell, which is facilitated by a process called diffusion, in which oxygen (like any gas) moves from an area of higher concentration to an area of lower concentration. At the same time, carbon dioxide crosses the capillary bed and enters the venules, where it is transported back to the lungs for reoxygenation.

Which of the following would MOST likely cause a reduction in tidal volume? A) Flaring of the nostrils B) Accessory muscle use C) Unequal chest expansion D) Increased minute volume

C) Unequal chest expansion Unequal (asymmetrical) or minimal expansion of the chest results in a decrease in the amount of air inhaled per breath (tidal volume). Accessory muscle use and nasal flaring are signs of increased work of breathing, which represents an attempt to maintain adequate tidal volume (and therefore, minute volume). An increase in tidal volume, respiratory rate, or both would result in an increase in minute volume. It should be noted, however, that a markedly fast respiratory rate would cause a natural decrease in t idal volume. For example, a patient breathing at a rate of 45 breaths/min would likely only inhale air into the anatomic dead space before promptly exhaling it.

A patient's skin will MOST likely become cyanotic if he or she has: A) a decrease in the amount of carbon dioxide. B) an increase in the amount of arterial oxygen. C) a decrease in the amount of arterial oxygen. D) an overall increase in circulating red blood cells.

C) a decrease in the amount of arterial oxygen. Cyanosis, a blue or purple tint to the skin, reflects an inadequate amount of oxygen in the arterial blood. More specifically, cyanosis indicates that a significant amount of hemoglobin has separated from the red blood cells (desaturation), which makes the arterial blood less able to carry oxygen. An overall increase in the number of circulating red blood cells (polycythemia) would likely cause a patient's skin to remain pink, not become cyanotic. Patients with cyanosis need supplemental oxygen; if they are breathing inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]), ventilation assistance will also be needed.

A 40-year-old man is conscious, but has an increased rate of breathing. You should: A) apply 100% oxygen via nonrebreathing mask. B) immediately insert a nasopharyngeal airway. C) assess the regularity and quality of breathing. D) ventilate him with a bag-mask device.

C) assess the regularity and quality of breathing. You must assess ALL parameters of a patient's breathing: rate, regularity, depth, and quality. If a patient is breathing outside the normal ranges for his or her age, you should assess the depth, quality, and regularity of the respirations to determine overall breathing adequacy. On the basis of this assessment, the most appropriate treatment can be provided--passive oxygenation with a nasal cannula or nonrebreathing mask, or some form of positive-pressure ventilation (ie, bag--mask ventilation). Breathing adequacy is not determined by respiratory rate alone. Conscious patients do not require an artificial airway adjunct (ie, oral or nasal airway).

When suctioning copious secretions from a semiconscious adult's airway, you should: A) suction for up to 20 seconds while withdrawing the catheter. B) apply suction as you carefully insert the catheter into the mouth. C) avoid touching the back of the airway with the suction catheter. D) use a flex ible catheter because it will remove the secretions faster.

C) avoid touching the back of the airway with the suction catheter. When suctioning a patient's airway, especially if he or she is semiconscious, you should avoid touching the back of the airway with the suction catheter. Inserting the catheter too far may stimulate the gag reflex, cause vomiting, and increase the risk of aspiration. Rigid (tonsil-tip) catheters are best for removing large amounts of fluid from the airway. Flexible (whistle-tip) catheters are used in situations in which rigid catheters cannot be used, such as with a patient who has a stoma, with patients whose teeth are clenched, or if suctioning the nose is necessary. Apply suction while you are withdrawing the catheter. Suction the airway until it is clear of secretions and the patient can be safely oxygenated and ventilated. ANY secretions left in the patient's oropharynx can be aspirated.

A 22-year-old male has a shard of glass impaled in his cheek. You look inside his mouth and see minor bleeding. The patient is conscious and alert with adequate breathing. You should: A) carefully remove the shard of glass in the same direction that it entered. B) be prepared for severe bleeding as you carefully remove the shard of glass. C) carefully stabilize the shard of glass and allow him to suction his own mouth. D) remove the shard of glass and place gauze in his mouth to control the bleeding.

C) carefully stabilize the shard of glass and allow him to suction his own mouth. It remains true that you should remove an impaled object if it compromises the airway or impedes your ability to manage the ai1way. However, neither is the case with this patient because he has an adequate airway. He is conscious and alert and has only minor bleeding in his mouth. The safest approach, and most practical given the situation, would be to carefully stabilize the shard of glass in place; consider wrapping the exposed glass with gauze to protect yourself from getting cut. Since the patient is conscious and alert and has only minor oral bleeding, it would not be unreasonable to hand him the suction catheter and allow him to use it as needed. Be sure to instruct the patient to use the suction and not to swallow any blood. Keep in mind that if you attempt to remove the shard of glass, you risk cutting yourself and causing further injury to the patient.

If an adult patient presents with a respiratory rate of 26 breaths/min, your initial action should be to: A) begin assisting his ventilations with a bag-valve-mask device. B) apply the pulse oximeter and assess his oxygen saturation. C) evaluate his mental status and the depth of his respirations. D) apply oxygen via a nonrebreathing mask and take his vital signs.

C) evaluate his mental status and the depth of his respirations. The normal respiratory rate for an adult at rest is 12 to 20 breaths/min. If a patient presents with a respiratory rate outside of the normal range, you should immediately assess him or her for other signs of inadequate breathing, such as a decreased level of consciousness, shallow breathing (reduced t idal volume), brief inhalations followed by prolonged exhalations, and cyanosis. If the patient is conscious and alert and has adequate tidal volume (eg, his or her chest rises adequately with each breath), supplemental oxygen may be indicated, depending on his or her chief complaint and oxygen saturation. However, if the patient's mental status is decreased and his or her tidal volume is reduced (eg, shallow breathing), some form of positive-pressure ventilation should be initiated (eg, bag-valve-mask ventilation). It is important to note that breathing adequacy is not determined solely by the patient's respiratory rate; you must assess all aspects of breathing (rate, regularity, depth) as well as the patient's mental status. A patient can be breathing at a "normal" rate; however, if his or her tidal volume is reduced, minute volume will decrease and some form of positive-pressure ventilation may be indicated.

An unresponsive patient has an end-tidal carbon dioxide level of70 mm Hg. From this, you should conclude that the patient is: A) hypercarbic and breathing adequately. B) hypocarbic and breathing adequately. C) hypercarbic and breathing inadequately. D) hypocarbic and breathing inadequately.

C) hypercarbic and breathing inadequately. End-tidal carbon dioxide (ETCO2) is a measure of the amount of carbon dioxide present in the patient's exhaled air. A normal value is 35 to 45 mm Hg. A value less than 35 mm Hg indicates hypocarbia (low CO2 content), whereas a level greater than 45 mm Hg indicates hypercarbia (high CO2 content). If a patient is not breathing adequately, you would expect his or her ETC02 to increase because a failing respiratory system cannot remove adequate carbon dioxide from the body. By contrast, a patient who is breathing too fast (ie, hyperventilation) would be expected to have a low ETC02 because he or she is eliminating too much carbon dioxide.

To ensure you deliver the highest concentration of oxygen with a nonrebreathing mask, you should: A) set the flow rate to at least 10 to 12 L/min. B) securely fasten the mask to the patient's face. C) make sure that the reservoir bag is preinflated. D) cover the one-way valves on the oxygen mask.

C) make sure that the reservoir bag is preinflated. To ensure delivery of high-flow (greater than 90%) oxygen to your patient with a nonrebreathing mask, you must first set the flowmeter at 12 to 15 L/min and then preinflate the reservoir bag. When the patient inhales, pure oxygen is inspired directly from this bag. The valves on the sides of the mask close during inhalation, which prevents outside carbon dioxide from mixing with the oxygen in the reservoir; they open during exhalation, which allows the patient to eliminate carbon dioxide. Following inflation of the reservoir, apply the mask to the patient and ensure that it is secured so as to prevent as much air leakage as possible.

You are dispatched to a residence for an elderly female who has possibly suffered a stroke. You find her lying supine in her bed. She is semiconscious; has vomited; and has slow, irregular breathing. You should: A) perform the head tilt-chin lift maneuver and insert an oral airway. B) insert a nasal airway and begin assisting her breathing. C) manually open her airway and suction her oropharynx. D) administer high-flow oxygen and place her on her side.

C) manually open her airway and suction her oropharynx. This patient's airway is in immediate jeopardy! The first step in caring for any semiconscious or unconscious patient is to manually open the airway (eg, head tilt-chin lift, jaw-thrust) and ensure it is clear of obstructions or secretions. Because the patient has vomited, she likely has vomitus in her mouth, which must be removed with suction before she aspirates it into her lungs. Mortality increases significantly if aspiration occurs. After opening her airway and removing any vomitus or secretions from her oropharynx with suction, you should insert an airway adjunct (a nasal airway in th is case; the patient is semiconscious and likely has an intact gag reflex) and begin assisting her breathing with a bag-valve-mask device. Her respiratory effo1·t is inadequate and should be treated with some form of positive-pressure ventilation, not a nonrebreathing mask. Placing a semiconscious or unconscious patient on his or her side (recovery position) is appropriate if only he or she is breathing adequately; this patient is not.

After an initial attempt to ventilate an unresponsive apneic patient fa ils, you reposition the patient's head and reattempt ventilation without success. You should next: A) turn the patient onto his side and deliver 5 to 10 back slaps. B) perform continuous chest compressions until ALS personnel arrive. C) perform chest compressions, open the airway, and look in the mouth. D) administer 5 to 10 abdominal thrusts and reattempt to ventilate.

C) perform chest compressions, open the airway, and look in the mouth. If you are unable to ventilate an unresponsive, apneic patient after two attempts, you should assume that he or she has a severe (complete) foreign body airway obstruction. Immediately perform 30 chest compressions (15 compressions if two EMTs are present and the patient is an infant or child). Next, open the patient's airway and look inside the mouth. If you can see the object, attempt to remove it with your finger (never perform blind finger sweeps of the mouth). If you cannot see the object, continue chest compressions. If you are able to remove the object, reattempt to ventilate. Unless paramedics are nearby, begin transport while continuing chest compressions, opening the airway and looking in the mouth, and attempting to ventilate (if you can remove the object). Abdominal thrusts are indicated for responsive children and adults with a severe airway obstruction. Back slaps are indicated for a responsive infant with a severe airway obstruction.

While ventilating an unresponsive man with a bag-mask device, you hear gurgling in his upper airway. You should: A) reposition the patient's airway. B) suction the patient's oropharynx. C) position the patient onto his side. D) squeeze the bag with less force.

C) position the patient onto his side. A gurgling sound indicates the presence of vomitus, blood, or other secretions in the airway. If this is noted, you should immediately position the patient onto his or her side to allow the secretions to drain. With the patient on his or her side, suction the airway until the secretions are removed. To continue ventilating a patient whose airway is full of secretions virtually assures that he or she will aspirate.

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: A. 24%. B. 35%. C. 44%. D. 52%.

C. 44%.

During the inhalation phase of breathing: A) the diaphragm and intercostal muscles contract and ascend. B) air passively enters the lungs as pressure within the thorax increases. C) pressure within the thorax decreases and air is drawn into the lungs. D) the muscles in between the ribs relax, which lifts the ribs up and out.

C) pressure within the thorax decreases and air is drawn into the lungs. Inhalation is the active, muscular part of breathing. During inhalation, the diaphragm and intercostal muscles contract. When the diaphragm contracts, it moves down (descends) slightly and enlarges the thoracic cage from top to bottom. Contraction of the intercostal muscles, the muscles in between the ribs, causes the ribs to move up and out. As we inhale, the combined actions of these structures enlarge the thorax in all directions. The air pressure outside the body, called the atmospheric pressure, is normally higher than the air pressure within the thorax. As we inhale and the thoracic cage expands, the air pressure within the thorax decreases, creating a slight vacuum. This draws air in through the trachea and into the lungs, a process called negative-pressure ventilation.

While managing a patient with acute shortness of breath, you attempt to apply a nonrebreathing mask set at 12 L/min. The patient pulls the mask away from his face, stating that it is smothering him. You should: A) increase the oxygen flow and reapply the mask. B) securely tape the oxygen mask to the patient's face. C) reassure the patient and apply a nasal cannula instead. D) inform the patient that refusing oxygen may result in his death.

C) reassure the patient and apply a nasal cannula instead. Some adults cannot tolerate the oppressive feel ing of an oxygen mask over their face; children are typically less tolerant than adults. You should provide reassurance to the patient and apply a nasal cannula at 2 to 6 L/min, which will likely be better tolerated. Do not force an oxygen mask on a patient's face; doing so will only increase his or her anxiety, which will in turn increase his or her body's oxygen consumption and demand.

Medications such as albuterol (Ventolin) relieve respiratory distress by: A) constricting the bronchioles in the lungs. B) contracting the smaller airways in the lungs. C) relaxing the smooth muscle of the bronchioles. D) dilating the large mainstem bronchi of the airway.

C) relaxing the smooth muscle of the bronchioles. Medications such as albuterol (Ventolin), metaproterenol (Alupent), and levalbuterol (Xopenex) are in a class of drugs called bronchodilators. They relax the smooth muscle found within the bronchioles in the lungs, which causes them to dilate. This effect opens the air passages and improves the patient's abil ity to breathe.

Clinically, reduced tidal volume would MOST likely present with respirations that are: A) deep. B)slow. C) shallow. D) eupneic.

C) shallow. Tidal volume is the amount of air, in milliliters (mL), that is breathed into or out of the lungs in a single breath. Shallow respirations (minimal chest rise) indicate that negative-pressure ventilation, and therefore tidal volume, are inadequate. Deep respirations (hyperpnea) would cause an increase in tidal volume. Slow respirations, especially if accompanied by a shallow depth of breathing, would lead to a reduction in minute volume. Eupnea is the medical term for normal breathing; therefore, eupneic respirations are of adequate rate, depth, and regularity.

When ventilating an apneic patient, you note decreased ventilatory compliance. This means that: A) the upper airway is blocked. B) fluid is occupying the alveoli. C) the lungs are difficult to ventilate. D) there is no resistance when ventilating.

C) the lungs are difficult to ventilate. As it applies to artificial ventilation, compliance is the ability of the lungs to expand during ventilation. Increased ventilatory compliance means that no resistance is met when you venti late the patient; you can ventilate the lungs with ease. Decreased ventilatory compliance means that significant resistance is met when you ventilate the patient; the lungs are difficult to ventilate. Conditions such as upper airway obstruction, widespread bronchospasm, fluid in the alveoli (eg, pulmonary edema), and COPD can all cause decreased venti latory compliance.

You are assessing a middle-aged male who is experiencing respiratory distress. The patient has a history of emphysema and hypertension. He appears fatigued; has weak retractions; and has labored, shallow breathing. You should: A) administer oxygen with a nonrebreathing mask. B) auscultate his breath sounds to detect wheezing. C) ventilate him with a bag-valve-mask device. D) assess his oxygen saturation with a pulse oximeter.

C) ventilate him with a bag-valve-mask device. Your patient is NOT breathing adequately. He is fatigued; has weak retractions; and demonstrates labored, shallow breathing. If you do not treat him immediately, he may stop breathing altogether. You should begin assisting his ventilations with a bag-valve-mask device and high-flow oxygen. After initiating ventilatory assistance, attach the pulse oximeter to assess his oxygen saturation and auscultate his breath sounds. A nonrebreathing mask is appropriate for patients with difficulty breathing who are moving air adequately; this patient is not!

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? A. "When are you due?" B. "Is this your first baby?" C. "Have you had a sonogram?" D. "Do you feel the urge to push?"

C. "Have you had a sonogram?"

Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? A. "Have you ever had any major surgeries?" B. "How long have you had your chest pain?" C. "How much Tylenol do you take each day?" D. "When was the last time you ate a meal?"

C. "How much Tylenol do you take each day?"

An adult at rest should have a respiratory rate that ranges between: A. 8 and 15 breaths/min. B. 10 and 18 breaths/min. C. 12 and 20 breaths/min. D. 16 and 24 breaths/min.

C. 12 and 20 breaths/min.

Typically medivac helicopters fly between: A. 100 and 120 mph. B. 120 and 140 mph. C. 130 and 150 mph. D. 150 and 200 mph.

C. 130 and 150 mph.

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of: A. 12. B. 13. C. 14. D. 15.

C. 14.

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

Which of the following patients is at highest risk for a pulmonary embolism? A. 59-year-old male who is recovering from pneumonia B. 66-year-old active female with a history of hypertension C. 71-year-old male with recent surgery to a lower extremity D. 78-year-old female who takes blood thinning medications

C. 71-year-old male with recent surgery to a lower extremity

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is: A. 6 B. 7 C. 8 D. 9

C. 8

With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen. A. 70 B. 80 C. 90 D. 100

C. 90

Which of the following statements regarding the scoop stretcher is NOT correct? A. The construction of the scoop stretcher prohibits x-rays while the patient is on it. B. You must fully secure the patient to the scoop stretcher before moving him or her. C. A scoop stretcher will provide adequate immobilization of a patient's spinal column. D. Both sides of the patient must be accessible in order for a scoop stretcher to be used.

C. A scoop stretcher will provide adequate immobilization of a patient's spinal column.

Which of the following statements regarding the one-person bag-mask device technique is correct? A. Bag-mask ventilations should be delivered every 2 seconds when the device is being operated by one person. B. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bagmask device. C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device. D. The bag-mask device delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.

C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device.

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray? A. Encourage the patient to chew the tablet to increase its effectiveness. B. Place the medication under the tongue and have the patient swallow it. C. Administer the medication sublingually and allow it to dissolve or absorb. D. Wait 15 minutes and reassess the blood pressure prior to administering another dose.

C. Administer the medication sublingually and allow it to dissolve or absorb.

Which of the following statements regarding agonal respirations is correct? A. Agonal respirations result in excessive tidal volume. B. Agonal respirations typically occur before the heart stops. C. Agonal respirations are ineffective and need to be assisted. D. Agonal respirations are characterized by fast irregular breaths.

C. Agonal respirations are ineffective and need to be assisted.

A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway? A. Suction his oropharynx with a rigid catheter until all secretions are removed. B. Insert a nasopharyngeal airway and provide suction and assisted ventilations. C. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation. D. Provide continuous ventilations with a bag-mask device to minimize hypoxia.

C. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.

Which of the following statements regarding the metered-dose inhaler (MDI) is correct? A. MDIs are contraindicated for patients with asthma or emphysema. B. MDIs are most commonly used by patients with cardiovascular disease. C. An MDI delivers the same amount of medication every time it is used. D. Shaking an MDI prior to use will cause deactivation of the medication.

C. An MDI delivers the same amount of medication every time it is used.

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next? A. Allow the mother to hold her baby. B. Clamp and cut the umbilical cord. C. Assess the brachial or umbilical pulse. D. Begin assisting the newborn's breathing.

C. Assess the brachial or umbilical pulse.

Which of the following is the MOST reliable method of estimating a patient's cardiac output? A. Listen to heart sounds with a stethoscope. B. Connect the patient to an electrocardiogram. C. Assess the heart rate and strength of the pulse. D. Determine the average diastolic blood pressure.

C. Assess the heart rate and strength of the pulse.

Which of the following statements regarding nervous system control of the cardiovascular system is correct? A. When stimulated, the parasympathetic nervous system is responsible for increasing the heart rate. B. Alpha-adrenergic receptors are located exclusively in the heart and are stimulated by epinephrine. C. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure. D. The sympathetic and parasympathetic nervous systems work together to perform the same function.

C. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure.

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? A. Look for blood or other secretions in the tube. B. Attempt to pass a suction catheter into the tube. C. Check the mechanical ventilator for malfunction. D. Listen to breath sounds to assess for a pneumothorax.

C. Check the mechanical ventilator for malfunction.

Which of the following statements regarding pediatric trauma is correct? A. Children are less likely than adults to be struck by a car. B. A child's head is less frequently injured than an adult's. C. Children are more likely to experience diving-related injuries. D. Inexperience and poor judgment are rare causes of pediatric trauma.

C. Children are more likely to experience diving-related injuries.

Which of the following statements regarding a pediatric patient's anatomy is correct? A. The tracheal rings of a child are more rigid than an adult's. B. A child's tongue is proportionately smaller than an adult's. C. Children have a larger, rounder occiput compared to adults. D. The child's epiglottis is less floppy and smaller than an adult's.

C. Children have a larger, rounder occiput compared to adults.

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? A. Avoid defibrillation as this will damage the patient's AICD. B. Contact medical control and request permission to defibrillate. C. Deliver the shock followed by immediate resumption of CPR. D. Continue CPR and transport the patient to the closest appropriate hospital.

C. Deliver the shock followed by immediate resumption of CPR.

Your partner, a veteran EMT who you have worked with regularly for the past 4 years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do? A. Remain quiet and simply request another partner. B. Report the incident to your EMS medical director. C. Discreetly report your suspicions to your supervisor. D. Tell your partner that he must seek professional help.

C. Discreetly report your suspicions to your supervisor.

A patient in a semireclined position with the head elevated to facilitate breathing is in the ___________ position: A. prone B. supine C. Fowler's D. recovery

C. Fowler's

You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control? A. Administer her epinephrine, reassess her condition, and transport her promptly. B. Begin immediate transport and request an intercept with a paramedic ambulance. C. Give her oxygen, transport her to the hospital, and monitor her condition en route. D. Give her half the dose of her epinephrine in case her allergic reaction is delayed.

C. Give her oxygen, transport her to the hospital, and monitor her condition en route.

Which of the following statements regarding hearing aids is correct? A. Over time, hearing aids can restore normal hearing. B. In-the-canal hearing aids fit in the outer part of the ear. C. Hearing aids cannot restore hearing to normal levels. D. A whistling sound indicates correct hearing aid placement.

C. Hearing aids cannot restore hearing to normal levels.

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.

Which of the following statements regarding secondary brain injury is correct? A. It results from direct brain trauma following an impact to the head. B. Because cerebral edema develops quickly, it is considered to be a primary brain injury. C. Hypoxia and hypotension are the two most common causes of secondary brain injury. D. Signs are often present immediately after an impact to the head.

C. Hypoxia and hypotension are the two most common causes of secondary brain injury.

Which of the following statements regarding oxygenation and ventilation is correct? A. In carbon monoxide (CO) poisoning, ventilation is impaired because CO binds to oxygen very quickly. B. Oxygenation is the movement of air into and out of the lungs, whereas ventilation is the exchange of gases. C. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation. D. Oxygenation without adequate ventilation can occur in climbers who quickly ascend to an altitude of lower atmospheric pressure.

C. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.

Which of the following statements regarding gestational diabetes is correct? A. Gestational diabetes results in permanent diabetes mellitus after delivery. B. The onset of gestational diabetes typically manifests with hypoglycemia. C. In some cases, women with gestational diabetes require insulin injections. D. Diet and exercise are typically ineffective in controlling gestational diabetes.

C. In some cases, women with gestational diabetes require insulin injections.

Which of the following statements regarding the H1N1 virus is correct? A. H1N1 has caused more deaths worldwide than all of the other strains of influenza combined. B. Unlike other strains of the influenza virus, H1N1 is primarily transmitted via the fecal-oral route. C. It is only one type of influenza among the many other strains of influenza that exist and infect humans. D. H1N1, also known as the "swine flu," is a newly discovered strain of influenza for which no vaccine exists.

C. It is only one type of influenza among the many other strains of influenza that exist and infect humans.

With regard to the three collisions that occur during a motor vehicle crash, which of the following statements regarding the first collision is correct? A. It provides the least amount of information about the mechanism of injury. B. It has a direct effect on patient care because of the obvious vehicular damage. C. It is the most dramatic part of the collision and may make extrication difficult. D. It occurs when the unrestrained occupant collides with the interior of the vehicle.

C. It is the most dramatic part of the collision and may make extrication difficult.

Which of the following statements regarding the power lift is correct? A. It involves using your lower back instead of your legs to lift. B. The leg muscles should remain relaxed during the power lift. C. It is the safest and most powerful method of lifting a patient. D. It is not recommended for people with weak knees or thighs.

C. It is the safest and most powerful method of lifting a patient.

An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the MOST appropriate method of immobilizing this patient? A. Apply a cervical collar and place her in a sitting position on the wheeled stretcher. B. Immobilize her in a supine position on a long backboard and secure her with straps. C. Leave her on her side and use blanket rolls to immobilize her to the long backboard. D. Move her to a supine position and immobilize her with a scoop stretcher and padding.

C. Leave her on her side and use blanket rolls to immobilize her to the long backboard.

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? A. Certain cases of SIDS are predictable and therefore preventable. B. SIDS is most commonly the result of an overwhelming infection. C. Most cases of SIDS occur in infants younger than 6 months. D. The cause of death following SIDS can be established by autopsy.

C. Most cases of SIDS occur in infants younger than 6 months.

Which of the following statements regarding autism is correct? A. Autism affects females four times greater than males. B. The majority of patients with autism do not speak at all. C. Most cases of autism are diagnosed by 3 years of age. D. Impairment of motor activity is a classic sign of autism.

C. Most cases of autism are diagnosed by 3 years of age.

Which of the following statements regarding shoulder dislocations is MOST correct? A. Posterior dislocations are most common. B. They are caused by forced arm adduction. C. Most shoulder dislocations occur anteriorly. D. They involve the acromion process and humerus.

C. Most shoulder dislocations occur anteriorly.

Which of the following statements regarding twins is correct? A. Twins are typically larger than single infants. B. Identical twins are typically of different gender. C. Most twins are born within 45 minutes of each other. D. Fraternal twins have two cords coming from one placenta.

C. Most twins are born within 45 minutes of each other.

Which of the following statements regarding oxygen is correct? A. Oxygen cylinders must always remain in an upright position. B. Oxygen is flammable and may explode if under high pressure. C. Oxygen supports the combustion process and may cause a fire. D. Oxygen is most safely administered in an enclosed environment.

C. Oxygen supports the combustion process and may cause a fire.

Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone? A. advanced age B. cerebral palsy C. Parkinson disease D. visual impairment

C. Parkinson disease

Which of the following statements regarding breathing adequacy is correct? A. Patients with a grossly irregular breathing pattern usually do not require assisted ventilation. B. The single most reliable sign of breathing adequacy in the adult is his or her respiratory rate. C. Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate. D. A patient with slow respirations and adequate depth will experience an increase in minute volume.

C. Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate.

Which of the following statements regarding dialysis is correct? A. Acute hypertension is a common adverse effect of dialysis. B. Hemodialysis is effective but carries a high risk of peritonitis. C. Patients who miss a dialysis treatment often present with weakness. D. The purpose of dialysis is to help the kidneys retain salt and water.

C. Patients who miss a dialysis treatment often present with weakness.

Which of the following statements regarding gastrostomy (gastric) tubes is correct? A. Gastrostomy tubes are placed directly into the small intestine. B. Most gastrostomy tubes are temporary and are not sutured in place. C. Patients with a gastrostomy tube may still be at risk for aspiration. D. Gastrostomy tubes are used for patients who cannot digest food.

C. Patients with a gastrostomy tube may still be at risk for aspiration.

Which of the following statements regarding a basilar skull fracture is correct? A. Bloody CSF commonly leaks from the nose. B. In most cases, mastoid bruising occurs. C. The absence of raccoon eyes or Battle's sign does not rule it out. D. They are typically the result of local, low-energy trauma to the head.

C. The absence of raccoon eyes or Battle's sign does not rule it out.

Which of the following statements regarding the epinephrine auto-injector is correct? A. The adult auto-injector delivers 0.5 to 1 mg of epinephrine. B. The auto-injector delivers epinephrine via the subcutaneous route. C. The epinephrine auto-injector delivers a preset amount of the drug. D. EMTs do not need physician authorization to use the auto-injector.

C. The epinephrine auto-injector delivers a preset amount of the drug.

Which of the following statements regarding the acute abdomen is correct? A. The most common cause of an acute abdomen is inflammation of the gallbladder and liver. B. The parietal peritoneum is typically the first abdominal layer that becomes inflamed or irritated. C. The initial pain associated with an acute abdomen tends to be vague and poorly localized. D. An acute abdomen almost always occurs as the result of blunt trauma to solid abdominal organs.

C. The initial pain associated with an acute abdomen tends to be vague and poorly localized.

Which of the following processes occurs during ovulation? A. Certain female hormone levels decrease significantly in quantity. B. The endometrium sheds its lining and is expelled from the vagina. C. The inner lining of the uterus thickens in preparation for implantation. D. Numerous follicles mature and release eggs into the fallopian tubes.

C. The inner lining of the uterus thickens in preparation for implantation.

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct? A. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting. B. The risk of HIV infection is high, even if an infected person's blood comes in contact with your intact skin. C. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream. D. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.

C. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream.

Which of the following statements regarding the different stages of the grieving process is correct? A. The grieving process typically begins with severe depression. B. It is rare that people will jump back and forth between stages. C. The stages of the grieving process may occur simultaneously. D. Bargaining is the most unpleasant stage of the grieving process.

C. The stages of the grieving process may occur simultaneously.

Why do middle adults commonly experience financial concerns? A. They are typically receiving social security and must budget with a fixed income. B. Most people in the middle adult age group have chronic illnesses and cannot work. C. They are preparing for retirement but must still manage everyday financial demands. D. The majority of middle adults still have small children that live at home with them.

C. They are preparing for retirement but must still manage everyday financial demands.

Which of the following occurs during true labor? A. Uterine contractions decrease in intensity. B. The uterus becomes very soft and movable. C. Uterine contractions become more regular. D. Uterine contractions last about 10 seconds.

C. Uterine contractions become more regular.

A patient who was bitten by a mosquito and presents with signs and symptoms of illness should be suspected of having: A. avian flu. B. hantavirus. C. West Nile virus. D. lyme disease.

C. West Nile virus.

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence? A. What time did the ingestion occur? B. Have you noticed any signs or symptoms? C. Why did your child ingest the poison? D. Do you know what substance was ingested?

C. Why did your child ingest the poison?

Which of the following statements regarding the secondary assessment is correct? A. If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment. B. The purpose of the secondary assessment is to systematically examine every patient from head to toe, regardless of the severity of his or her injury. C. You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment. D. A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems.

C. You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.

Which of the following patients should you place in the recovery position? A. a 19-year-old conscious male with a closed head injury and normal respirations B. a 24-year-old unconscious female who overdosed and has a reduced tidal volume C. a 31-year-old semiconscious male with low blood sugar and adequate breathing D. a 40-year-old conscious female with a possible neck injury and regular respirations

C. a 31-year-old semiconscious male with low blood sugar and adequate breathing

Which of the following patients has experienced the MOST significant fall? A. a 4′8″ patient who fell 13′ B. a 5′0″ patient who fell 13′ C. a 4′6″ patient who fell 13′ D. a 5′9″ patient who fell 14′

C. a 4′6″ patient who fell 13′

Osteoporosis is MOST accurately defined as: A. increased flexibility of bone mass. B. decreased bone marrow production. C. a decrease in bone mass and density. D. an abnormality near the growth plate.

C. a decrease in bone mass and density.

A subluxation occurs when: A. ligaments are partially severed. B. a fracture and a dislocation exist. C. a joint is incompletely dislocated. D. a bone develops a hairline fracture.

C. a joint is incompletely dislocated.

In which of the following patients should you remove an impaled object? A. a semiconscious patient with an ice pick impaled in the chest B. an apneic patient with a shard of glass impaled in the abdomen C. a pulseless and apneic patient with a knife impaled in the back D. a conscious and alert patient with a fishhook impaled in the eye

C. a pulseless and apneic patient with a knife impaled in the back

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: A. a swimmer breathes shallowly before entering the water. B. a diver holds his or her breath during a staged ascent. C. a swimmer hyperventilates prior to entering the water. D. a diver holds his or her breath for a long period of time.

C. a swimmer hyperventilates prior to entering the water.

Down syndrome is a genetic defect that occurs as the result of: A. an extra pair of chromosomes. B. a separation of chromosome 21. C. a triplication of chromosome 21. D. a sperm that contains 24 chromosomes.

C. a triplication of chromosome 21.

Signs of late heatstroke include: A. hot, moist skin. B. nausea and vomiting. C. a weak, rapid pulse. D. a change in behavior.

C. a weak, rapid pulse.

To assess a patient's general temperature, pull back on your glove and place the back of your hand on his or her skin at the: A. neck. B. chest. C. abdomen. D. forehead.

C. abdomen.

The femoral head forms a ball-and-socket joint with the: A. ilium. B. ischium. C. acetabulum. D. femoral condyle.

C. acetabulum.

In preconventional reasoning, children: A. make decisions based on their conscience. B. look for approval from their peers and society. C. act almost purely to avoid punishment and to get what they want. D. blame their actions on what they have observed in older children.

C. act almost purely to avoid punishment and to get what they want.

The primary prehospital treatment for most medical emergencies: A. typically does not require the EMT to contact medical control. B. focuses on definitive care because a diagnosis can usually be made. C. addresses the patient's symptoms more than the actual disease process. D. involves transport only until treatment can be performed at the hospital.

C. addresses the patient's symptoms more than the actual disease process.

A 39-year-old male was struck in the head by a baseball during a game. He is confused, has a large hematoma in the center of his forehead, and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: A. perform a neurologic exam. B. palpate his radial pulses. C. administer high-flow oxygen. D. apply ice to the hematoma.

C. administer high-flow oxygen.

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: A. requesting a paramedic ambulance to insert an advanced airway device. B. separating the child from her mother and providing ventilatory assistance. C. administering blow-by oxygen and transporting the child with her mother. D. allowing the child to remain with her mother and applying a nasal cannula.

C. administering blow-by oxygen and transporting the child with her mother.

In the presence of oxygen, the mitochondria of the cells convert glucose into energy through a process called: A. perfusion. B. respiration. C. aerobic metabolism. D. anaerobic metabolism.

C. aerobic metabolism.

When immobilizing a seated patient with a short backboard or vest-style immobilization device, you should apply a cervical collar: A. after the torso has been adequately secured. B. after moving the patient to a long backboard. C. after assessing distal neurovascular functions. D. before manually stabilizing the patient's head.

C. after assessing distal neurovascular functions.

When functioning at the scene of a motor vehicle crash in which a patient will require complex extrication, you should enter the vehicle and provide care to the patient: A. only if the patient has experienced a major injury. B. after rescue personnel have cut the battery cables. C. after receiving approval from the extrication officer. D. only after you believe the vehicle has been stabilized.

C. after receiving approval from the extrication officer.

When communicating with an older patient, it is important to remember that: A. deafness and blindness are a normal part of the process of aging. B. most older patients are confused due to a decrease in brain cells. C. age-related changes diminish the effectiveness of the eyes and ears. D. the majority of older patients experience a loss of low-frequency hearing.

C. age-related changes diminish the effectiveness of the eyes and ears.

Common causes of depression in the elderly include all of the following, EXCEPT: A. chronic medical conditions. B. prescription medication use. C. an acute onset of dementia. D. alcohol abuse and dependence.

C. an acute onset of dementia.

Signs of a severe airway obstruction in an infant or child include: A. pink, dry skin. B. crying and anxiety. C. an ineffective cough. D. mild respiratory distress.

C. an ineffective cough.

Which of the following children would benefit the LEAST from a nonrebreathing mask? A. a conscious 4-year-old male with adequate tidal volume B. a responsive 6-year-old male who responds appropriately C. an unresponsive 5-year-old male with shallow respirations D. a semiconscious 7-year-old female with normal ventilation

C. an unresponsive 5-year-old male with shallow respirations

A 17-year-old male was shot in the right anterior chest during an altercation with a gang member. As your partner is applying 100% oxygen, you perform a rapid secondary assessment and find an open chest wound with a small amount of blood bubbling from it. You should: A. place a sterile dressing over the wound and apply direct pressure. B. control the bleeding from the wound and prepare to transport at once. C. apply an occlusive dressing to the wound and continue your assessment. D. direct your partner to assist the patient's ventilations with a bag-mask device.

C. apply an occlusive dressing to the wound and continue your assessment.

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should: A. stabilize the impaled glass in her eye. B. administer 100% supplemental oxygen. C. apply direct pressure to her arm wound. D. carefully remove the glass from her eye.

C. apply direct pressure to her arm wound.

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. The MOST appropriate method of splinting this injury involves: A. applying a traction splint to realign the deformity. B. applying and fully inflating the pneumatic antishock garment (PASG). C. applying padded board splints to both sides of the leg. D. binding the legs together and elevating them 6″ to 8″.

C. applying padded board splints to both sides of the leg.

Common activities that occur while you and your partner are en route to the scene of an emergency call include all of the following, EXCEPT: A. assigning tasks to each member of the response team. B. obtaining additional information from the dispatcher. C. apprising the medical director of the nature of the call. D. fastening your seatbelts before the ambulance departs.

C. apprising the medical director of the nature of the call.

During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you: A. acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others. B. adequately safeguarded the patient's PHI because the cases were discussed internally. C. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand. D. violated the patient's privacy because you should have only discussed the information with the EMTs who provided it.

C. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.

Febrile seizures: A. often result in permanent brain damage. B. are also referred to as petit mal seizures. C. are usually benign but should be evaluated. D. occur when a child's fever progressively rises.

C. are usually benign but should be evaluated.

With regard to musculoskeletal injuries, the zone of injury is defined as the: A. area of obvious deformity over the site of impact. B. exact part of the bone or joint that was disrupted. C. area of soft-tissue damage surrounding the injury. D. part of the body that sustained secondary injury.

C. area of soft-tissue damage surrounding the injury.

When assessing a 78-year-old female who complains of shortness of breath, the EMT should: A. give oxygen only if the patient has labored breathing. B. conclude that the patient is experiencing a heart attack. C. ask her how many pillows she uses when she sleeps. D. place the patient supine to see if the problem worsens.

C. ask her how many pillows she uses when she sleeps.

When assessing arm movement of a patient with a suspected stroke, you should: A. observe for approximately 5 minutes. B. expect to see one arm slowly drift down to the patient's side. C. ask the patient to close his or her eyes during the assessment. D. ask the patient to hold his or her arms up with the palms down.

C. ask the patient to close his or her eyes during the assessment.

When interacting with a developmentally disabled patient, the best approach is to: A. speak primarily with the patient's family to establish the degree of disability. B. approach the patient as a team to reassure him or her that you are there to help. C. ask your team members to wait until you can establish a rapport with the patient. D. position yourself slightly above the patient's level to reduce his or her anxiety.

C. ask your team members to wait until you can establish a rapport with the patient.

You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport, she begins to complain of numbness and tingling in her hand. You should: A. remove the bandage and dressing and apply another one. B. carefully manipulate her arm until the symptoms subside. C. assess distal circulation and readjust the bandage as needed. D. remove the gauze bandage and replace it with an elastic one.

C. assess distal circulation and readjust the bandage as needed.

You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should: A. apply 100% oxygen. B. place her on her left side. C. assess her for crowning. D. transport her immediately.

C. assess her for crowning.

You have applied a zippered air splint to a patient's left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to: A. elevate the injured arm and reassess distal sensory function. B. inflate the splint with more air until the patient is comfortable. C. assess the amount of air in the splint and let air out as necessary. D. remove the air splint and reimmobilize with padded board splints.

C. assess the amount of air in the splint and let air out as necessary.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to: A. quickly gain access to the patient. B. notify the dispatcher of your arrival. C. assess the scene for potential hazards. D. place a paramedic ambulance on standby.

C. assess the scene for potential hazards.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should: A. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment. B. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest. C. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible. D. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.

C. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should: A. place a bite block in her mouth in case she has a seizure and transport at once. B. apply oxygen via a nonrebreathing mask, place her on her left side, and transport. C. assist ventilations, perform a rapid exam, and prepare for immediate transport. D. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.

C. assist ventilations, perform a rapid exam, and prepare for immediate transport.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: A. limit your physical examination to the area of pain or injury. B. rely exclusively on family members for the medical history. C. attempt to differentiate between chronic and acute problems. D. perform a rapid assessment on all geriatric patients you treat.

C. attempt to differentiate between chronic and acute problems.

Upon initial contact with a patient who appears to be unconscious, you should: A. assess breathing depth and determine the respiratory rate. B. squeeze the trapezius muscle to see if the patient responds. C. attempt to elicit a verbal response by talking to the patient. D. direct your partner to apply oxygen via nonrebreathing mask.

C. attempt to elicit a verbal response by talking to the patient.

If suctioning of the tracheostomy tube is necessary, the EMT should: A. attach a bag-mask device to the tracheostomy tube and hyperventilate the patient for 2 minutes. B. instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds. C. attempt to use the patient's suction device first because it is probably already sized correctly. D. insert the suction catheter to a depth of no more than 15-cm and set the suction unit to 140 mm Hg.

C. attempt to use the patient's suction device first because it is probably already sized correctly.

Which of the following situations requires you to notify the appropriate authorities? A. cardiac arrest B. drug overdose C. attempted suicide D. accidental knife wound

C. attempted suicide

Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A. evaluating the patient's chest for cyanosis B. applying a pulse oximeter and monitoring the SpO2 C. auscultating breath sounds with a stethoscope D. looking for the presence of accessory muscle use

C. auscultating breath sounds with a stethoscope

The body's functions that occur without conscious effort are regulated by the _________ nervous system. A. sensory B. somatic C. autonomic D. voluntary

C. autonomic

When controlling bleeding from a scalp laceration with a suspected underlying skull fracture, you should: A. elevate the patient's head and apply an ice pack. B. apply manual pressure and avoid applying a bandage. C. avoid excessive pressure when applying the bandage. D. apply firm compression for no longer than 5 minutes.

C. avoid excessive pressure when applying the bandage.

When treating a patient who experienced a pulmonary blast injury, you should: A. use a demand valve to ventilate the patient. B. suspect an accompanying cardiac tamponade. C. avoid giving oxygen under positive pressure. D. administer large amounts of intravenous fluid.

C. avoid giving oxygen under positive pressure.

When a patient is dying, he or she may experience regression. This is MOST accurately defined as: A. anger projected toward the EMT or other providers. B. fear of being completely dependent upon other people. C. behavior consistent with an earlier developmental stage. D. a decreased ability to exercise age-appropriate judgment.

C. behavior consistent with an earlier developmental stage.

A patient has fractured both femurs. Anatomically, these injuries would be described as being: A. medial. B. proximal. C. bilateral. D. unilateral.

C. bilateral.

A medication with antagonistic properties is one that: A. stimulates receptor sites and allows other chemicals to attach to them. B. enhances the effects of another medication when given in a higher dose. C. blocks receptor sites and prevents other chemicals from attaching to them. D. produces a cumulative effect when mixed with the same type of medication.

C. blocks receptor sites and prevents other chemicals from attaching to them.

Intrapulmonary shunting occurs when: A. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs. B. a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. C. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state. D. any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane.

C. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.

Contraction of the right ventricle causes: A. closure of the mitral and aortic valves. B. a return of blood from the pulmonary veins. C. blood to flow into the pulmonary circulation. D. ejection of blood into the systemic circulation.

C. blood to flow into the pulmonary circulation.

Which of the following structures is regulated by smooth muscle? A. heart B. skeleton C. blood vessels D. diaphragm

C. blood vessels

Pale skin in a child indicates that the: A. child is in severe decompensated shock. B. oxygen content in the blood is decreased. C. blood vessels near the skin are constricted. D. child's core body temperature is elevated.

C. blood vessels near the skin are constricted.

Cerebral palsy is characterized by poorly controlled ________ movement. A. eye B. neck C. body D. extremity

C. body

The autonomic nervous system controls all of the following functions, EXCEPT: A. digestion. B. breathing. C. breath holding. D. vessel dilation.

C. breath holding.

Air bags are designed to: A. prevent a second collision inside the car. B. be used with or without a shoulder harness. C. decrease the severity of deceleration injuries. D. prevent the driver from sustaining head trauma.

C. decrease the severity of deceleration injuries.

Which of the following findings would be LEAST suggestive of a head injury? A. one pupil larger in size than the other pupil B. failure of the eyes to move in the same direction C. briskly constricting pupils when exposed to light D. failure of the eyes to follow movement of an object

C. briskly constricting pupils when exposed to light

Which of the following structures is NOT found in the upper airway? A. larynx B. pharynx C. bronchus D. oropharynx

C. bronchus

While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is irregular. You should be MOST suspicious for: A. underlying cardiac disease. B. a lacerated coronary artery. C. bruising of the heart muscle. D. traumatic rupture of the aorta.

C. bruising of the heart muscle.

Hyperventilation during the preoxygenation phase of endotracheal intubation: A. will decrease the likelihood of aspiration. B. is acceptable if done for fewer than 2 minutes. C. can cause gastric distention and hypotension. D. provides a better oxygen reserve for the patient.

C. can cause gastric distention and hypotension.

The primary waste product of aerobic metabolism is: A. lactic acid. B. pyruvic acid. C. carbon dioxide. D. adenosine triphosphate.

C. carbon dioxide.

While using lights and siren, most state laws permit an ambulance to: A. disregard all traffic control signals. B. drive as fast as the department allows. C. carefully exceed the posted speed limit. D. proceed through red lights without stopping.

C. carefully exceed the posted speed limit.

The head and brain receive their supply of oxygenated blood from the: A. iliac arteries. B. brachial arteries. C. carotid arteries. D. subclavian arteries.

C. carotid arteries.

The umbilical cord: A. separates from the placenta shortly after birth. B. carries blood away from the baby via the artery. C. carries oxygen to the baby via the umbilical vein. D. contains two veins and one large umbilical artery.

C. carries oxygen to the baby via the umbilical vein.

In contrast to animal bites, the bite of a human: A. is usually less severe because the human mouth is cleaner. B. typically results in a minor infection that is slow-spreading. C. carries with it a wide variety of virulent bacteria and viruses. D. is associated with a much higher incidence of rabies infection.

C. carries with it a wide variety of virulent bacteria and viruses.

Coordination of balance and body movement is controlled by the: A. medulla. B. cerebrum. C. cerebellum. D. brain stem.

C. cerebellum.

Interruption of cerebral blood flow may result from all of the following, EXCEPT: A. a thrombus. B. an embolism. C. cerebral vasodilation. D. an acute arterial rupture.

C. cerebral vasodilation.

The jaw-thrust maneuver is used to open the airway of patients with suspected: A. mandibular fractures. B. upper airway swelling. C. cervical spine injuries. D. copious oral secretions.

C. cervical spine injuries.

When would it be MOST appropriate for a patient to take his or her prescribed nitroglycerin? A. sharp chest pain that lasts longer than 10 to 15 minutes B. an acute onset of dizziness during a period of exertion C. chest pain that does not immediately subside with rest D. difficulty breathing that awakens the patient from sleep

C. chest pain that does not immediately subside with rest

The descending aorta branches into the: A. deep femoral arteries. B. internal carotid arteries. C. common iliac arteries. D. external carotid arteries.

C. common iliac arteries.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? A. hyperventilation and hypersalivation B. a rapidly improving level of consciousness C. confusion and fatigue D. a gradually decreasing level of consciousness

C. confusion and fatigue

Which of the following findings is LEAST suggestive of child abuse? A. evidence of alcohol consumption or drug use at the scene B. burns to the hands or feet that involve a glove distribution C. consistency in the method of injury reported by the caregiver D. an unexplained delay in seeking medical care after the injury

C. consistency in the method of injury reported by the caregiver

While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: A. document the error and report it to your supervisor. B. notify law enforcement so they can file an incident report. C. contact medical control and notify him or her of the error. D. exclude this from the PCR since it did not harm the patient.

C. contact medical control and notify him or her of the error.

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called: A. radiation. B. conduction. C. convection. D. evaporation.

C. convection.

During the transport phase of an ambulance call, it is MOST important to: A. reassess the patient only if he or she deteriorates. B. reassess unstable patients at least every 15 minutes. C. converse with the patient and provide reassurance. D. complete the run form before arrival at the hospital.

C. converse with the patient and provide reassurance.

All of the following snakes are pit vipers, EXCEPT for the: A. copperhead. B. rattlesnake. C. coral snake. D. cottonmouth.

C. coral snake.

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should: A. scrape the splinter away with moist, sterile gauze. B. cover his right eye and flush the left eye with saline. C. cover both of his eyes and transport to the hospital. D. remove the object with a cotton-tipped applicator.

C. cover both of his eyes and transport to the hospital.

You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a definitive sign of death? A. absence of a pulse B. profound cyanosis C. dependent lividity D. absent breath sounds

C. dependent lividity

A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: A. wait for family members to arrive before asking any questions. B. defer SAMPLE history questions until you arrive at the hospital. C. determine if the patient has a medical alert bracelet or wallet card. D. ask law enforcement officials if they are familiar with the patient.

C. determine if the patient has a medical alert bracelet or wallet card.

A patient with profuse sweating is referred to as being: A. flushed. B. plethoric. C. diaphoretic. D. edematous.

C. diaphoretic.

Inhalation occurs when the: A. diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure. B. diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure. C. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure. D. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.

C. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.

An EMT would MOST likely be held liable for abandonment if he or she: A. refused to care for a violent patient who is armed with a knife. B. remained at the hospital for 30 minutes to give a patient report. C. did not make provisions for continued care of an injured patient. D. terminated care of a competent adult patient at his or her request.

C. did not make provisions for continued care of an injured patient.

Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called: A. osmosis. B. breathing. C. diffusion. D. ventilation.

C. diffusion.

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with: A. pressure dressings and chemical ice packs. B. digital pressure to an adjacent pulse point. C. direct pressure using dry, sterile dressings. D. ice packs and elevation of the patient's head.

C. direct pressure using dry, sterile dressings.

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should: A. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment. B. open her airway with the head tilt-chin lift maneuver, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia. C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing. D. begin assisting her ventilations with a bag-mask device while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation.

C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

Pathophysiology is the study of the functional changes that occur when the body reacts to a particular: A. medication. B. assessment. C. disease. D. protocol.

C. disease.

When working as an independent health care group member, the EMT should expect that he or she: A. will receive no support or guidance from an EMS supervisor. B. will be specifically instructed on how to perform a specific task. C. does not have to wait for an assignment before performing a task. D. will rely on the group leader for making virtually all decisions.

C. does not have to wait for an assignment before performing a task.

Which of the following components are needed to prove negligence? A. abandonment, breach of duty, damages, and causation B. duty to act, abandonment, breach of duty, and causation C. duty to act, breach of duty, injury/damages, and causation D. breach of duty, injury/damages, abandonment, and causation

C. duty to act, breach of duty, injury/damages, and causation

In dependent groups: A. each individual is responsible for his or her own area. B. everyone works together with shared tasks C. each individual is told what to do by his or her supervisor or group leader. D. individuals do not have to wait for their assignment before taking action.

C. each individual is told what to do by his or her supervisor or group leader.

Which of the following areas of the body has the thinnest skin? A. scalp B. back C. ears D. soles of the feet

C. ears

Which of the following systems is responsible for releasing hormones that regulate body activities? A. skeletal B. nervous C. endocrine D. reproductive

C. endocrine

Structures of the lower airway include all of the following, EXCEPT the: A. alveoli. B. trachea. C. epiglottis. D. bronchioles.

C. epiglottis.

The hormone responsible for the actions of the sympathetic nervous system is: A. insulin. B. thyroxine. C. epinephrine. D. aldosterone.

C. epinephrine.

A(n) __________ fracture occurs in the growth section of a child's bone and may lead to bone growth abnormalities. A. greenstick B. diaphyseal C. epiphyseal D. metaphyseal

C. epiphyseal

The MOST important treatment for patients with a head injury, regardless of severity, is to: A. immobilize the spine. B. administer 100% oxygen. C. establish an adequate airway. D. transport to a trauma center.

C. establish an adequate airway.

Assessing a person's neurovascular status following a musculoskeletal injury includes all of the following, EXCEPT: A. assessing motor function. B. assessing sensory function. C. evaluating proximal pulses. D. determining capillary refill.

C. evaluating proximal pulses.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: A. have relatively smaller heads. B. have less body fat. C. exhibit poor thermoregulation. D. have smaller body surface areas.

C. exhibit poor thermoregulation.

You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should: A. reassure him that he will not receive a bill for the EMS call if he cannot pay. B. tell him that he is having a heart attack and that he needs to go to the hospital. C. explain the seriousness of the situation to him, but avoid causing undue alarm. D. proceed to treat him because the stress of the situation has impaired his thinking.

C. explain the seriousness of the situation to him, but avoid causing undue alarm.

Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should: A. restrain her and provide ventilatory assistance. B. insert a nasopharyngeal airway and give oxygen. C. explain to her that you will assist her ventilations. D. ventilate her at the rate at which she is breathing.

C. explain to her that you will assist her ventilations.

You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. What type of consent is her agreement considered? A. implied B. informed C. expressed D. minor's

C. expressed

Activated charcoal is frequently suspended in sorbitol, a complex sugar that: A. significantly slows the process of digestion. B. binds to any chemicals that are in the stomach. C. facilitates movement through the digestive system. D. disguises the unpleasant taste of the activated charcoal.

C. facilitates movement through the digestive system.

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

C. failing to deliver a shock when one is needed.

A blood pressure cuff that is too small for a patient's arm will give a: A. falsely low systolic and diastolic reading. B. falsely high systolic but low diastolic reading. C. falsely high systolic and diastolic reading. D. falsely low systolic but high diastolic reading.

C. falsely high systolic and diastolic reading.

Risk factors for AMI that cannot be controlled include: A. excess stress. B. hyperglycemia. C. family history. D. lack of exercise.

C. family history.

When considering his or her personal life, it is important for the EMT to realize that: A. he or she should not discuss stressful issues with family members. B. shift work is the least stressful type of an EMS-related work schedule. C. family or friends may not understand the stress associated with EMS. D. it is more difficult to effectively relax at home than it is while on duty.

C. family or friends may not understand the stress associated with EMS.

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse. A. radial B. carotid C. femoral D. popliteal

C. femoral

Traction splints are used primarily to immobilize and secure fractures of the: A. hip. B. pelvis. C. femur. D. humerus.

C. femur.

The atlas is the: A. point where the ribs attach to the sternum. B. seventh cervical vertebra, which is easily palpable. C. first cervical vertebra, which articulates with the skull. D. attachment between the first and second cervical vertebrae.

C. first cervical vertebra, which articulates with the skull.

Together, the right and left lungs contain how many lobes? A. three B. four C. five D. six

C. five

General communication techniques with the elderly include: A. using medical terms to ensure patient understanding. B. explaining procedures while you are performing them. C. frequently asking the patient if he or she understands. D. having at least two EMTs talk to the patient at a time.

C. frequently asking the patient if he or she understands.

The direct carry is used to transfer a patient: A. with multiple long bone injuries. B. with a possible cervical spine injury. C. from a bed to the ambulance stretcher. D. who cannot be placed on a backboard.

C. from a bed to the ambulance stretcher.

In most children, febrile seizures are characterized by: A. a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase. B. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase. C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase. D. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase.

C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should: A. limit your primary assessment to airway and breathing only. B. treat only critical injuries before moving him to a safe place. C. grab him by the clothes and immediately move him to safety. D. perform a rapid assessment and move him to a place of safety.

C. grab him by the clothes and immediately move him to safety.

Distraction injuries of the spine are MOST commonly the result of: A. falls. B. diving. C. hangings. D. compression.

C. hangings.

Hepatitis B is more virulent than hepatitis C, which means that it: A. is less resistant to treatment. B. is a more contagious type of disease. C. has a greater ability to produce disease. D. leads to chronic infection after exposure.

C. has a greater ability to produce disease.

You should suspect that a patient is experiencing respiratory failure if he or she: A. is restless and is working hard to breathe. B. has an increased heart rate and retractions. C. has bradycardia and diminished muscle tone. D. is anxious, tachycardic, and leaning forward.

C. has bradycardia and diminished muscle tone.

Eclampsia is MOST accurately defined as: A. high levels of protein in the patient's urine. B. hypertension in the 20th week of pregnancy. C. seizures that result from severe hypertension. D. a blood pressure greater than 140/90 mm Hg.

C. seizures that result from severe hypertension.

EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider: A. needs simple assistance in providing patient care. B. must confirm that a specific intervention is required. C. has recognized a change in the patient's health status. D. has a question that is specific to the patient's condition.

C. has recognized a change in the patient's health status.

Vaccination against the hepatitis A virus is unnecessary if you: A. are older than 35 years of age. B. have a weak immune system. C. have been infected in the past. D. received a hepatitis B vaccination.

C. have been infected in the past.

A precipitous labor and delivery is MOST common in women who: A. have gestational diabetes. B. are younger than 30 years of age. C. have delivered a baby before. D. are pregnant for the first time.

C. have delivered a baby before.

CPAP is indicated for patients who: A. have signs of pneumonia but are breathing adequately. B. are unresponsive and have signs of inadequate ventilation. C. have pulmonary edema and can follow verbal commands. D. are hypotensive and have a marked reduction in tidal volume.

C. have pulmonary edema and can follow verbal commands.

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two bystanders performing CPR on the patient, a 58-year-old male. Your initial action should be to: A. assess the effectiveness of the bystanders' CPR. B. quickly attach the AED and push the analyze button. C. have the bystanders stop CPR and assess the patient. D. request a paramedic unit and quickly attach the AED.

C. have the bystanders stop CPR and assess the patient.

You are attending to a 68-year-old female patient in cardiac arrest. An ALS provider arrives shortly after you do and the transfer of care is made. The ALS provider asks that you assist in the endotracheal intubation. As part of this process, you may be required to: A. ventilate and preoxygenate the patient but not handle any of the equipment required for the intubation. B. visualize the airway and look for any potential complications in advance of the intubation. C. help position the patient for a better view of the airway during the procedure. D. perform the intubation with assistance.

C. help position the patient for a better view of the airway during the procedure.

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia? A. hypoperfusion B. severe infection C. hyperglycemia D. spinal cord injury

C. hyperglycemia

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose level is 450 mg/dL. She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: A. diabetic ketoacidosis. B. hyperglycemia with moderate dehydration. C. hyperosmolar hyperglycemic nonketotic coma (HHNC). D. acute renal failure with associated hyperglycemia.

C. hyperosmolar hyperglycemic nonketotic coma (HHNC).

Advil, Nuprin, and Motrin are brand (trade) names for the generic medication: A. aspirin. B. nitrostat. C. ibuprofen. D. acetaminophen.

C. ibuprofen.

In which of the following situations should the EMT splint an injured limb in the position of deformity? A. when distal circulation and neurological functions are absent B. if transport time to the hospital is greater than 20 to 30 minutes C. if resistance is encountered or the patient experiences severe pain D. if a traction splint will be used to immobilize the injured extremity

C. if resistance is encountered or the patient experiences severe pain

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should: A. begin triage to determine injury severity. B. call medical control for further direction. C. immediately request additional resources. D. request law enforcement for traffic control.

C. immediately request additional resources.

A 17-year-old football player collided with another player and has pain to his left clavicular area. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should: A. perform a rapid secondary assessment. B. straighten his arm and apply a board splint. C. immobilize the injury with a sling and swathe. D. place a pillow under his arm and apply a sling.

C. immobilize the injury with a sling and swathe.

The LEAST practical place to store a portable oxygen cylinder is: A. inside the jump kit. B. near the side or rear door. C. in the driver's compartment. D. on the ambulance stretcher.

C. in the driver's compartment.

Physical changes that typically occur in early adults include an: A. increase in muscle strength and reflexes. B. increase in height because of spinal disc expansion. C. increase in fatty tissue, which leads to weight gain. D. increase in respiratory rate due to increased metabolism.

C. increase in fatty tissue, which leads to weight gain.

In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include: A. a collapsible undercarriage. B. a weight capacity of up to 650 lb. C. increased stability due to a wider wheelbase. D. two safety rails on both sides of the stretcher

C. increased stability due to a wider wheelbase.

Which of the following is NOT a common factor that would affect a 75-year-old patient's vital signs? A. medications B. overall health C. increased weight D. medical conditions

C. increased weight

In late adults, the amount of air left in the lungs after expiration of the maximum amount of air: A. remains unchanged because the lungs have become accustomed to years of breathing pollution. B. decreases, resulting in widespread collapsing of the alveoli and impaired diffusion of gases. C. increases, which hampers diffusion of gases because of stagnant air that remains in the alveoli. D. decreases, which increases diffusion in the lungs and causes an accumulation of carbon dioxide.

C. increases, which hampers diffusion of gases because of stagnant air that remains in the alveoli.

Deoxygenated blood from the abdomen, pelvis, and lower extremities is returned to the right atrium via the: A. common iliac vein. B. coronary sinus vein. C. inferior vena cava. D. superior vena cava.

C. inferior vena cava.

What function does the pneumotaxic center serve? A. stimulates the DRG, resulting in prolonged inspiration B. inhibits the DRG, but only affects the respiratory rate C. inhibits the DRG, resulting in shorter, faster respirations D. stimulates the DRG, resulting in longer, slower respirations

C. inhibits the DRG, resulting in shorter, faster respirations

The leading cause of maternal death during the first trimester of pregnancy is: A. massive brain damage secondary to a prolonged seizure. B. unrecognized or untreated supine hypotensive syndrome. C. internal bleeding caused by a ruptured ectopic pregnancy. D. blunt trauma to the abdomen during a motor vehicle crash.

C. internal bleeding caused by a ruptured ectopic pregnancy.

The MOST common and usually the most serious ambulance crashes occur at: A. stop signs. B. stop lights. C. intersections. D. railroad crossings.

C. intersections.

Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of: A. spinal cord injury. B. airway compromise. C. intracranial bleeding. D. a fracture of the skull.

C. intracranial bleeding.

After spiking a bag of IV fluid for the paramedic, the EMT notices that the drip chamber is too full. The EMT should: A. let the IV flow rapidly for 20 to 30 seconds. B. replace the administration set with a new one. C. invert the IV bag and squeeze the drip chamber. D. squeeze the IV bag to force fluid into the tubing.

C. invert the IV bag and squeeze the drip chamber.

In contrast to a cerebral concussion, a cerebral contusion: A. does not cause pressure within the skull. B. results from a laceration to the brain tissue. C. involves physical injury to the brain tissue. D. usually does not cause a loss of consciousness.

C. involves physical injury to the brain tissue.

A laceration: A. is an injury that separates various layers of soft tissue. B. is a sharp, smooth cut that is made by a surgical scalpel. C. is a jagged cut caused by a sharp object or blunt force trauma. D. rarely penetrates through the subcutaneous tissue to the muscle.

C. is a jagged cut caused by a sharp object or blunt force trauma.

The diaphragm is a unique muscle because it: A. is the exclusive muscle of breathing. B. does not receive impulses from the brain. C. is both a voluntary and involuntary muscle. D. does not have striations like skeletal muscle.

C. is both a voluntary and involuntary muscle.

The mental status of a patient who has experienced a typical seizure: A. progressively worsens over a period of a few hours. B. is easily differentiated from that of acute hypoglycemia. C. is likely to improve over a period of 5 to 30 minutes. D. typically does not improve, even after several minutes.

C. is likely to improve over a period of 5 to 30 minutes.

The secondary assessment of a medical patient: A. should routinely include a comprehensive examination from head to toe. B. should be performed at the scene, especially if the patient is critically ill. C. is not practical if the patient is critically ill or your transport time is short. D. is typically limited to a focused exam for patients who are unconscious.

C. is not practical if the patient is critically ill or your transport time is short.

Chronic renal failure is a condition that: A. can be reversed with prompt treatment. B. occurs from conditions such as dehydration. C. is often caused by hypertension or diabetes. D. causes dehydration from excessive urination.

C. is often caused by hypertension or diabetes.

An abdominal aortic aneurysm: A. is usually not repairable, even if discovered early. B. causes dull pain that often radiates to the shoulders. C. is often the result of hypertension and atherosclerosis. D. can sometimes be palpated as a mass in the groin area.

C. is often the result of hypertension and atherosclerosis.

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. is pregnant for the first time.

When afterload increases: A. the volume of venous blood that returns to the right atrium increases. B. the amount of resistance that the ventricle must beat against decreases. C. it becomes harder for the ventricle to push blood through the blood vessels. D. the blood pressure falls because of significant dilation of the blood vessels.

C. it becomes harder for the ventricle to push blood through the blood vessels.

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless: A. the patient adamantly denies neck pain. B. lateral immobilization has been applied. C. it causes a problem managing the ABCs. D. sensory and motor functions remain intact.

C. it causes a problem managing the ABCs.

Aggressive ambulance driving may have a negative effect on other motorists because: A. they may become enraged and attempt to run you off the road. B. they move to the right or drive as close to the curb as possible. C. it may not allow for their reaction time to respond to your vehicle. D. they often freeze when they see the lights in the rearview mirror.

C. it may not allow for their reaction time to respond to your vehicle.

With regard to the pediatric rule of nines, the: A. head is proportionately smaller than an adult's. B. thorax is proportionately larger than an adult's. C. legs are proportionately smaller than an adult's. D. arms are proportionately larger than an adult's.

C. legs are proportionately smaller than an adult's.

You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should: A. tell her that he is being resuscitated by other EMTs. B. immediately tell her of his death so that she may grieve. C. let clergy or hospital staff relay the bad news if possible. D. avoid answering her questions and focus on her injuries.

C. let clergy or hospital staff relay the bad news if possible.

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: A. brain. B. kidneys. C. liver. D. pancreas.

C. liver.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should: A. perform a rapid assessment and look for signs of trauma. B. place him in a sitting position and have him drink 1 L of water. C. load him into the ambulance and begin rapid cooling interventions. D. administer one tube of oral glucose and reassess his mental status.

C. load him into the ambulance and begin rapid cooling interventions.

Which of the following is NOT considered to be protected health information (PHI)? A. patient history B. treatment rendered C. location of the call D. assessment findings

C. location of the call

Motor nerve neuropathy is characterized by: A. numbness, tingling, and severe muscle pain. B. loss of bladder control and sensitivity to touch. C. loss of balance, muscle weakness, and spasms. D. constipation, low blood pressure, and bradycardia.

C. loss of balance, muscle weakness, and spasms.

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: A. try basic sign language first. B. speak in a monotone voice. C. lower the pitch of your voice. D. increase the pitch of your voice.

C. lower the pitch of your voice.

The lower jawbone is called the: A. zygoma. B. maxillae. C. mandible. D. mastoid.

C. mandible.

Lacerations to the scalp: A. bleed minimally because the scalp has few vessels. B. uncommonly cause hypovolemic shock in children. C. may be an indicator of deeper, more serious injuries. D. are most commonly associated with skull fractures.

C. may be an indicator of deeper, more serious injuries.

If a person is partially immune to a particular disease, he or she: A. is not protected from a new infection if exposed to another individual. B. must be revaccinated at least every 18 months to avoid infection. C. may develop illness from germs that lie dormant from the initial infection. D. will not experience future illness, even if his or her immune system is stressed.

C. may develop illness from germs that lie dormant from the initial infection.

The secondary assessment of a sick or injured child: A. is a rapid head-to-toe exam to detect life threats. B. should be performed, regardless of the circumstances. C. may not be possible if the child's condition is critical. D. is most appropriate when your transport time is short.

C. may not be possible if the child's condition is critical.

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? A. speech B. arm drift C. memory D. facial droop

C. memory

Which of the following is NOT a function of the skin? A. sensory reception B. temperature regulation C. metabolic coordination D. pressure and pain perception

C. metabolic coordination

Each cell of the body combines nutrients and oxygen and produces energy and waste products through a process called: A. respiration. B. ventilation. C. metabolism. D. oxygenation.

C. metabolism.

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: A. administer one tube of oral glucose and prepare for immediate transport. B. place her in the recovery position and transport her with lights and siren. C. monitor her airway and breathing status and assess her blood glucose level. D. give her small cups of water to drink and observe for further seizure activity.

C. monitor her airway and breathing status and assess her blood glucose level.

The chief complaint is MOST accurately defined as the: A. most life-threatening condition that you discover. B. condition that exacerbates an underlying problem. C. most serious thing the patient is concerned about. D. gross physical signs that you detect on assessment.

C. most serious thing the patient is concerned about.

A frostbitten foot can be identified by the presence of: A. gross deformity. B. soft, smooth skin. C. mottling and blisters. D. blanching of the skin.

C. mottling and blisters.

Atrophy is a condition that occurs when: A. increased use of skeletal muscle causes an increase in its strength. B. the tendons that attach muscle to bone become stretched or injured. C. muscle decreases in size and function because of disease or trauma. D. carbon dioxide, lactic acid, and other wastes accumulate in the muscle.

C. muscle decreases in size and function because of disease or trauma.

When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of: A. assault. B. battery. C. negligence. D. abandonment.

C. negligence.

Skeletal muscle is also called: A. smooth muscle. B. autonomic muscle. C. voluntary muscle. D. involuntary muscle.

C. voluntary muscle.

During the normal wound healing process, bleeding may occur from even a minor injury because: A. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding. B. histamines released by the immune system constrict the blood vessels, which increases the pressure within them. C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. D. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding.

C. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.

Prescription glasses do not provide adequate eye protection because they: A. have large rounded lenses. B. are not secured with a strap. C. offer little or no side protection. D. do not have shatterproof lenses.

C. offer little or no side protection.

Which of the following MOST accurately describes the correct position of the EMTs who are executing the diamond carry technique? A. two at the head, two at the feet, and a fifth EMT balancing the torso B. one at the head, two at the feet, and a fourth EMT balancing the torso C. one at the head, one at the feet, and one on each side of the patient's torso D. two at the head, one at the feet, and one on the left side of the patient's torso

C. one at the head, one at the feet, and one on each side of the patient's torso

Which of the following MOST accurately describes paradoxical movement of the chest wall? A. multiple rib fractures that cause a marked deformity of the chest wall B. a marked decrease in chest wall movement due to abdominal breathing C. only one section of the chest rises on inspiration while another area falls D. one side of the chest wall moves opposite the direction of the other

C. only one section of the chest rises on inspiration while another area falls

Findings during the social assessment of an older patient include all of the following, EXCEPT: A. interaction with others. B. daily activity assistance. C. outdated medications. D. delays in obtaining meals.

C. outdated medications.

When assessing an infant's ventilation status, you should: A. observe the chest for rise and fall. B. rule out hypoxia if cyanosis is absent. C. palpate the abdomen for rise and fall. D. give oxygen if the SpO2 is less than 90%.

C. palpate the abdomen for rise and fall.

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

C. pancreas

The exocrine gland of the pancreas secretes: A. bile. B. insulin. C. pancreatic juice. D. glucose.

C. pancreatic juice.

Which of the following is a severe burn in a 65-year-old patient? A. superficial burn to 30% of the BSA B. full-thickness burn to 1% of the BSA C. partial-thickness burn to 20% of the BSA D. second-degree burn covering 10% of the BSA

C. partial-thickness burn to 20% of the BSA

The EMT should use an AED on a child between 1 month and 8 years of age if: A. he or she is not breathing and has a weakly palpable pulse. B. his or her condition is rapidly progressing to cardiac arrest. C. pediatric pads and an energy-reducing device are available. D. special pads are used and the child has profound tachycardia.

C. pediatric pads and an energy-reducing device are available.

Which of the following fractures has the greatest potential for internal blood loss and shock? A. hip B. femur C. pelvis D. humerus

C. pelvis

The MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is: A. fracturing the septum. B. damaging the turbinates. C. penetrating the cranium. D. causing severe bleeding.

C. penetrating the cranium.

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

C. perform a hands-on assessment of the ABCs.

During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that his: A. respiratory status is adequate. B. systolic blood pressure is normal. C. peripheral circulation is decreased. D. skin temperature is abnormally cold.

C. peripheral circulation is decreased.

Physiologic manifestations of stress include: A. flushed skin, decreased muscle control, and vomiting. B. slow heart rate, low blood pressure, and severe headaches. C. perspiration, increased blood glucose levels, and dilated pupils. D. increased blood pressure, decreased blood glucose levels, and chest pain.

C. perspiration, increased blood glucose levels, and dilated pupils.

The bones that comprise the fingers and toes are called: A. carpals. B. metacarpals. C. phalanges. D. metatarsals

C. phalanges.

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should: A. manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop. B. carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg. C. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps. D. bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher.

C. place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

Shortly after assisting a 65-year-old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should: A. transport her in a sitting position. B. wait 5 minutes and reassess her blood pressure. C. place her supine and elevate her legs. D. assist ventilations with a bag-mask device.

C. place her supine and elevate her legs.

When arriving at the scene of an overturned tractor-trailer rig, you note that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but bleeding profusely from the head. After notifying the hazardous materials team, you should: A. park downhill from the scene. B. ask the driver to exit the vehicle. C. position the ambulance upwind. D. quickly gain access to the patient.

C. position the ambulance upwind.

Crepitus and false motion are: A. indicators of a severe sprain. B. only seen with open fractures. C. positive indicators of a fracture. D. most common with dislocations.

C. positive indicators of a fracture.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. suctioning of the upper airway. B. thorough drying with a towel. C. positive-pressure ventilations. D. some form of tactile stimulation.

C. positive-pressure ventilations.

The EMT must assume that any unwitnessed water-related incident is accompanied by: A. an air embolism. B. alcohol intoxication. C. possible spinal injury. D. cold water immersion.

C. possible spinal injury.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A. pregnant patients can dramatically increase their heart rate. B. pregnancy causes vasodilation and a lower blood pressure. C. pregnant patients have an overall increase in blood volume. D. blood is shunted to the uterus and fetus during major trauma.

C. pregnant patients have an overall increase in blood volume.

A 50-year-old male presents with an altered mental status. His wife tells you that he had a "small stroke" 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should: A. repeat the primary assessment. B. inquire about his family history. C. prepare for immediate transport. D. perform a head-to-toe assessment.

C. prepare for immediate transport.

A palpable pulse is created by: A. the pressure of circulating blood against the walls of the arteries. B. the pressure that is caused when venous blood returns to the heart. C. pressure waves through the arteries caused by cardiac contraction. D. electrical conduction in the heart producing ventricular contraction.

C. pressure waves through the arteries caused by cardiac contraction.

You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should: A. ask a police officer to transport the patient to the hospital. B. allow him to refuse treatment since the injury was not his fault. C. proceed with treatment and utilize law enforcement if necessary. D. have the police arrest him so that you can legally begin treatment.

C. proceed with treatment and utilize law enforcement if necessary.

An intoxicated 40-year-old male is found lying face down. How would you document his body's position? A. dorsal B. supine C. prone D. recumbent

C. prone

When removing a critically injured patient from his or her vehicle, you should: A. remove him or her using a short backboard. B. move him or her in one fast, continuous step. C. protect the cervical spine during the entire process. D. release c-spine control to facilitate rapid removal.

C. protect the cervical spine during the entire process.

White blood cells are also called leukocytes and function by: A. producing the body's erythrocytes. B. producing blood-clotting factors. C. protecting the body from infection. D. carrying oxygen and other nutrients.

C. protecting the body from infection.

You are dispatched to the county jail for an inmate who is "sick." When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to: A. apply a pulse oximeter. B. request a paramedic unit. C. provide assisted ventilation. D. assess his blood pressure.

C. provide assisted ventilation.

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should: A. begin full resuscitation and transport. B. report the case to the medical examiner. C. provide emotional support to the mother. D. dry the infant off to stimulate breathing.

C. provide emotional support to the mother.

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should: A. suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once. B. ventilate with a bag-mask device, apply a cervical collar, remove his wet clothing, and transport rapidly. C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully. D. apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.

C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.

Which of the following is a typical function of the rescue team? A. initial triage and patient prioritization B. shutting off power to downed electrical lines C. providing safe entry and access to patients D. providing emergency care during extrication

C. providing safe entry and access to patients

The left ventricle has the thickest walls because it: A. pumps blood to the lungs to be reoxygenated. B. uses less oxygen than other chambers of the heart. C. pumps blood into the aorta and systemic circulation. D. receives blood directly from the systemic circulation.

C. pumps blood into the aorta and systemic circulation.

Which of the following is NOT a known risk factor of SIDS? A. mother younger than 20 years B. low birth weight C. putting a baby to sleep on his or her back D. mother smoked during pregnancy

C. putting a baby to sleep on his or her back

When the speed of a motor vehicle doubles, the amount of kinetic energy: A. doubles. B. triples. C. quadruples. D. is not affected.

C. quadruples.

The MOST common cause of dehydration in pediatric patients is: A. high fever. B. internal blood loss. C. vomiting and diarrhea. D. refusal to drink fluids.

C. vomiting and diarrhea.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is: A. requesting a paramedic ambulance. B. careful monitoring her vital signs. C. rapidly transporting her to the hospital. D. quickly immobilizing her spinal column.

C. rapidly transporting her to the hospital.

A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should: A. check the drug's expiration date to ensure that it is still current. B. contact medical control and apprise him or her of what you did. C. reassess the patient and document her response to the medication. D. administer another treatment in 30 seconds if she is still in distress.

C. reassess the patient and document her response to the medication.

When performing your secondary assessment on an older patient who has been injured, it is important to: A. routinely perform a focused exam to minimize time at the scene. B. perform an in-depth physical exam prior to initiating any treatment. C. recall that it will take a less severe mechanism of injury to cause significant injuries. D. focus your assessment just on the area(s) of pain or obvious injury.

C. recall that it will take a less severe mechanism of injury to cause significant injuries.

If a patient develops difficulty breathing after your primary assessment, you should immediately: A. determine his or her respiratory rate. B. begin assisting his or her breathing. C. reevaluate his or her airway status. D. auscultate his or her breath sounds.

C. reevaluate his or her airway status.

A pulse with a consistent pattern is considered to be: A. weak. B. strong. C. regular. D. irregular.

C. regular.

General guidelines for safe ambulance driving include all of the following, EXCEPT: A. avoiding one-way streets whenever possible. B. assuming that other drivers will not see you. C. regularly using the siren as much as possible. D. avoiding routes with heavy traffic congestion.

C. regularly using the siren as much as possible.

When assessing a patient with a closed soft-tissue injury, it is MOST important to: A. manipulate the injury site for signs of a fracture. B. assess circulation distal to the site of the injury. C. remain alert for more severe underlying injuries. D. recognize that the integrity of the skin is broken.

C. remain alert for more severe underlying injuries.

Extrication is MOST accurately defined as: A. using heavy equipment to access a patient. B. dismantling an automobile to remove a victim. C. removal from a dangerous situation or position. D. immobilizing a patient before moving him or her.

C. removal from a dangerous situation or position.

The kidneys help to regulate blood pressure by: A. retaining key electrolytes, such as potassium. B. eliminating toxic waste products from the body. C. removing sodium, and thus water, from the body. D. accommodating a large amount of blood volume.

C. removing sodium, and thus water, from the body.

When performing a reassessment of your patient, you should first: A. obtain updated vital signs. B. reassess your interventions. C. repeat the primary assessment. D. confirm medical history findings.

C. repeat the primary assessment.

Reassessment of a patient with a medical complaint should begin by: A. reassessing the nature of illness. B. taking another set of vital signs. C. repeating the primary assessment. D. reviewing all treatment performed.

C. repeating the primary assessment.

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: A. carefully probe the wound to determine if the bleeding is venous or arterial. B. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing. C. replace the avulsed flap to its original position and cover it with a sterile dressing. D. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing.

C. replace the avulsed flap to its original position and cover it with a sterile dressing.

Prior to applying a nonrebreathing mask on a patient, you must ensure that the: A. one-way valve is sealed. B. flow rate is set at 6 L/min. C. reservoir bag is fully inflated. D. patient has reduced tidal volume.

C. reservoir bag is fully inflated.

Early signs of respiratory distress in the child include: A. cyanosis. B. bradycardia. C. restlessness. D. decreased LOC.

C. restlessness.

Which of the following is NOT generally considered an obstetrical emergency? A. failure of the placenta to deliver after 30 minutes B. significant bleeding after delivery of the placenta C. return of contractions following delivery of the baby D. more than 500 mL of blood loss before placental delivery

C. return of contractions following delivery of the baby

You have inserted an oral airway and are ventilating an apneic woman with a bag-mask device. She suddenly begins regurgitating large amounts of vomit. You should: A. perform a finger sweep of her mouth. B. insert a nasal airway and then suction her mouth. C. roll her onto her side and remove the oral airway. D. remove the oral airway and suction her oropharynx.

C. roll her onto her side and remove the oral airway.

Which of the following veins is located inferior to the trunk? A. cephalic B. axillary C. saphenous D. subclavian

C. saphenous

The large, flat, triangular bone that overlies the posterior thoracic wall is called the: A. glenoid. B. clavicle. C. scapula. D. acromion.

C. scapula.

The white portion of the eye is called the: A. iris. B. retina. C. sclera. D. cornea.

C. sclera.

Which of the following situations would require an urgent patient move? A. conscious patient with abrasions and a possibly fractured humerus B. imminent risk of a fire or explosion in or near the patient's vehicle C. semiconscious patient with shallow respirations and signs of shock D. stable patient who is blocking access to a critically injured patient

C. semiconscious patient with shallow respirations and signs of shock

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with: A. irritability of the left ventricle. B. a sudden ventricular arrhythmia. C. severe hypoxia and bradycardia. D. acute hypoxia and tachycardia.

C. severe hypoxia and bradycardia.

Which of the following is NOT a possible cause of airway obstruction? A. relaxation of the tongue B. aspirated vomitus C. shallow breathing D. foreign objects

C. shallow breathing

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: A. the AED has detected asystole. B. the AED detected patient motion. C. she is not in ventricular fibrillation. D. she has a pulse and does not need CPR.

C. she is not in ventricular fibrillation.

In contrast to secure attachment, anxious-avoidant attachment occurs when a child: A. becomes acutely anxious at the presence of strangers or in unfamiliar surroundings. B. clings to a parent or caregiver because he or she knows that the person can be trusted. C. shows little emotional response to a parent or caregiver following repeated rejection. D. reaches out and explores because he or she knows that the parents are there as a safety net.

C. shows little emotional response to a parent or caregiver following repeated rejection.

The electrical impulse generated by the heart originates in the: A. bundle of His. B. coronary sinus. C. sinoatrial (SA) node. D. atrioventricular (AV) node.

C. sinoatrial (SA) node.

Which of the following structures does NOT contain smooth muscle? A. blood vessels B. urinary system C. skeletal system D. gastrointestinal tract

C. skeletal system

The axial skeleton is composed of the: A. arms, legs, and pelvis. B. lower part of the torso and the legs. C. skull, face, thorax, and vertebral column. D. bones that comprise the pelvic girdle.

C. skull, face, thorax, and vertebral column.

In contrast to the sympathetic nervous system, the parasympathetic nervous system: A. prepares the body to handle stress. B. causes an increase in the heart rate. C. slows the heart and respiratory rates. D. dilates the blood vessels in the muscles.

C. slows the heart and respiratory rates.

The primary organ responsible for absorption of products of digestion is the: A. pancreas. B. gallbladder. C. small intestine. D. large intestine.

C. small intestine.

Which of the following is an example of regional equipment or supplies? A. oral glucose B. vacuum splint C. snake bite kit D. bronchodilator

C. snake bite kit

What part of the nervous system controls the body's voluntary activities? A. central B. sensory C. somatic D. autonomic

C. somatic

Assisting with vascular access may include: A. visualization of the vocal cords. B. inserting the needle at a 45-degree angle. C. spiking the IV bag. D. ensuring that the equipment is handled only by the ALS provider and not by you.

C. spiking the IV bag.

Which of the following organs assists in the filtration of blood, serves as a blood reservoir, and produces antibodies? A. liver B. kidney C. spleen D. pancreas

C. spleen

During your rapid secondary assessment of a 30-year-old male who fell 25′, you note crepitus when palpating his pelvis. Your partner advises you that the patient's blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, you should: A. defer spinal immobilization and transport to a trauma center. B. perform a focused physical exam with emphasis on the pelvis. C. stabilize the pelvis with a pelvic binder and protect the spine. D. log roll the patient onto a long backboard and transport at once.

C. stabilize the pelvis with a pelvic binder and protect the spine.

The manner in which the EMT must act or behave when caring for a patient is called the: A. EMT oath. B. code of ethics. C. standard of care. D. scope of practice.

C. standard of care.

If a nasopharyngeal airway is too long, it may: A. result in tachycardia. B. push the tongue anteriorly. C. stimulate the vagus nerve. D. become obstructed by mucus.

C. stimulate the vagus nerve.

If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave? A. severe burns B. fractured bones C. stomach rupture D. impaled objects

C. stomach rupture

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital? A. seizures and infection B. cardiac arrest and shock C. stroke and heart attack D. diabetes and migraines

C. stroke and heart attack

Cardiac output (CO) is affected by: A. heart rate only. B. stroke volume only. C. stroke volume and heart rate. D. the patient's blood pressure.

C. stroke volume and heart rate.

Which of the following conditions is NOT categorized as a psychiatric condition? A. depression B. schizophrenia C. substance abuse D. Alzheimer's disease

C. substance abuse

The parietal peritoneum lines the: A. retroperitoneal space. B. lungs and chest cavity. C. walls of the abdominal cavity. D. surface of the abdominal organs.

C. walls of the abdominal cavity.

Patients with acute abdominal pain should not be given anything to eat or drink because: A. it will create referred pain and obscure the diagnosis. B. food will rapidly travel through the digestive system. C. substances in the stomach increase the risk of aspiration. D. digestion prevents accurate auscultation of bowel sounds.

C. substances in the stomach increase the risk of aspiration.

As you and your team are removing an unconscious patient from her wrecked car, you note that she has closed deformities to both of her legs and a deformity to her left humerus. You should: A. realign the deformed extremities before continuing. B. splint the deformities before moving her any further. C. support the injured extremities and continue removal. D. assess distal neurovascular functions in her extremities.

C. support the injured extremities and continue removal.

The two MOST efficient ways for the body to eliminate excess heat are: A. respiration and bradycardia. B. perspiration and tachycardia. C. sweating and dilation of skin blood vessels. D. hyperventilation and tachycardia.

C. sweating and dilation of skin blood vessels.

Which of the following infectious diseases confers no protection from reinfection after exposure? A. mumps B. rubella C. syphilis D. chickenpox

C. syphilis

Which of the following would the EMT most likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A. focused secondary assessment B. assessment of oxygen saturation C. systemic head-to-toe examination D. noninvasive blood pressure monitoring

C. systemic head-to-toe examination

When the mother is experiencing a contraction, you should instruct her to: A. hold her breath. B. push for 30 seconds. C. take quick short breaths. D. rest and breathe deeply.

C. take quick short breaths.

In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because: A. their red blood cells are destroyed at a faster than normal rate. B. the aging process results in an overall increase in blood volume. C. the baroreceptors have become less sensitive to blood pressure. D. any change in position causes blood to be shunted to the brain.

C. the baroreceptors have become less sensitive to blood pressure.

Internal injuries caused by gunshot wounds are difficult to predict because: A. the caliber of the bullet is frequently unknown. B. the area of damage is usually smaller than the bullet. C. the bullet may tumble or ricochet within the body. D. exit wounds caused by the bullet are usually small.

C. the bullet may tumble or ricochet within the body.

When treating a patient with chest pain, you should assume that he or she is having an AMI because: A. angina usually occurs after an AMI. B. most patients with chest pain are experiencing an AMI. C. the cause of the pain cannot be diagnosed in the field. D. angina and AMI present identically.

C. the cause of the pain cannot be diagnosed in the field.

Large amounts of adenosine triphosphate (ATP) is generated when: A. the cells function without oxygen. B. circulating blood glucose levels fall. C. the cells function with adequate oxygen. D. carbon dioxide levels in the blood are high.

C. the cells function with adequate oxygen.

A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Considering the fact that this patient is probably in shock, what is the MOST likely explanation for the absence of tachycardia? A. deterioration of the cardiac conduction system B. intrathoracic bleeding and cardiac compression C. the effects of her antihypertensive medication D. failure of the parasympathetic nervous system

C. the effects of her antihypertensive medication

You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with: A. performing a detailed secondary assessment to locate all of her injuries. B. assessing the bruises that overlie major organs in the chest and abdomen. C. the fact that her clinical signs could indicate that she is bleeding internally. D. obtaining a complete set of vital signs to rule out the possibility of shock.

C. the fact that her clinical signs could indicate that she is bleeding internally.

When caring for a geriatric patient with a traumatic injury, it is important to consider that: A. geriatric patients usually present with little to no pain. B. decreased bone density often results in incomplete fractures. C. the injury may have been preceded by a medical condition. D. geriatric patients typically present with classic signs of shock.

C. the injury may have been preceded by a medical condition.

A dissecting aortic aneurysm occurs when: A. all layers of the aorta suddenly contract. B. a weakened area develops in the aortic wall. C. the inner layers of the aorta become separated. D. the aorta ruptures, resulting in profound bleeding.

C. the inner layers of the aorta become separated.

When determining the exact location and position of the patient(s) in a wrecked vehicle, you and your team should routinely consider all of the following, EXCEPT: A. the position of the crashed vehicle. B. hazards that pose a risk to rescuers. C. the make and model of the vehicle. D. the possibility of vehicle instability.

C. the make and model of the vehicle.

Patients with full-thickness (third-degree) burns generally do not complain of pain because: A. blister formation protects the burn. B. he or she is generally not conscious. C. the nerve endings have been destroyed. D. subcutaneous vessels are usually clotted.

C. the nerve endings have been destroyed.

A transient ischemic attack (TIA) occurs when: A. medications are given to dissolve a cerebral blood clot. B. a small cerebral artery ruptures and causes minimal damage. C. the normal body processes destroy a clot in a cerebral artery. D. signs and symptoms resolve spontaneously within 48 hours.

C. the normal body processes destroy a clot in a cerebral artery.

The simplest yet most effective method of preventing the spread of an infectious disease is to: A. undergo an annual physical examination. B. ensure that your immunizations are up-to-date. C. wash your hands in between patient contacts. D. undergo human immunodeficiency virus (HIV) testing at least twice a year.

C. wash your hands in between patient contacts.

An infant or small child's airway can be occluded if it is overextended or overflexed because: A. the back of the head is flat, which prevents a neutral position. B. he or she has a long neck, which makes the trachea prone to collapse. C. the occiput is proportionately large and the trachea is flexible. D. the tongue is proportionately small and can fall back into the throat.

C. the occiput is proportionately large and the trachea is flexible.

Functions of the skin include all of the following, EXCEPT: A. maintenance of water balance. B. regulation of body temperature. C. the production of key antibodies. D. sending information to the brain.

C. the production of key antibodies.

The left cerebral hemisphere controls: A. the right side of the face. B. heart rate and pupil reaction. C. the right side of the body. D. breathing and blood pressure.

C. the right side of the body.

The term "pharmacology" is MOST accurately defined as: A. the study of drugs that are produced illegally. B. the study of how medications affect the brain. C. the study of drugs and their actions on the body. D. the study of drug excretion from the human body.

C. the study of drugs and their actions on the body.

Greenstick fractures occur in infants and children because: A. the growth plate is commonly injured. B. their bones are more brittle than an adult's. C. their bones bend more easily than an adult's. D. twisting injuries are more common in children.

C. their bones bend more easily than an adult's.

A low ETCO2 reading, as measured by capnography, would MOST likely be observed if: A. a patient in cardiac arrest is receiving high-quality CPR. B. an endotracheal (ET) tube is correctly placed in the trachea. C. there is an absence or decrease in the level of CO2 in the lungs. D. the cells produce large amounts of CO2 and return it to the lungs.

C. there is an absence or decrease in the level of CO2 in the lungs.

Twelve pairs of ribs attach to what section of the spinal column? A. sacral B. lumbar C. thoracic D. coccyx

C. thoracic

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the: A. thoracic and sacral spine. B. lumbar and coccygeal spine. C. thoracic and lumbar spine. D. lumbar and sacral spine.

C. thoracic and lumbar spine.

The small, rounded, fleshy bulge immediately anterior to the ear canal is called the: A. incus. B. pinna. C. tragus. D. stapes.

C. tragus.

If you are exposed to a patient's blood or other bodily fluid, your first action should be to: A. report the incident to the infection control officer. B. abandon patient care and seek medical attention. C. transfer care of your patient to another EMS provider. D. vigorously clean the area with soap and water.

C. transfer care of your patient to another EMS provider.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: A. use tweezers to try to remove the object. B. remove the peanut with a cotton-tipped swab. C. transport her to the emergency department. D. thoroughly flush her ear with sterile saline.

C. transport her to the emergency department.

The MOST important treatment for a patient with severe abdominal pain and signs of shock includes: A. administering high-flow oxygen. B. giving oral fluids to maintain perfusion. C. transporting the patient without delay. D. positioning the patient on his or her side.

C. transporting the patient without delay.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A. recognize that the batteries in his hearing aids are probably depleted. B. remove his hearing aids, turn up the volume, and replace them in his ears. C. try repositioning the hearing aid or remove it and turn down the volume. D. remove both of his hearing aids and use pencil and paper to communicate.

C. try repositioning the hearing aid or remove it and turn down the volume.

A patient who is experiencing aphasia is: A. not able to swallow without choking. B. experiencing a right hemispheric stroke. C. unable to produce or understand speech. D. usually conscious but has slurred speech.

C. unable to produce or understand speech.

The reasons for rescue failure can be referred to by the mnemonic FAILURE. According to this mnemonic, the "U" stands for: A. underutilizing personnel at the scene. B. unprepared to effectively manage the scene. C. underestimating the logistics of the incident. D. undertrained to correctly utilize equipment.

C. underestimating the logistics of the incident.

Relative to the kidneys, the liver is: A. medial. B. dorsal. C. unilateral. D. posterior.

C. unilateral.

Your unit and a fire department vehicle are responding to the scene of a patient in cardiac arrest. As you approach an intersection that is highly congested, you should: A. turn off your lights and siren and proceed with safety. B. advise the fire department vehicle to follow you closely. C. use a different siren tone than the fire department vehicle. D. ask the fire department vehicle to remain 1,000′ behind you.

C. use a different siren tone than the fire department vehicle.

When carrying a patient up or down stairs, you should avoid: A. flexing your body at the knees. B. the use of more than two EMTs. C. using a wheeled stretcher whenever possible. D. the use of a long backboard or scoop stretcher.

C. using a wheeled stretcher whenever possible.

While evaluating a patient with chest pain, your partner tells you that the patient's blood pressure is 140/94 mm Hg. The lower number represents the pressure from the: A. atria relaxing. B. atria contracting. C. ventricles relaxing. D. ventricles contracting.

C. ventricles relaxing.

A patient has a blood pressure of 130/70 mm Hg. The "130" represents: A. atrial contraction. B. ventricular filling. C. ventricular contraction. D. ventricular relaxation.

C. ventricular contraction.

Sudden death following AMI is MOST often caused by: A. cardiogenic shock. B. severe bradycardia. C. ventricular fibrillation. D. congestive heart failure.

C. ventricular fibrillation.

The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to: A. wear a heavy, thick jacket or coat. B. avoid outer clothing with zippers. C. wear at least three layers of clothing. D. wear socks made of heavy-duty cotton.

C. wear at least three layers of clothing.

When caring for a patient with an open facial injury, the EMT must: A. closely assess the patient's airway. B. consider the mechanism of injury. C. wear gloves and facial protection. D. manually stabilize the patient's head.

C. wear gloves and facial protection.

Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT: A. when personnel are assessed during periods of rest. B. before personnel are preparing to reenter the scene. C. when patients are actively being assessed or treated. D. before leaving the scene after the incident is resolved.

C. when patients are actively being assessed or treated.

The index of suspicion is MOST accurately defined as: A. the way in which traumatic injuries occur. B. a predictable pattern that leads to serious injuries. C. your concern for potentially serious underlying injuries. D. the detection of less obvious life-threatening injuries.

C. your concern for potentially serious underlying injuries.

Patients who become dependent upon EMS personnel or other health care providers often feel: A. relieved. B. superior. C. hopeful. D. shamed.

D. shamed.

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? A. dismounted seats B. steering wheel deformity C. intrusion into the vehicle D. deployment of the air bag

D. deployment of the air bag

You are ventilating an apneic adult with a bag-valve-mask device and high-flow oxygen. Her pulse rate is 130 beats/min and she has cyanosis to her face and chest. Which of the following is the MOST reliable indicator of adequately performed ventilations in this patient? A) Slight dissipation of her cyanosis B) Noted abdominal rise with each ventilation C) Decreased compliance with each ventilation D) A decrease in her heart rate to 90 beats/min

D) A decrease in her heart rate to 90 beats/min Signs of adequate positive-pressure ventilation include an improvement in heart rate, a marked improvement in skin color, a ventilation rate that is appropriate for the patient's age, and the presence of visible chest rise with each ventilation. In the adult, tachycardia is a compensatory response to hypoxemia. Adequate ventilation with high-flow oxygen increases the oxygen content of the blood; as a result, the body's need to compensate decreases, which manifests as a decrease in heart rate. Decreased compliance (increased resistance) during ventilations indicates that the airway is blocked or that the patient's lungs are difficult to ventilate (ie, asthma, COPD, CHF). The presence of abdominal rise during positive-pressure ventilation indicates that more air is going into the stomach than into the lungs.

Which of the following patients is the BEST candidate for an oropharyngeal airway? A) Any patient whom you suspect of being acutely hypoxemic B) A semiconscious patient who ingested a large quantity of aspirin C) An unresponsive patient with uncontrolled oropharyngeal bleeding D) An unresponsive trauma patient with blood draining from the nose

D) An unresponsive trauma patient with blood draining from the nose The oropharyngeal airway is used to keep the tongue off of the posterior pharynx and is indicated for unresponsive patients without a gag reflex. If an unresponsive patient has severe, uncontrolled oropharyngeal bleeding, your priority is to suction his or her airway to prevent aspiration and transport rapidly. Semiconscious patients typ ically have a gag reflex, although it may be somewhat depressed. Oxygen should be administered to any patient with suspected hypoxemia.

Which of the following is the correct technique for ventilating an apneic adult who has a pulse? A) Hyperventilate at a rate between 20 and 24 breaths/min. B) Deliver each breath over 2 seconds at a rate of 10 breaths/min. C) Ventilate at a rate of 15 breaths/min and look for visible chest rise. D) Deliver each breath over 1 second at a rate of 12 breaths/min.

D) Deliver each breath over 1 second at a rate of 12 breaths/min. When ventilating an apneic adult who has a pulse, deliver each breath over a period of 1 second (just enough to produce visible chest rise), at a rate of 10 to 12 breaths/min (one breath every 5 to 6 seconds). A ventilation rate of 10 breaths/min (one breath every 6 seconds) is appropriate for infants (except newborns), children, and adult patients in cardiac arrest after an advanced airway device (eg, ET tube, multilumen ai1way, supraglottic airway) has been inserted. Do NOT hyperventilate the patient; doing so may impede blood return to the heart, thus reducing cardiac output, secondary to hyperinflation of the lungs. Hyperventilation also increases the risks of gastric distention, regurgitation, and aspiration.

Which of the following situations would MOST likely impair oxygenation, despite the fact that the patient is inhaling and exhaling? A) Limb amputation B) lntracranial hemorrhage C) Acute myocardial infarction D) Entrapment in a mine

D) Entrapment in a mine Oxygenation, the loading of oxygen molecules onto hemoglobin molecules in the bloodstream, requires that the air used for ventilation contains an adequate percentage of oxygen. The mere presence of ventilation (inhalation and exhalation) does not guarantee that oxygenation is occurring. For example, if a patient is trapped in a mine, grain silo, or any other confined space that contains little or no oxygen, the patient may continue to ventilate; however, due to the low (or absent) levels of oxygen, oxygenation cannot continue. The other conditions listed, acute myocardial infarction, intracerebral hemorrhage, and limb amputations do not typically create a ventilation/oxygenation mismatch.

A 35-year-old male complains of shortness of breath. He is conscious and alert and is able to speak in complete sentences. Assessment reveals diffuse wheezing to auscultation, a respiratory rate of 22 breaths/min, a heart rate of 110 beats/min, and an oxygen saturation of 92%. Which of the following interventions would be of MOST benefit to this patient? A) A beta antagonist B) Assisted ventilation C) Supplemental oxygen D) Inhaled bronchodilator

D) Inhaled bronchodilator The patient's clinical presentation is classic for bronchospasm, such as what occurs with asthma and other reactive diseases of the lower airway. Of the interventions listed, an inhaled bronchodilator (beta-2 agonist) would be of the most immediate benefit. Beta-2 agonists dilate the bronchioles, which improves airflow through them and makes it easier for the patient to breathe. The patient's oxygen saturation (92%) indicates mild hypoxemia; however, by dilating the bronchioles and increasing airflow, his oxygenation saturation will increase; if it does not, then administer a sufficient amount of oxygen to maintain his oxygen saturation at or above 94%. The patient does not require assisted ventilation at this t ime because he has no outward signs of inadequate breathing.

You arrive at a residence approximately 20 minutes after a 7-year-old boy, who weighs 22 kg, ingested a bottle of Advil. He is conscious and alert and has stable vital signs. Medical control orders you to administer activated charcoal and oxygen and then transport the child at once. The appropriate maximum dose of activated charcoal for this child is: A. 11 g. B. 22 g. C. 36 g. D. 44 g.

D. 44 g.

In which position should you place an uninjured, unresponsive patient with a respiratory rate of 14 breaths/min and adequate tidal volume? A) Supine B) Full Fowler's C) Semi-Fowler's D) Lateral recumbent

D) Lateral recumbent The recovery position, which involves placing the patient on his or her side (lateral recumbent), is used to maintain a patent airway in an unresponsive patient who is not injured AND is breathing on his or her own with a normal rate and adequate tidal volume (depth of breathing). Patients who are in shock or require positive-pressure venti lation should be placed in a supine (on his or her back) position. The semi-Fowler's position involves placing the patient in a semisitting position at a 45-degree angle; it is the position of comfort for most patients. The full Fowler's position involves sitting the patient in an upright position at a 90-degree angle; it is often used for patients with respiratory distress.

Which of the following devices is contraindicated in patients with blunt thoracic trauma? A) Oral airway B) Nasal airway C) Bag-valve-mask device D) Oxygen-powered ventilator

D) Oxygen-powered ventilator The oxygen-powered ventilator, also called a manually triggered ventilator, should not be used in patients with chest trauma; it delivers oxygen under high pressure and may worsen the patient's injury. Oxygen-powered ventilators are also associated with a high incidence of gastric distention. They are also contraindicated in pediatric patients and in patients with COPD. Infants and children have small lungs; the high ventilatory pressure delivered by the oxygen-powered ventilator can cause a pneumothorax. Patients with COPD often have air trapped in their lungs; excessive ventilatory pressure may cause alveolar rupture or a pneumothorax.

Which of the following patients obviously needs positive-pressure ventilation assistance? A) Combative; respiratory rate of 24 breaths/min and deep B) Semiconscious; respiratory rate of14 breaths/min and good chest rise C) Restless; respiratory rate of12 breaths/min with adequate tidal volume D) Responsive to pain only; respiratory rate of 8 breaths/min and shallow

D) Responsive to pain only; respiratory rate of 8 breaths/min and shallow Any patient with a decreased level of consciousness should be assessed for inadequate breathing (eg, fast or slow respiratory rate, reduced tidal volume [shallow breathing]). Of the patients listed, the patient who is responsive to pain only and has shallow respirations of 8 breaths/min clearly needs positivepressure ventilation assistance. Slow, shallow respirations will not produce the minute volume needed to support adequate oxygenation of the blood.

Which of the following statements regarding artificial ventilation of an apneic patient who has dentures is correct? A) Because of the risk of airway obstruction, the EMT should routinely remove a patient's dentures. B) If a patient's dentures are loose, the EMT should use the jaw-thrust maneuver to keep the airway open. C) The EMT should not attempt to remove a patient's dentures because this may cause an airway obstruction. D) Tight-fitting dentures should be left in place because they facilitate the delivery of adequate tidal volume.

D) Tight-fitting dentures should be left in place because they facilitate the delivery of adequate tidal volume. Providing artificial ventilation with a bag-valve-mask or pocket face mask device is usually much easier when dentures can be left in place. Leaving the dentures in place provides "structure" to the face and will assist you in maintaining a good mask-to-face seal, thus facilitating the delivery of adequate tidal volume. However, loose dentures make it difficult to perform artificial ventilation by any method and can easily obstruct the airway. Therefore, dentures and dental appliances that do not stay firmly in place should be removed. When ventilating a patient who has dentures or a dental appliance, frequently reassess his or her airway to ensure it remains firmly in place.

Which of the following airway sounds indicates a lower airway obstruction? A) Stridor B) Crowing C) Gurgling D) Wheezing

D) Wheezing Wheezing is a whistling sound that results from narrowing and/or inflammation of the bronchioles in the lungs and is an indicator of a lower airway disease (ie, asthma, bronchiolitis). Crowing and stridor are both high-pitched sounds that indicate an upper airway disease or obstruction (ie, croup, epiglottitis, foreign body obstruction), and gurgling indicates secretions in the oropharynx.

A 33-year-old female presents with acute respiratory distress. She is conscious but anxious, and tells you that she has a history of asthma. She took two puffs of her albuterol inhaler prior to your arrival, but states that it did not help. Her oxygen saturation reads 89% and you hear diffuse wheezing while auscultating her lungs. You should: A) give her 100% humidified oxygen to dilate her bronchioles, monitor her oxygen saturation, and transport her to an appropriate medical facil ity. B) assist her with a third albuterol treatment, contact medical control for further advice, give her high-flow oxygen, and transport her to the hospital. C) ventilate her with a bag-valve-mask device until her oxygen saturation is at least 94% and rapidly transport her to the closest appropriate medical facility. D) administer high-flow oxygen, contact medical control to request permission to assist her with another albuterol treatment, and prepare for transport.

D) administer high-flow oxygen, contact medical control to request permission to assist her with another albuterol treatment, and prepare for transport. Despite two albuterol treatments, the patient is still experiencing respiratory distress. Furthermore, the presence of wheezing indicates continued bronchospasm. After administering high-flow oxygen via a nonrebreathing mask (her oxygen saturation is 89%), you should contact medical control and request permission to assist the patient with a third albuterol treatment. Drugs such as albuterol (Proventil, Ventolin), metaproterenol (Alupent), and levalbuterol (Xopenex) stimulate beta2 receptors in the lungs, resulting in bronchodilation. Up to three bronchodilator treatments are typically given in the prehospital setting. In some EMS systems, EMTs are not allowed to assist patients with their medication without medical control authorization. After assisting the patient with a third albuterol treatment, reassess her breath sounds and oxygen saturation and transport her promptly.

You are ventilating an apneic 50-year-old woman with a bag-valve-mask device. After squeezing the bag and noting visible chest rise, you should: A) squeeze the bag again in 3 seconds. B) thorough suction the patient's oropharynx. C) reopen the airway and ventilate again. D) allow the patient to completely exhale.

D) allow the patient to completely exhale. When ventilating an apneic patient, it is important to allow for complete exhalation. To do this, deliver each breath over l second, just enough to make the chest visibly rise, and then deliver the next breath 5 to 6 seconds later (3 to 5 seconds later for infants and children). Failure to allow for complete exhalation may cause the patient to retain carbon dioxide (carbon dioxide elimination occurs during exhalation) and may also impair venous return to the heart secondary to hyperinflation of the lungs. If you observe visible chest rise when you ventilate the patient, there is no need to reopen the airway. Suction the airway only if secretions are present.

With the flowmeter set at 6 L/min, the nasal cannula will deliver up to _______ oxygen. A. 14% B. 24% C. 34% D. 44%

D. 44%

A patient is unresponsive and has sonorous breathing. This indicates: A) vomitus in the airway. B) upper airway swell ing. C) reduced tidal volume. D) anatomic obstruction.

D) anatomic obstruction. When a patient is unresponsive, the tongue falls back and partially occludes the airway, resulting in a snoring (sonorous) sound. Therefore, sonorous breathing indicates an anatomic airway obstruction. The presence of vomitus or other secretions in the airway produces a gurgling sound. Upper ai,way swelling, such as from burns or an infection, produces a characteristic high-pitched sound on inhalation called stridor. Reduced tidal volume would manifest with shallow rise of the chest during inhalation.

The main waste product of aerobic metabolism is: A) oxygen. B) glucose. C) lactic acid. D) carbon dioxide.

D) carbon dioxide. Oxygen is not a byproduct, it is the fuel our bodies need to function. In the presence of oxygen, cells convert glucose into energy through a process called aerobic metabolism. When the cells use oxygen to convert glucose to energy, carbon dioxide, the main waste product, accumulates in the cell. Carbon dioxide is then transported through the circulatory system and back to the lungs for exhalation. Without adequate oxygen, the cells do not completely convert glucose into energy, and lactic acid and other toxins accumulate in the cell. This process, called anaerobic metabolism, cannot meet the metabolic demands of the cell. It is at this point that the patient develops acidosis, which can be life-threatening if not promptly corrected.

Signs of inadequate breathing in an unresponsive patient include: A) an irregular pulse. B) warm, moist skin. C) symmetrical chest rise. D) cyanotic oral mucosa.

D) cyanotic oral mucosa. Signs of inadequate breathing in both responsive and unresponsive patients include a respiratory rate that is too slow (less than 12 breaths/min) or too fast (greater than 20 breaths/min); shallow (reduced tidal volume), irregular, or gasping respirations; asymmetrical (unequal) chest rise; abnormal respiratory sounds, such as wheezing, stridor, or gurgling; and abnormal skin color and condition (ie, cool or cold skin, pallor, diaphoresis, cyanosis). An irregular pulse indicates a cardiac dysrhythmia.

An elderly man is found lying unresponsive in his garage. The patient's wife did not witness the event that led to his unresponsiveness. You should: A) assess the patient's respirations. B) apply supplemental oxygen. C) thoroughly suction his oropharynx. D) grasp the angles of the lower jaw and lift.

D) grasp the angles of the lower jaw and lift. Because this patient was found unresponsive and his wife did not witness the event, you should assume that he fell from a standing position and potentially injured his spine. Because of the potential trauma, the jaw-thrust maneuver should be used, which involves grasping the angles of the lower jaw and lifting forward without manipulating the head. After manually opening his airway, use suction to clear secretions from his oropharynx if indicated. Assess the patient's breathing and then begin appropriate treatment (ie, bag-mask ventilation, passive supplemental oxygen).

A 30-year-old woman overdosed on pain pills and is unresponsive. She is breathing at a rate of 6 breaths/min with shallow depth. Left untreated, she will develop: A) hypocarbia and acidosis. B) hypercarbia and alkalosis. C) hypocarbia and alkalosis. D) hypercarbia and acidosis.

D) hypercarbia and acidosis. When the respiratory system is depressed, the patient is unable to eliminate adequate amounts of carbon dioxide from the body; as a result, it will accumulate in the blood (hypercarbia). Immediate ventilation is required to help the patient eliminate this excess carbon dioxide. If not treated, the pH of the blood will fa ll below 7.35 (acidosis). If the patient is breathing too rapidly and/or deeply, too much carbon dioxide would be eliminated from the body (hypocarbia). If th is is left untreated, the pH of the blood would rise above 7.45 (alkalosis).

A 56-year-old man has labored, shallow breathing at a rate of 28 breaths/min. He is responsive to pain only. You should: A) suction his oropharynx and insert an oropharyngeal airway. B) ventilate him with a bag-valve-mask device at a rate of 30 breaths/min. C) place him on his side and administer oxygen via nonrebreathing mask. D) insert a nasopharyngeal airway and begin assisting his ventilations.

D) insert a nasopharyngeal airway and begin assisting his ventilations. This patient in this scenario is not breathing adequately. He is responsive to pain only, and his respirations are rapid, labored, and shallow. You should insert a nasopharyngeal airway, which is better tolerated in patients who are semiconscious and have a gag reflex, and assist his ventilations with a bag-valve-mask device. When assisting a patient's breathing, you should squeeze the bag-valve-mask device to ensure that he or she receives 10 to 12 adequate breaths per minute. Do not hyperventilate the patient, as this increases the risks of vomiting and aspiration. Hyperventilation also increases intra thoracic pressure, which may impair venous return to the heart (preload} and cause a decrease in cardiac output. Oxygen via nonrebreathing mask is appropriate for patients who are breathing adequately, but are suspected of being hypoxic. The recovery position (patient is placed on his or her side) is appropriate for unresponsive, uninjured patients with adequate breathing.

You receive a call for a 49-year-old woman who passed out. The patient's husband tells you that they were watching TV when the incident occurred. No trauma was involved. The patient is semiconscious and has cyanosis to her lips. After opening her airway with the head tiltchin lift maneuver, you should: A) assess her respiratory effort. B) begin ventilation assistance. C) insert an oropharyngeal airway. D) insert a nasopharyngeal airway.

D) insert a nasopharyngeal airway. In the absence of trauma, open the patient's airway with the head tilt-chin lift maneuver. To help maintain airway patency, a nasopharyngeal airway should be inserted. Your patient is semiconscious, not unconscious, so she will likely gag if you attempt to insert an oropharyngeal airway; this may result in aspiration if she vomits. Remember, you must first open the patient's airway and, if needed, suction any secretions from the mouth. Next, insert an airway adjunct and assess respiratory effort. The method of oxygenation you provide depends on the adequacy of the patient's breathing.

To obtain the MOST reliable assessment of a patient's tidal volume, you should: A) assess for retractions. B) listen for airway noises. C) count the respiratory rate. D) look at the rise of the chest.

D) look at the rise of the chest. Tidal volume is the amount of air, in milliliters (mL), breathed into or out of the lungs in a single breath. The most effective (and practical) way to assess tidal volume is to evaluate the rise of the patient's chest. If the patient's chest rises minimally during inhalation, his or her respirations are shallow; shallow respirations reflect a reduced tidal volume.

The average adult has approximately ___________ of blood in his or her body. A. 3 L B. 4 L C. 5 L D. 6 L

D. 6 L

At the peak of the inspiratory phase, the alveoli in the lungs contain: A) large quantities of carbon dioxide. B) minimal levels of oxygen and carbon dioxide. C) equal levels of oxygen and carbon dioxide. D) more oxygen than carbon dioxide.

D) more oxygen than carbon dioxide. At the peak of the inspiratory (inhalation) phase, the alveoli are filled with fresh oxygen that the patient just breathed in. During the expiratory (exhalation) phase, the oxygen moves from the alveoli to the left side of the heart and the carbon dioxide is exhaled into the atmosphere. The process of oxygen and carbon dioxide exchange in the lungs is called pulmonary (external) respiration.

The method by which you administer supplemental oxygen to a hypoxemic patient depends MOSTLY on the: A) presence or absence of cyanosis. B) patient's level of consciousness and heart rate. C) suspected underlying cause of the hypoxemia. D) severity of hypoxemia and adequacy of breathing.

D) severity of hypoxemia and adequacy of breathing. All hypoxemic patients, whatever the cause of their condition, should be treated with supplemental oxygen. The method of oxygen delivery depends on the severity of the hypoxemia and the adequacy of the patient's breathing. For example, a hypoxemic patient who is breathing adequately (eg, normal rate, adequate tidal volume) should receive oxygen via nasal cannula or nonrebreathing mask, depending on the severity of the hypoxemia. However, if the patient is breathing inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]), he or she may require ventilation assistance with a bag-valve-mask device. The absence of cyanosis does not rule out hypoxia; cyanosis is a later sign and indicates significant hemoglobin desaturation. A patient's level of consciousness and heart rate can give you clues as to the severity of his or her hypoxemia; a decreased level of consciousness and a rapid, weak pulse rate are signs of significant hypoxemia.

A 5O-year-old man, who fell approximately 20 feet and landed on a hard surface, is semiconscious. You should: A) check for a carotid pulse if the patient is breathing rapidly. B) gently tilt the patient's head back to assess for breathing. C) begin positive-pressure ventilations with a bag-valve-mask device. D) stabilize his head while performing the jaw-thrust maneuver.

D) stabilize his head while performing the jaw-thrust maneuver. Because of the significant mechanism of injury (fa ll of greater than 15 feet), spinal injury should be assumed. The fir t step in managing this patient is to manually stabilize his head in a neutral position and open his airway with the jaw-thrust maneuver, both of which can be performed simultaneously. After the patient's airway is open, assess the rate and quality of his breathing and treat accordingly. The head tilt-chin lift maneuver should not be used on a patient with a possible spinal injury unless the jaw-thrust maneuver does not adequately open his or her airway. The patient in this scenario is semiconscious; therefore, he has a pulse (pulseless patients are unresponsive). If an uninjured patient is found to be unresponsive, you should simultaneously assess for breathing and a pulse; take no longer than 10 seconds to do this.

An elderly woman with COPD is semiconscious with labored breathing. Her face is cyanotic, her pulse is rapid and weak, and her oxygen saturation is 75%. You should: A) avoid high-flow oxygen because this may cause her to stop breathing. B) apply oxygen via nasal cannula and reassess her respiratory status. C) insert a nasal airway and give her oxygen via a nonrebreathing mask. D) ventilate her with a bag-valve-mask device and high-flow oxygen.

D) ventilate her with a bag-valve-mask device and high-flow oxygen. The patient in this scenario is experiencing an exacerbation (worsening) of her COPD. Her decreased level of consciousness; cyanosis; weak, rapid pulse; low oxygen saturation (Sp02); and labored breathing clearly indicate that she is not breathing adequately. Therefore, you should ventilate her with a bag-valvemask device and high-flow oxygen; if you do not, she will continue to deteriorate, possibly to the point of cardiac arrest. If needed, insert a nasopharyngeal airway to help keep her airway open. Regardless of the patient's history of COPD, you must NOT withhold oxygen from her for fear of supressing her respirations .. Respiratory depression in COPD patients who receive higher concentrations of oxygen is highly uncommon.

Which of the following patient responses would establish the "E" in the SAMPLE history? A. "I was in the hospital a week ago." B. "I am not having any difficulty breathing." C. "The chest pain started about 45 minutes ago." D. "I was mowing the lawn when the pain began."

D. "I was mowing the lawn when the pain began."

At rest, the normal adult heart rate should not exceed: A. 70 beats/min. B. 80 beats/min. C. 90 beats/min. D. 100 beats/min.

D. 100 beats/min.

The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg. A. 70, 28 B. 88, 30 C. 90, 50 D. 104, 40

D. 104, 40

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A. 4 hours. B. 8 hours. C. 10 hours. D. 16 hours.

D. 16 hours.

The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age. A. 2, 4 B. 6, 12 C. 12, 4 D. 18, 6

D. 18, 6

The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi). A. 500 B. 1,000 C. 1,500 D. 2,000

D. 2,000

With proper technique, you and your partner should be able to safely lift a patient who weighs up to ______ lb. A. 150 B. 175 C. 190 D. 220

D. 220

Hydroplaning of the ambulance on wet roads would MOST likely occur at speeds of greater than _____ mph. A. 10 B. 15 C. 20 D. 30

D. 30

Normal respiratory rates should not exceed _______ breaths per minute in children and _______ breaths per minute in infants. A. 18, 28 B. 20, 30 C. 24, 45 D. 30, 50

D. 30, 50

Preeclampsia MOST commonly occurs after the ____ week of gestation. A. 12th B. 20th C. 24th D. 30th

D. 30th

The Microdrip administration delivers 1 mL of fluid for every ____ drops. A. 10 B. 15 C. 45 D. 60

D. 60

In which of the following situations would it be MOST appropriate to utilize an air medical transportation service? A. 29-year-old woman who is 18 weeks pregnant, has light vaginal bleeding, and stable vital signs B. 43-year-old man experiencing a heart attack, and the closest appropriate hospital is 15 minutes away C. 50-year-old conscious woman with severe nausea and vomiting, fever, and chills of 3 days' duration D. 61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes

D. 61-year-old man with signs and symptoms of a stroke and your ground transport time is 50 minutes

A critical incident stress debriefing should be conducted no longer than ________ hours following the incident. A. 6 B. 12 C. 24 D. 72

D. 72

At present, the average life expectancy is ________ years, while the maximum life expectancy is estimated at ________ years. A. 68, 100 B. 70, 102 C. 72, 110 D. 78, 120

D. 78, 120

The anterior fontanelle fuses together between the ages of: A. 3 and 4 months. B. 6 and 8 months. C. 7 and 14 months. D. 9 and 18 months.

D. 9 and 18 months.

The low normal systolic blood pressure for a 30-year-old is: A. 60 mm Hg. B. 70 mm Hg. C. 80 mm Hg. D. 90 mm Hg.

D. 90 mm Hg.

Which of the following statements regarding a 3-month-old infant is correct? A. The infant is unable to turn his or her head and focus. B. The infant should be aroused easily from a sleeping state. C. At this age, the infant typically sleeps for up to 8 hours a day. D. A 3-month-old infant can distinguish a parent from a stranger.

D. A 3-month-old infant can distinguish a parent from a stranger.

In which of the following situations is a pertinent negative identified? A. A 50-year-old woman states that nothing makes her chest pain better or worse. B. A 53-year-old man with dizziness also tells you that he has vomited three times. C. A 56-year-old woman states that her chest hurts every time she takes a deep breath. D. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

D. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction? A. An EMT with many years of field experience becomes irritable with her coworkers and experiences headaches and insomnia. B. A newly certified EMT becomes extremely nauseated and diaphoretic at the scene of an incident involving grotesque injuries. C. An EMT is emotionally exhausted and depressed after a school bus crash involving critical injuries and the death of several children. D. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.

D. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.

Which of the following statements regarding the blood pressure is correct? A. The systolic pressure represents ventricular relaxation. B. Blood pressure falls early in patients with hypoperfusion. C. Blood pressure is the most reliable indicator of perfusion. D. Blood pressure is usually not measured in children younger than 3 years of age.

D. Blood pressure is usually not measured in children younger than 3 years of age.

Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called: A. ataxic respirations. B. agonal respirations. C. eupneic respirations. D. Cheyne-Stokes respirations.

D. Cheyne-Stokes respirations.

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? A. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. B. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition. C. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness. D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other lifethreatening injuries, how you should care for his wound? A. Irrigate it with sterile water and cover it with a dry dressing. B. Cover the exposed bowel and keep his legs in a straight position. C. Carefully replace the exposed bowel into the abdomen and transport. D. Cover it with moist, sterile gauze and secure with an occlusive dressing.

D. Cover it with moist, sterile gauze and secure with an occlusive dressing.

Which of the following statements regarding the cranium is correct? A. The skull is a subdivision of the cranium. B. Thirty percent of the cranium is occupied by blood. C. The cranium protects the structures of the face. D. Eighty percent of the cranium is occupied by brain tissue.

D. Eighty percent of the cranium is occupied by brain tissue.

Which of the following is the MOST effective strategy for managing stress? A. Frequently reflect on troublesome calls. B. Avoid friends and interests outside of EMS. C. Request overtime to increase your income. D. Focus on delivering high-quality patient care.

D. Focus on delivering high-quality patient care.

Which of the following statements regarding spinal injuries in pediatric patients is correct? A. Because of a child's proportionately large head, they are more prone to spinal cord injuries than adults. B. The majority of cervical spine injuries in children are partial transections of the spinal cord, resulting in partial paralysis. C. Most cervical spine fractures in infants and children occur between the first and second cervical vertebrae. D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.

D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.

Which of the following statements regarding the pain associated with AMI is correct? A. It is often described by the patient as a sharp feeling. B. It often fluctuates in intensity when the patient breathes. C. Nitroglycerin usually resolves the pain within 30 minutes. D. It can occur during exertion or when the patient is at rest.

D. It can occur during exertion or when the patient is at rest.

Which of the following statements regarding striated muscle is correct? A. Striated muscle is involuntary because you have no conscious control over it. B. Most of the body's striated muscle is found within the walls of the blood vessels. C. Striated muscle tissue is attached directly to the bones by tough bands of cartilage. D. It forms the major muscle mass of the body and usually crosses at least one joint.

D. It forms the major muscle mass of the body and usually crosses at least one joint.

How does positive-pressure ventilation affect cardiac output? A. There is no effect on cardiac output because positive-pressure ventilation is the act of normal breathing. B. It decreases intrathoracic pressure, which facilitates venous return to the heart and increases cardiac output. C. It causes pressure in the chest to decrease, which increases stroke volume and cardiac output. D. It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output.

D. It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output.

Which of the following statements regarding the Good Samaritan law is correct? A. It provides the EMT immunity from a lawsuit. B. It guarantees that the EMT will not be held liable if he or she is sued. C. The law does not protect EMTs who are off duty. D. It will not protect the EMT in cases of gross negligence.

D. It will not protect the EMT in cases of gross negligence.

Which of the following statements regarding drowning is correct? A. Hypoxia in the drowning victim initially occurs due to water in the lungs. B. Artificial ventilations can easily be performed in patients with a laryngospasm. C. Large amounts of water enter the lungs in a small number of drowning victims. D. Laryngospasm following submersion in water makes rescue breathing difficult.

D. Laryngospasm following submersion in water makes rescue breathing difficult.

Which of the following statements regarding nitroglycerin is correct? A. The potency of nitroglycerin is increased when exposed to light. B. A maximum of five nitroglycerin doses should be given to a patient. C. Nitroglycerin should be administered between the cheek and gum. D. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

D. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

Which of the following statements regarding communications with the elderly is correct? A. The majority of elderly patients are hearing or visually impaired. B. Attempt to calm the elderly patient by using his or her first name. C. Explain the justification for a procedure after it has been completed. D. Older patients have difficulty understanding when they are stressed.

D. Older patients have difficulty understanding when they are stressed.

By what mechanism is a person injured when he or she falls from a significant height? A. Kinetic energy is converted to potential energy; the potential energy is then converted into the work of bringing the body to a stop. B. Potential energy is created as the person is falling; the potential energy is then converted into kinetic energy upon impact. C. As the person falls, the amount of kinetic energy is converted into work; work is then converted to kinetic energy upon impact. D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

D. Potential energy is converted to kinetic energy; the kinetic energy is then converted into the work of bringing the body to a stop.

Which of the following would the EMT MOST likely be asked to do when assisting a paramedic with endotracheal intubation? A. Visualization of the vocal cords B. Placement of the endotracheal tube C. Suction under direct laryngoscopy D. Preoxygenation with a BVM

D. Preoxygenation with a BVM

You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. Which of the following should be your MOST appropriate action? A. Perform a rapid assessment and then move the patients from their residence. B. Request another ambulance to assist with lifting and moving the patients. C. Quickly exit the residence and request the fire department to move the patients. D. Rapidly remove the patients from their residence using a blanket or clothes drag.

D. Rapidly remove the patients from their residence using a blanket or clothes drag.

How does respiration differ from ventilation? A. Ventilation occurs when air is forced into the lungs, whereas respiration occurs when air is drawn or sucked into the lungs. B. Respiration occurs when the diaphragm and intercostal muscles contract, whereas ventilation occurs when those same muscles relax. C. Respiration occurs when oxygen is delivered to the cells of the body, whereas ventilation occurs when carbon dioxide is removed. D. Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment.

D. Respiration is the process of gas exchange, whereas ventilation is the simple movement of air between the lungs and the environment.

Which of the following statements regarding severe burns is correct? A. Severe burns involving the airway have a 100% mortality rate. B. The majority of severe burns involve full-thickness burns only. C. Patients with severe burns are especially prone to hyperthermia. D. Severe burns are typically a combination of all degrees of burn.

D. Severe burns are typically a combination of all degrees of burn.

Which of the following statements regarding low-energy penetrating injuries is correct? A. Internal injuries caused by low-velocity bullets are usually easy to predict. B. Exit wounds are typically easy to locate with low-energy penetrating injuries. C. It is usually easy to differentiate between an entrance wound and an exit wound. D. The area of injury is usually close to the path the object took through the body.

D. The area of injury is usually close to the path the object took through the body.

What happens when blood volume is lost from the body? A. Arterial blood is diverted to the skin and muscles. B. The veins dilate to increase systemic perfusion. C. Widespread vasodilation causes blood pressure to decrease. D. The arteries contract to increase the blood pressure.

D. The arteries contract to increase the blood pressure.

Which of the following statements regarding the rapid extrication technique is correct? A. The only indication for performing a rapid extrication is if the patient is not entrapped and is in cardiac arrest. B. Rapid extrication involves the use of heavy equipment to disentangle a patient from his or her crashed vehicle. C. It involves rapidly removing a patient from his or her vehicle after immobilizing him or her with a short backboard. D. The rapid extrication technique is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

D. The rapid extrication technique is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

Which of the following statements regarding gunshot wounds is correct? A. High-velocity bullets will cause less severe internal injuries. B. The size of a bullet has the greatest impact on producing injury. C. Low-velocity bullets will cause the greatest amount of trauma. D. The speed of a bullet has the greatest impact on producing injury.

D. The speed of a bullet has the greatest impact on producing injury.

Which of the following statements regarding HIV is correct? A. It is far more contagious than hepatitis B. B. It is easily transmittable in the EMS field. C. HIV is transmitted exclusively via blood. D. There is no vaccine against HIV infection.

D. There is no vaccine against HIV infection.

Which of the following statements regarding preschool-age children is correct? A. They realize that injuries are not a form of punishment. B. Preschoolers are usually not fearful of pain or separation. C. The preschool age begins after the child turns 2 years old. D. They can usually identify painful areas when questioned.

D. They can usually identify painful areas when questioned.

Which of the following statements regarding anterior nosebleeds is correct? A. They cause blood to drain into the posterior pharynx. B. They are usually severe and require aggressive treatment to control. C. They are usually caused by a fracture of the basilar skull. D. They usually originate from the septum area and bleed slowly.

D. They usually originate from the septum area and bleed slowly.

Which of the following statements regarding toddlers and preschoolers is correct? A. The normal respiratory rate in toddlers and preschoolers is between 12 and 20 breaths/min. B. Toddlers and preschoolers have well-developed lung musculature, even though they have less lung tissue. C. Muscle mass and bone density decrease in toddlers and preschoolers because of increased physical activity. D. Toddlers and preschoolers commonly experience upper respiratory infections because of a loss of passive immunity.

D. Toddlers and preschoolers commonly experience upper respiratory infections because of a loss of passive immunity.

Common signs and symptoms of a hypertensive emergency include: A. pallor, cool skin, and a temporary loss of hearing. B. syncope, a weak pulse, and bleeding from the ears. C. tachycardia, pain behind the eyes, and weakness. D. a bounding pulse, a severe headache, and dizziness.

D. a bounding pulse, a severe headache, and dizziness.

Abnormal variations in pupil size and reaction would MOST likely be observed in a patient with: A. retinitis. B. contact lenses. C. conjunctivitis. D. a brain injury.

D. a brain injury.

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced: A. conjunctivitis. B. acute hyphema. C. a blowout fracture. D. a detached retina.

D. a detached retina.

An infectious disease is MOST accurately defined as: A. any disease that enters the body via the bloodstream and renders the immune system nonfunctional. B. the invasion of the human body by a bacterium that cannot be destroyed by antibiotics or other drugs. C. a disease that can be spread from one person or species to another through a number of mechanisms. D. a medical condition caused by the growth and spread of small harmful organisms within the body.

D. a medical condition caused by the growth and spread of small harmful organisms within the body.

In general, medivac helicopters should be utilized when: A. ground transport would leave your service area without an ambulance for greater than 30 minutes. B. ground transport to the hospital exceeds 30 to 45 minutes, even if the patient's present condition is stable. C. a patient has been in cardiac arrest for more than 15 minutes and has not responded to CPR and defibrillation. D. a patient has a time-dependent injury or illness and traffic conditions would cause a significant delay in definitive care.

D. a patient has a time-dependent injury or illness and traffic conditions would cause a significant delay in definitive care.

Spina bifida is a developmental defect in which: A. an excessive amount of cerebrospinal fluid damages the spinal cord. B. nerve fibers that arise from the spinal cord do not function properly. C. the spinal column is severely deformed, resulting in permanent paralysis. D. a portion of the spinal cord or meninges protrudes outside of the vertebrae.

D. a portion of the spinal cord or meninges protrudes outside of the vertebrae.

A significant number of patients with cerebral palsy also have: A. paralysis. B. brain tumors. C. type 2 diabetes. D. a seizure disorder.

D. a seizure disorder.

A reflex arc occurs when: A. the motor nerves function automatically without receiving a message from the CNS. B. a sensory nerve sends a message to the brain but the motor nerve fails to send the appropriate response to the body. C. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles. D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

D. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve.

Stimulation of the parasympathetic nervous system would result in: A. tachycardia. B. a strong pulse. C. vasoconstriction. D. a slow heart rate.

D. a slow heart rate.

The MOST prominent symptom of decompression sickness is: A. tightness in the chest. B. difficulty with vision. C. dizziness and nausea. D. abdominal or joint pain.

D. abdominal or joint pain.

Movement or motion away from the body's midline is called: A. flexion. B. extension. C. adduction. D. abduction.

D. abduction.

Which of the following conditions or situations presents the MOST unique challenge to the EMT when immobilizing an elderly patient on a long backboard? A. joint flexibility B. patient disorientation C. naturally deformed bones D. abnormal spinal curvature

D. abnormal spinal curvature

An infant with severe dehydration would be expected to present with: A. excessive tearing. B. moist oral mucosa. C. bulging fontanelles. D. absent urine output.

D. absent urine output.

The final stage of death and dying is MOST commonly displayed as: A. anger. B. denial. C. depression. D. acceptance.

D. acceptance.

When caring for the parents of a child who has died of leukemia, the EMT should: A. immediately refer them to a counselor. B. tell them that their feelings are understood. C. refrain from using words such as "died" or "dead." D. acknowledge the death of their child in private.

D. acknowledge the death of their child in private.

The BEST way to reduce your risk of contracting a work-related disease following exposure is to: A. vigorously wash the affected area with an antimicrobial solution. B. be evaluated by a physician within 72 hours following the exposure. C. get vaccinated against the disease you think you were exposed to. D. activate your department's infection control plan as soon as possible.

D. activate your department's infection control plan as soon as possible.

Which of the following is the MOST reliable indicator of adequately performed bag-mask ventilations in an apneic adult with a pulse? A. 20 breaths/min being delivered to the adult B. decreased compliance when squeezing the bag C. an adult's heart rate that is consistently increasing D. adequate rise of the chest when squeezing the bag

D. adequate rise of the chest when squeezing the bag

Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to: A. perform a head-to-toe secondary assessment. B. assess her oxygen saturation and blood pressure. C. retrieve the stretcher and prepare for transport. D. administer oxygen with the appropriate device.

D. administer oxygen with the appropriate device.

A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n): A. statute of care. B. power of attorney. C. physician directive. D. advance directive.

D. advance directive.

A team of EMTs is caring for a critically injured patient. The team leader advises the EMT that transport will not begin until the patient's closed forearm fracture is splinted. Utilizing the crew resource management model, the EMT should: A. repeat the request back to the team leader and then splint the patient's arm. B. ensure that the entire team is aware that transport will be delayed for splinting. C. disregard the team leader's request and contact medical control for guidance. D. advise the team leader that immediate transport is more important than splinting.

D. advise the team leader that immediate transport is more important than splinting.

A normal level of consciousness in an infant or child is characterized by: A. normal interactiveness, awareness to time, and pink skin color. B. awareness to place, pink and dry skin, and consistent eye contact. C. crying or combativeness, good muscle tone, and awareness to time. D. age-appropriate behavior, good muscle tone, and good eye contact.

D. age-appropriate behavior, good muscle tone, and good eye contact.

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of: A. chronic dementia, which inhibits communication. B. interactions of the numerous medications they take. C. progressive deterioration of abdominal organ function. D. age-related deterioration of their sensory systems.

D. age-related deterioration of their sensory systems.

What is the function of the sternocleidomastoid muscle? A. allows flexion of the neck B. provides respiration C. connects the scapulae together D. allows movement of the head

D. allows movement of the head

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: A. preeclampsia. B. placenta previa. C. gestational diabetes. D. an ectopic pregnancy.

D. an ectopic pregnancy.

When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds. B. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. C. as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient has respiratory distress. D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

When performing the rapid extrication technique to remove a patient from his or her vehicle, you should: A. apply a vest-style extrication device prior to moving the patient. B. apply a cervical collar and immobilize the patient on a short backboard. C. grasp the patient by the clothing and drag him or her from the car. D. apply a cervical collar and remove the patient on a long backboard.

D. apply a cervical collar and remove the patient on a long backboard.

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should: A. apply direct pressure below the lacerated vessel. B. circumferentially wrap a dressing around his neck. C. apply pressure to the closest arterial pressure point. D. apply direct pressure above and below the wound.

D. apply direct pressure above and below the wound.

Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: A. hyperventilate him with a bag-mask device and monitor his oxygen saturation. B. apply high-flow oxygen, perform a detailed secondary assessment, and transport. C. focus your assessment on his scapulae and clavicles and apply high-flow oxygen. D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

D. apply high-flow oxygen, consider spinal precautions, and transport without delay.

A 49-year-old male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (Vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering 100% oxygen, you should: A. obtain physician approval to give the nitroglycerin. B. place him in a supine position and transport at once. C. administer one nitroglycerin and call medical control. D. ask him if he took his Viagra within the past 24 hours.

D. ask him if he took his Viagra within the past 24 hours.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: A. list all of the patient's current medications. B. obtain a complete set of baseline vital signs. C. administer glucose to rule out hypoglycemia. D. ask his wife when she noticed the symptoms.

D. ask his wife when she noticed the symptoms.

Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should: A. contact medical control and apprise him or her of the situation. B. park your ambulance behind the incident commander's vehicle. C. set up a staging area where fire fighters can be treated if necessary. D. ask the incident commander where the ambulance should be staged.

D. ask the incident commander where the ambulance should be staged.

Which of the following is an example of a drug's generic name? A. Bayer B. Advil C. Excedrin D. aspirin

D. aspirin

You receive a call to a local daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to: A. open the airway and give 2 rescue breaths. B. begin chest compressions and request backup. C. immediately transport the child to the hospital. D. assess for a brachial pulse for 5 to 10 seconds.

D. assess for a brachial pulse for 5 to 10 seconds.

A young male sustained a gunshot wound to the abdomen during an altercation with a rival gang member. As your partner is assessing and managing his airway, you should control the obvious bleeding and then: A. apply a cervical collar. B. obtain baseline vital signs. C. auscultate bowel sounds. D. assess for an exit wound.

D. assess for an exit wound.

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to 324 mg of baby aspirin. B. administer up to three doses of nitroglycerin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations.

D. assess the adequacy of his respirations.

A partial-thickness burn involves the outer layer of skin and a portion of the: A. epidermis. B. fatty layer. C. muscle fascia. D. dermal layer.

D. dermal layer.

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should: A. document the patient's request but continue to transport him. B. have the patient sign a refusal form and return him to his office. C. request that the police place the patient under protective custody. D. assess whether or not the patient's mental condition is impaired.

D. assess whether or not the patient's mental condition is impaired.

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 to 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-mask device, 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.

A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes: A. hyperventilating her at 30 breaths/min. B. administering oxygen via a nonrebreathing mask. C. ventilation assistance to maintain an oxygen saturation of 90%. D. assisting ventilations at an age-appropriate rate.

D. assisting ventilations at an age-appropriate rate.

Narrowing of the coronary arteries due to a buildup of fatty deposits is called: A. angina pectoris. B. arteriosclerosis. C. acute ischemia. D. atherosclerosis.

D. atherosclerosis.

The decline in cardiac function that commonly occurs in late adulthood is MOST often related to: A. hypotension. B. medication use. C. kidney failure. D. atherosclerosis.

D. atherosclerosis.

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should: A. immediately clamp and cut the umbilical cord. B. give 100% oxygen to the mother and transport at once. C. provide free-flow oxygen to the infant and transport. D. attempt to slip the cord gently over the infant's head.

D. attempt to slip the cord gently over the infant's head.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: A. excitability. B. contractility. C. impulsivity. D. automaticity.

D. automaticity.

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: A. parietal lobe. B. pons and medulla. C. somatic nervous system. D. autonomic nervous system.

D. autonomic nervous system.

When documenting a case of suspected elder abuse, it is MOST important for the EMT to: A. theorize as to why the patient was abused. B. document his or her perceptions of the event. C. list the names of all of the suspected abusers. D. avoid documenting any unsupported opinions.

D. avoid documenting any unsupported opinions.

When treating a partial-thickness burn, you should: A. immerse the affected part in warm water. B. rupture any blisters to prevent an infection. C. cover the burn with a moist, sterile dressing. D. avoid the use of creams, lotions, or antiseptics.

D. avoid the use of creams, lotions, or antiseptics.

The third stage of labor begins when the: A. placenta is fully delivered. B. cervix is completely dilated. C. umbilical cord has been clamped. D. baby is expelled from the vagina.

D. baby is expelled from the vagina.

A dysbarism injury refers to the signs and symptoms related to changes in: A. rapid ascent. B. rapid descent. C. decompression. D. barometric pressure.

D. barometric pressure.

The MOST appropriate carrying device to use when moving a patient across rough or uneven terrain is the: A. stair chair. B. wheeled stretcher. C. scoop stretcher. D. basket stretcher.

D. basket stretcher.

Regardless of where portable and mounted oxygen cylinders are stored in the ambulance, they must: A. undergo hydrostatic testing on a weekly basis. B. hold a minimum capacity of 1,500 L of oxygen. C. be easily identifiable by their bright green color. D. be capable of delivering oxygen at 1 to 15 L/min.

D. be capable of delivering oxygen at 1 to 15 L/min.

When transporting a patient to the hospital, you should: A. generally exceed the posted speed limit by 10 to 20 mph. B. place the patient on a long backboard, even if no trauma is involved. C. secure the patient to the ambulance stretcher with at least two straps. D. be safe and get the patient to the hospital in the shortest practical time.

D. be safe and get the patient to the hospital in the shortest practical time.

When you shine a light into one pupil, the normal reaction of the other pupil should be to: A. dilate. B. not react. C. become larger. D. become smaller.

D. become smaller.

With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of: A. severe kyphosis. B. distracting injuries. C. spinal cord tearing. D. compression fractures.

D. compression fractures.

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should: A. advise your partner that you cannot provide care to this patient. B. wait for the backup ambulance while your partner performs CPR. C. obtain permission from medical control to not attempt resuscitation. D. begin two-rescuer CPR and apply the automated external defibrillator (AED) as soon as possible.

D. begin two-rescuer CPR and apply the automated external defibrillator (AED) as soon as possible.

The posterior tibial pulse can be palpated: A. on the dorsum of the foot. B. above the lateral malleolus. C. in the fossa behind the knee. D. behind the medial malleolus.

D. behind the medial malleolus.

The vagina and the neck of the uterus comprise the: A. womb. B. cervix. C. fundus. D. birth canal.

D. birth canal.

Other than personal safety equipment, which of the following should be the MOST readily accessible item in the back of an ambulance? A. emergency childbirth kit B. stethoscope and penlight C. pneumatic antishock garment (PASG) and traction splint D. bleeding control supplies

D. bleeding control supplies

Hypothermia can worsen internal bleeding secondary to: A. cardiac arrhythmias. B. a decreased heart rate. C. severe muscular rigidity. D. blood clotting abnormalities.

D. blood clotting abnormalities.

An infant's blood pressure typically increases with age because: A. the infant's total blood volume decreases with age. B. his or her normal heart rate usually increases with age. C. as the infant gets older, his or her blood vessels dilate. D. blood pressure directly corresponds to body weight.

D. blood pressure directly corresponds to body weight.

Which of the following is NOT a component of the Apgar score? A. pulse B. activity C. grimace D. body size

D. body size

When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery. A. radial B. apical C. femoral D. brachial

D. brachial

The MOST ominous sign of impending cardiopulmonary arrest in infants and children is: A. pallor. B. retractions. C. nasal flaring. D. bradycardia.

D. bradycardia.

All necessary life functions are coordinated in what part of the brain? A. cerebrum B. gray matter C. cerebellum D. brain stem

D. brain stem

When caring for a patient whose arm is covered with a dry chemical, you should: A. deactivate the chemical with a 5% vinegar solution. B. quickly irrigate the arm with large amounts of water. C. use forceful streams of water to remove the chemical. D. brush away the chemical before flushing with water.

D. brush away the chemical before flushing with water.

Which of the following is characteristic of peptic ulcer disease (PUD)? A. the passage of bright red blood in the stool or coughing up blood B. symptom relief after taking nonsteroidal anti-inflammatory drugs C. sharp pain that is typically located in both lower abdominal quadrants D. burning or pain in the stomach that subsides immediately after eating

D. burning or pain in the stomach that subsides immediately after eating

The nasopharyngeal airway is MOST beneficial because it: A. can effectively stabilize fractured nasal bones if it is inserted properly. B. is generally well tolerated in conscious patients with an intact gag reflex. C. effectively maintains the airway of a patient in cardiopulmonary arrest. D. can maintain a patent airway in a semiconscious patient with a gag reflex.

D. can maintain a patent airway in a semiconscious patient with a gag reflex.

The exchange of oxygen and nutrients for waste products of metabolism occurs at the cellular level in the: A. venules. B. arteries. C. arterioles. D. capillaries.

D. capillaries.

Medications encased in a gelatin shell taken by mouth are called: A. pills. B. tablets. C. caplets. D. capsules.

D. capsules.

The waste products of aerobic metabolism include: A. ATP and glucose. B. glucose and lactic acid. C. uric acid and nitrogen. D. carbon dioxide and water.

D. carbon dioxide and water.

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should: A. leave the contact lenses in place and flush his eyes with sterile water. B. remove the contact lenses and cover his eyes with a dry, sterile dressing. C. leave the contact lenses in place and cover both eyes with a dry dressing. D. carefully remove the contact lenses and then irrigate his eyes with saline.

D. carefully remove the contact lenses and then irrigate his eyes with saline.

Hyperthermia differs from fever in that it is an increase in body temperature: A. of more than 2°F to 3°F per hour. B. secondary to a severe bacterial infection. C. caused by inflammation of the spinal cord. D. caused by the inability of the body to cool itself.

D. caused by the inability of the body to cool itself.

The venom of a brown recluse spider is cytotoxic, meaning that it: A. suppresses the respiratory drive. B. destroys the body's red blood cells. C. weakens the structure of the bones. D. causes severe local tissue damage.

D. causes severe local tissue damage.

The three major parts of the brain are the: A. cerebellum, medulla, and occiput. B. brain stem, midbrain, and spinal cord. C. midbrain, cerebellum, and spinal cord. D. cerebrum, cerebellum, and brain stem.

D. cerebrum, cerebellum, and brain stem.

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: A. palpating the carotid pulse to determine the approximate rate and checking capillary refill time. B. taking a blood pressure and determining if the patient is alert and oriented or confused. C. applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. D. checking the radial pulse and noting the color, temperature, and condition of his or her skin.

D. checking the radial pulse and noting the color, temperature, and condition of his or her skin.

The chief component of connective tissues and bones that deteriorates as people age is called: A. fibrin. B. elastin. C. sebum. D. collagen.

D. collagen.

Rapid deceleration of the head, such as when it impacts the windshield, causes: A. compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain. B. primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels. C. stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain. D. compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

D. compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

Two thirds of children born with Down syndrome have: A. diabetes mellitus. B. intracranial bleeding. C. unilateral paralysis. D. congenital heart disease.

D. congenital heart disease.

The inner surface of the eyelids and the exposed surface of the eye itself are covered by a delicate membrane called the: A. sclera. B. cornea. C. retina. D. conjunctiva.

D. conjunctiva.

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should: A. assist his ventilations with a bag-mask device. B. immediately perform a rapid physical examination. C. continue transporting and alert the receiving hospital. D. consider requesting a rendezvous with an ALS unit.

D. consider requesting a rendezvous with an ALS unit.

General guidelines for carrying a patient on a stretcher include: A. maintaining slight flexion of your back. B. leaning back from your waist when lifting. C. slightly twisting your body when carrying. D. constant communication with your partners.

D. constant communication with your partners.

Stimulation of alpha-adrenergic receptors results in: A. increased heart rate. B. dilation of the blood vessels. C. increased cardiac contractility. D. constriction of the blood vessels.

D. constriction of the blood vessels.

The purpose of a jump kit is to: A. facilitate defibrillation within 5 to 10 minutes after making patient contact. B. manage a critically injured patient until he or she is loaded into the ambulance. C. carry advanced life support equipment approved by the EMS medical director. D. contain anything that you might need during the first 5 minutes of patient care.

D. contain anything that you might need during the first 5 minutes of patient care.

Dead space is the portion of the respiratory system that: A. includes the alveoli and capillaries surrounding the alveoli. B. must be filled with air before gas exchange can take place. C. receives oxygen but is unable to release carbon dioxide. D. contains no alveoli and does not participate in gas exchange.

D. contains no alveoli and does not participate in gas exchange.

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your MOST appropriate action should be to: A. ask a bystander to remain with your patient as you treat the crash victims. B. remain at the scene until law enforcement and another ambulance arrive. C. stop and triage the patients while your partner remains in the ambulance. D. continue transporting your patient and notify the dispatcher of the crash.

D. continue transporting your patient and notify the dispatcher of the crash.

The onset of labor begins with: A. thinning of the uterus. B. full dilation of the cervix. C. increased fetal movement. D. contractions of the uterus.

D. contractions of the uterus.

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should: A. assess distal pulses as well as sensory and motor functions. B. manually stabilize the leg above and below the site of injury. C. gently manipulate the injured leg until the numbness dissipates. D. control the bleeding and cover the wound with a sterile dressing.

D. control the bleeding and cover the wound with a sterile dressing.

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. A. coronary sinus, vena cava B. aorta, inferior vena cava C. vena cava, coronary veins D. coronary arteries, aorta

D. coronary arteries, aorta

When palpating a patient's pulse, you note that it is grossly irregular. You should: A. count the pulse rate for at least 30 seconds to ensure accuracy. B. count the number of pulsations in 15 seconds and multiply by four. C. count the number of pulsations in 30 seconds and multiply by two. D. count the pulse rate for a full minute to obtain an accurate reading.

D. count the pulse rate for a full minute to obtain an accurate reading.

Cyanosis of the skin is caused by: A. increased blood oxygen. B. peripheral vasodilation. C. venous vasoconstriction. D. decreased blood oxygen.

D. decreased blood oxygen.

Which of the following is NOT a characteristic of epinephrine? A. secreted naturally by the adrenal glands B. dilates passages in the lungs C. constricts blood vessels D. decreases heart rate and blood pressure

D. decreases heart rate and blood pressure

Determination of exposure is an important component of an infection control plan because it: A. determines the time of day that most exposures are likely to occur. B. determines which type of communicable disease might be present in the workplace. C. defines who is most likely to transmit communicable diseases in the workplace. D. defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure.

D. defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure.

The MOST significant hazard associated with splinting is: A. aggravation of the injury or worsened pain. B. reduction in circulation distal to the injury site. C. compression of nerves, tissues, and vasculature. D. delaying transport of a critically injured patient.

D. delaying transport of a critically injured patient.

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: A. delirium. B. delusion. C. paranoia. D. dementia.

D. dementia.

Placenta previa is MOST accurately defined as: A. delivery of a portion of the placenta before the baby. B. premature placental separation from the uterine wall. C. abnormal development and functioning of the placenta. D. development of the placenta over the cervical opening.

D. development of the placenta over the cervical opening.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: A. scraping fatty deposits off of the lumen of the coronary artery. B. bypassing the coronary artery with a vessel from the chest or leg. C. placing a stent inside the coronary artery to keep it from narrowing. D. dilating the affected coronary artery with a small inflatable balloon.

D. dilating the affected coronary artery with a small inflatable balloon.

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include: A. assisting him with his migraine medication and transporting without lights and siren. B. placing him in a supine position and transporting with lights and siren to a stroke center. C. applying warm compresses to the back of his neck and transporting with lights and siren. D. dimming the lights in the back of the ambulance and transporting without lights and siren.

D. dimming the lights in the back of the ambulance and transporting without lights and siren.

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unconscious, has slow and shallow respirations, and has bilaterally closed femur deformities. You should: A. stabilize her legs with the pneumatic antishock garment (PASG). B. apply 100% oxygen via a nonrebreathing mask. C. obtain baseline vital signs and transport at once. D. direct your partner to begin ventilatory assistance.

D. direct your partner to begin ventilatory assistance.

The disruption of a joint in which the bone ends are no longer in contact is called a: A. strain. B. sprain. C. fracture. D. dislocation.

D. dislocation.

Which of the following musculoskeletal injuries would MOST likely result in deformity? A. severe strain B. moderate sprain C. hairline fracture D. displaced fracture

D. displaced fracture

A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the: A. proximal forearm. B. superior forearm. C. dorsal forearm. D. distal forearm.

D. distal forearm.

Which of the following medications increases a person's risk of a heat-related emergency? A. Motrin B. Tylenol C. Aspirin D. diuretics

D. diuretics

What is the MOST appropriate method to use when moving a patient from his or her bed to the wheeled stretcher? A. log roll B. direct carry C. extremity carry D. draw sheet method

D. draw sheet method

The tough, fibrous outer meningeal layer is called the: A. pia mater. B. arachnoid. C. gray mater. D. dura mater.

D. dura mater.

In order for a team to function effectively: A. all members are trained to the same level. B. only one member of the team speaks and provides direction. C. team member remains committed to their individual goals. D. each member knows what is expected of him or her.

D. each member knows what is expected of him or her.

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience: A. midback pain. B. a bloated feeling. C. an urge to push. D. easier breathing.

D. easier breathing.

When the body loses sweat, it also loses: A. plasma. B. nutrients. C. erythrocytes. D. electrolytes.

D. electrolytes.

A 37-year-old male has an apparent foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes: A. a series of back blows and chest thrusts. B. finger sweeps to remove the obstruction. C. performing a series of abdominal thrusts. D. encouraging him to cough and transporting.

D. encouraging him to cough and transporting.

During the primary assessment of a semiconscious 70-year-old female, you should: A. insert a nasopharyngeal airway and assist ventilations. B. immediately determine the patient's blood glucose level. C. ask family members if the patient has a history of stroke. D. ensure a patent airway and support ventilation as needed.

D. ensure a patent airway and support ventilation as needed.

Prior to defibrillating a patient with an AED, it is MOST important that you: A. properly position the defibrillation pads. B. perform up to 5 minutes of effective CPR. C. confirm that the patient is in cardiac arrest. D. ensure that no one is touching the patient.

D. ensure that no one is touching the patient.

When immobilizing a patient on a long backboard, you should: A. have the patient exhale before fastening the torso straps. B. secure the torso and then center the patient on the board. C. follow the commands of the person at the patient's torso. D. ensure that you secure the torso before securing the head.

D. ensure that you secure the torso before securing the head.

The MOST important consideration at the scene of a hazardous material incident is: A. identifying the material. B. calling the hazardous materials team. C. evacuating the bystanders. D. ensuring your personal safety.

D. ensuring your personal safety.

Burns in children are commonly caused by all of the following, EXCEPT: A. hot items on a stovetop. B. scalding water in a bathtub. C. exposure to caustic chemicals. D. entrapment in a structural fire.

D. entrapment in a structural fire.

Which of the following head injuries would cause the patient's condition to deteriorate MOST rapidly? A. cerebral contusion B. subdural hematoma C. cerebral concussion D. epidural hematoma

D. epidural hematoma

Which of the following structures is contained within the mediastinum? A. lungs B. larynx C. bronchioles D. esophagus

D. esophagus

When caring for a morbidly obese patient, you should: A. leave him or her in a supine position, as this often facilitates breathing. B. ask the patient if he or she knows what led to his or her obesity problem. C. call for ALS backup because obese patients are at high risk for heart attack. D. establish his or her chief complaint and then communicate your plan to help.

D. establish his or her chief complaint and then communicate your plan to help.

Prior to applying medical restraints to a combative patient, you should: A. have at least three rescuers present, one for the upper extremities, one for the lower extremities, and one for the head. B. place the patient in a prone position to avoid airway and breathing compromise once restrained and placed onto the stretcher. C. advise the patient that medical restraint is necessary, but can be removed if he or she cooperates with you during transport. D. evaluate the patient for potentially correctible cause of combativeness, such as head injury, hypoxia, or hypoglycemia.

D. evaluate the patient for potentially correctible cause of combativeness, such as head injury, hypoxia, or hypoglycemia.

High humidity reduces the body's ability to lose heat through: A. radiation. B. convection. C. conduction. D. evaporation.

D. evaporation.

The body's natural cooling mechanism, in which sweat is converted to a gas, is called: A. radiation. B. convection. C. conduction. D. evaporation.

D. evaporation.

When performing his or her duties, the EMT is generally expected to: A. consistently exceed the standard of care. B. contact medical control on every EMS call. C. function above his or her scope of practice. D. exercise reasonable care and act prudently.

D. exercise reasonable care and act prudently.

What type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital? A. formal B. implied C. informed D. expressed

D. expressed

The Glasgow Coma Scale (GCS) is used to assess: A. mental status, eye opening, and respiratory rate. B. sensory response, pupil reaction, and heart rate. C. verbal response, eye opening, and mental status. D. eye opening, verbal response, and motor response.

D. eye opening, verbal response, and motor response.

Which of the following is of LEAST pertinence when obtaining medical history information from a patient complaining of chest discomfort? A. history of cigarette smoking B. history of previous heart attack C. presence of personal risk factors D. family history of hypertension

D. family history of hypertension

The brain connects to the spinal cord through a large opening at the base of the skull called the: A. foramen ovale. B. vertebral foramen. C. spinous foramen. D. foramen magnum.

D. foramen magnum.

Bile is produced by the liver and concentrated and stored in the: A. kidneys. B. pancreas. C. stomach. D. gallbladder.

D. gallbladder.

A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following would NOT be appropriate for this patient? A. performing a full-body scan B. 100% supplemental oxygen C. treating her for possible shock D. gentle palpation of the pelvis

D. gentle palpation of the pelvis

Delivering a patient to the hospital involves all of the following activities, EXCEPT: A. completing a detailed written report. B. informing the dispatcher of your arrival. C. restocking any disposable items you used. D. giving a verbal report to the triage clerk.

D. giving a verbal report to the triage clerk.

The bony prominence on the lateral/superior aspect of the thigh is called the: A. iliac crest. B. sacroiliac joint. C. sacral symphysis. D. greater trochanter.

D. greater trochanter.

A service dog is easily identified by its: A. size. B. breed. C. color. D. harness.

D. harness.

According to the American College of Surgeons, an adult trauma patient meets Level I criteria if he or she: A. was involved in a motor vehicle crash in which another patient in the same vehicle was killed. B. has a systolic blood pressure of less than 110 mm Hg or a heart rate greater than 110 beats/min. C. has a bleeding disorder or takes anticoagulant medications and has any blunt or penetrating injury. D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

D. has a GCS score of less than or equal to 8 with a mechanism attributed to trauma.

Immediate transport is indicated for a child when he or she: A. is experiencing mild to moderate pain. B. falls from a height greater than 5′. C. has a possible closed fracture of the radius. D. has a history suggestive of a serious illness.

D. has a history suggestive of a serious illness.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: A. has had a prior heart attack. B. is older than 60 years of age. C. has a GCS score that is less than 8. D. has bleeding within the brain.

D. has bleeding within the brain.

A patient with an altered mental status is: A. completely unresponsive to all forms of stimuli. B. typically alert but is confused as to preceding events. C. usually able to be aroused with a painful stimulus. D. not thinking clearly or is incapable of being aroused.

D. not thinking clearly or is incapable of being aroused.

You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should: A. stop any active bleeding and advise dispatch to send a paramedic crew. B. ventilate the patient for 5 minutes and then stop if there is no response. C. request the fire department to extricate the patient so you can begin cardiopulmonary resuscitation (CPR). D. have your partner check for a pulse to confirm that the patient is deceased.

D. have your partner check for a pulse to confirm that the patient is deceased.

An elderly patient may understate or minimize the symptoms of his or her illness because: A. the nervous system has deteriorated. B. of decreased perception of pain. C. of conditions such as dementia. D. he or she fears hospitalization.

D. he or she fears hospitalization.

All of the following are normal findings in an infant or child, EXCEPT: A. quiet breathing. B. fear or anxiety. C. belly breathing. D. head bobbing.

D. head bobbing.

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for: A. stroke. B. delirium. C. dementia. D. head trauma.

D. head trauma.

The leading cause of death in the geriatric patient is: A. hypertension. B. altered mental status. C. arthritis. D. heart disease.

D. heart disease.

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A. nausea. B. headache. C. tachycardia. D. hot, dry skin.

D. hot, dry skin.

If ventilation is impaired, carbon dioxide levels in the bloodstream will increase. This condition is called: A. acidosis. B. hypoxia. C. hypoxemia. D. hypercarbia.

D. hypercarbia.

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: A. child abuse. B. meningitis. C. severe infection. D. hyperglycemia.

D. hyperglycemia.

Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to: A. determine the vehicle's speed at the time of impact. B. assess the severity of the third collision of the crash. C. recognize if the driver hit the brakes before impact. D. identify contact points and predict potential injuries.

D. identify contact points and predict potential injuries.

You and your partner are EMTs and have been dispatched to standby at the scene of a residential fire. While standing next to the ambulance observing the fire fighters, you see a woman frantically moving around in her burning house. You should: A. request permission from the fire chief to enter the structure. B. don a self-contained breathing apparatus (SCBA) and rescue the woman. C. stay where you are until fire fighters remove her from the house. D. immediately notify the incident commander or safety officer.

D. immediately notify the incident commander or safety officer.

Which of the following is the MOST significant factor in determining if a person will become ill from certain germs? A. age B. race C. gender D. immunity

D. immunity

When splinting an injury of the wrist, the hand should be placed: A. into a fist. B. in a straight position. C. in an extended position. D. in a functional position.

D. in a functional position.

Hypoxia is MOST accurately defined as: A. low venous oxygen levels. B. a decrease in arterial oxygen levels. C. an increase in carbon dioxide in the blood. D. inadequate oxygen to the tissues and cells.

D. inadequate oxygen to the tissues and cells.

Without adequate oxygen, the body's cells: A. rely solely on glucose, which is completely converted into adenosine triphosphate (ATP). B. cease metabolism altogether, resulting in carbon dioxide accumulation in the blood. C. begin to metabolize fat, resulting in the production and accumulation of ketoacids. D. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

D. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

Breathing occurs as the result of a(n): A. decrease in oxygen, which increases the pH of the cerebrospinal fluid (CSF). B. increase in oxygen, which decreases the pH of the CSF. C. decrease in carbon dioxide, which increases the pH of the CSF. D. increase in carbon dioxide, which decreases the pH of the CSF.

D. increase in carbon dioxide, which decreases the pH of the CSF.

Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, EXCEPT: A. a loss of respiratory muscle mass. B. increased stiffness of the thoracic cage. C. decreased residual volume. D. increased surface area available for air exchange.

D. increased surface area available for air exchange.

All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT: A. delivering each breath over 1 second. B. ensuring the appropriate airway position. C. ventilating the patient at the appropriate rate. D. increasing the amount of delivered tidal volume.

D. increasing the amount of delivered tidal volume.

You are organizing a group of EMTs to provide triage in a mass-casualty exercise. In order for the group to be successful, it is essential that: A. individual goals are accomplished. B. individuals understand that their roles will all be accomplished the same way. C. individuals understand that this is a one-time exercise and that things will change in the field. D. individuals have an understanding of how the group will accomplish its goals.

D. individuals have an understanding of how the group will accomplish its goals.

Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in obvious distress. Your first action should be to: A. ask the patient what's wrong. B. obtain a set of baseline vital signs. C. assess the patient's airway status. D. introduce yourself to the patient.

D. introduce yourself to the patient.

A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she: A. is wearing only a lap belt. B. remains within the vehicle. C. experiences multiple impacts. D. is ejected or partially ejected.

D. is ejected or partially ejected.

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: A. possesses a valid driver's license. B. is mentally competent and able to refuse. C. has a poor relationship with his or her parents. D. is self-supporting and lives by him- or herself.

D. is self-supporting and lives by him- or herself.

In contrast to the parietal peritoneum, the visceral peritoneum: A. is supplied by the same nerves from the spinal cord that supply the skin of the abdomen. B. lines the walls of the abdominal cavity and is stimulated when the solid abdominal organs contract. C. is less likely to become inflamed or infected because it lines the abdominal organs themselves. D. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

D. is supplied by nerves of the autonomic nervous system, which are less able to localize pain or sensation.

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT: A. loss of appetite and a cough. B. vomiting, fever, and fatigue. C. pain in the muscles and joints. D. jaundice and abdominal pain.

D. jaundice and abdominal pain.

When opening the airway of a patient with a suspected spinal injury, you should use the: A. tongue-jaw lift maneuver. B. head tilt-neck lift maneuver. C. head tilt-chin lift maneuver. D. jaw-thrust maneuver.

D. jaw-thrust maneuver.

The superficial temporal artery can be palpated: A. slightly above the ear. B. at the angle of the jaw. C. over the mastoid process. D. just anterior to the tragus.

D. just anterior to the tragus.

To minimize the risk of injuring yourself when lifting or moving a patient, you should: A. flex at the waist instead of the hips. B. avoid the use of log rolls or body drags. C. use a direct carry whenever possible. D. keep the weight as close to your body as possible.

D. keep the weight as close to your body as possible.

The FIRST rule of safe lifting is to: A. always lift with your palms facing down. B. spread your legs approximately 20″ apart. C. keep your back in a slightly curved position. D. keep your back in a straight, vertical position.

D. keep your back in a straight, vertical position.

Maintaining a cushion of safety when operating an ambulance means: A. remaining in the far right-hand lane when transporting a critical patient and refraining from passing other motorists on the left side. B. driving at the posted speed limit, regardless of the patient's condition, and routinely using your lights and siren when driving on a freeway. C. driving about 2 to 3 seconds behind any vehicles in front of you and exceeding the posted speed limit by no more than 20 to 25 mph. D. keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirror's blind spots.

D. keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirror's blind spots.

Which of the following is of LEAST importance when initially assessing the severity of a burn? A. area(s) burned B. age of the patient C. past medical history D. known drug allergies

D. known drug allergies

The conjunctiva are kept moist by fluid produced by the: A. corneal duct. B. posterior orbit. C. optic chiasma. D. lacrimal gland.

D. lacrimal gland.

Which of the following factors is NOT taken into consideration when assessing a person's potential for violence? A. poor impulse control B. tattoos, such as those with gang identification C. substance abuse D. large physical size

D. large physical size

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): A. esophageal tear. B. crushed cricoid. C. collapsed trachea. D. laryngeal fracture.

D. laryngeal fracture.

Injury to a hollow abdominal organ would MOST likely result in: A. pain secondary to blood in the peritoneum. B. profound shock due to severe internal bleeding. C. impairment in the blood's clotting abilities. D. leakage of contents into the abdominal cavity.

D. leakage of contents into the abdominal cavity.

When caring for a patient with a possible head injury, it is MOST important to monitor the patient's: A. pupil size. B. blood pressure. C. pulse regularity. D. level of consciousness.

D. level of consciousness.

Which of the following steps is NOT proper procedure when performing an emergency move? A. using a long-axis body drag during the move B. pulling the patient on a blanket or similar object C. pulling the patient's clothing in the shoulder area D. lifting the patient by the belt to move him or her

D. lifting the patient by the belt to move him or her

Bones are connected to other bones by bands of tough fibrous tissues called: A. bursa. B. tendons. C. cartilage. D. ligaments.

D. ligaments.

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. back of the neck. B. forehead and face. C. dorsum of the hand. D. lips or oral mucosa.

D. lips or oral mucosa.

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to: A. monitor the child's heart rate. B. observe the child's skin color. C. monitor the pulse oximeter reading. D. observe the chest for adequate rise.

D. observe the chest for adequate rise.

Trauma to the __________ lobe of the brain would likely result in visual disturbances. A. frontal B. parietal C. temporal D. occipital

D. occipital

You are attending to a patient who was experiencing abdominal pain at a local shopping mall. The patient sitting on a bench and appears in moderate distress. You are met by a first responder at the scene who wishes to provide you with a patient care report. Your best course of action is to: A. move the responder out of the way and begin patient care. B. ask the responder to wait and take their report after you have completed a primary survey. C. listen to the report while you perform a primary survey and render care to the patient. D. listen to the responder while your partner performs a primary survey.

D. listen to the responder while your partner performs a primary survey.

The goal of the full-body scan that is performed during the secondary assessment is to: A. detect and treat all non-life-threatening injuries. B. assess only the parts of the body that are injured. C. definitively rule out significant internal injuries. D. locate injuries not found in the primary assessment.

D. locate injuries not found in the primary assessment.

A strangulated hernia is one that: A. spontaneously reduces without any surgical intervention. B. can be pushed back into the body cavity to which it belongs. C. is reducible if surgical intervention occurs within 2 hours. D. loses its blood supply due to compression by local tissues.

D. loses its blood supply due to compression by local tissues.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. B. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. C. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device. D. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

D. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DNR) order is presented to you. When caring for this patient, you should: A. depart the scene and allow her to die with dignity. B. start cardiopulmonary resuscitation (CPR) if she experiences cardiopulmonary arrest. C. provide no interventions and transport to the hospital. D. make her comfortable and provide emotional support.

D. make her comfortable and provide emotional support.

At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should: A. proceed with normal extrication procedures. B. remove the lines with a nonconductive object. C. advise the patients to carefully get out of the car. D. mark off a danger zone around the downed lines.

D. mark off a danger zone around the downed lines.

The upper jawbones are called the: A. mandible. B. mastoid. C. zygoma. D. maxillae.

D. maxillae.

Febrile seizures in a child: A. typically last less than 30 minutes. B. occur after a week of a febrile illness. C. are usually caused by viral meningitis. D. may indicate a serious underlying illness.

D. may indicate a serious underlying illness.

According to the terminal drop hypothesis: A. a person's physical health begins to decline after the age of 75 years. B. most late-stage adults retain high brain function until 1 month before death. C. most elderly patients experience depression after the death of a loved one. D. mental function is presumed to decline in the 5 years preceding death.

D. mental function is presumed to decline in the 5 years preceding death.

The ___________ plane separates the body into left and right halves. A. sagittal B. coronal C. transverse D. midsagittal

D. midsagittal

As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the: A. mouth-to-mouth technique. B. one-person bag-mask device. C. manually triggered ventilation device. D. mouth-to-mask technique with a one-way valve.

D. mouth-to-mask technique with a one-way valve.

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should: A. give him a liquid salt solution to drink. B. administer 100% supplemental oxygen. C. apply chemical ice packs to his axillae. D. move him into the cooled ambulance.

D. move him into the cooled ambulance.

Which of the following is MORE common in children than in adults following a head injury? A. spinal cord injury B. loss of consciousness C. seizures and hypoxia D. nausea and vomiting

D. nausea and vomiting

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem. A. cardiac B. endocrine C. respiratory D. neurologic

D. neurologic

Maintaining the chain of evidence at the scene of a crime should include: A. quickly moving any weapons out of the patient's sight. B. placing the patient in a private area until the police arrive. C. making brief notes at the scene and then completing them later. D. not cutting through holes in clothing that were caused by weapons.

D. not cutting through holes in clothing that were caused by weapons.

When a person is standing upright, the weight of anything being lifted and carried in the hands is FIRST reflected onto the: A. pelvic girdle. B. spinal column. C. thigh muscles. D. shoulder girdle.

D. shoulder girdle.

An abdominal evisceration: A. is most commonly the result of blunt force trauma. B. should be covered with bulky dry, sterile dressings. C. often causes severe hypothermia because of heat loss. D. occurs when organs protrude through an open wound.

D. occurs when organs protrude through an open wound.

When preparing a pregnant patient for delivery, you should position her: A. in a supine position with her legs spread. B. on her left side with the right leg elevated. C. in a sitting position with her hips elevated 12″. D. on a firm surface with her hips elevated 2″ to 4″.

D. on a firm surface with her hips elevated 2″ to 4″.

Most medical models base a pregnant woman's due date: A. two weeks after her last menstrual cycle. B. on the last day of her last menstrual cycle. C. two weeks before her last menstrual cycle. D. on the first day of her last menstrual cycle.

D. on the first day of her last menstrual cycle.

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should: A. insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device. B. open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing. C. immediately apply high-flow oxygen via a nonrebreathing mask and then assess her pulse rate. D. open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

D. open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

Common signs and symptoms of AMI include all of the following, EXCEPT: A. irregular heartbeat. B. sudden unexplained sweating. C. shortness of breath or dyspnea. D. pain exacerbated by breathing.

D. pain exacerbated by breathing.

The hallmark sign of compartment syndrome is: A. a lack of pain despite the severity of the injury. B. extreme redness to the injury site. C. a bounding pulse distal to the injury. D. pain out of proportion to the injury.

D. pain out of proportion to the injury.

For every emergency request, the dispatcher should routinely gather and record all of the following information, EXCEPT the: A. nature of the call. B. caller's phone number. C. location of the patient(s). D. patient's medical history.

D. patient's medical history.

A full-body scan should be performed on: A. stable patients who are able to tell you exactly what happened. B. all patients with traumatic injuries who will require EMS transport. C. responsive medical patients and patients without a significant MOI. D. patients with a significant MOI and unresponsive medical patients.

D. patients with a significant MOI and unresponsive medical patients.

Burns to pediatric patients are generally considered more serious than burns to adults because: A. pediatric patients are more prone to hyperthermia. B. most burns in children are the result of child abuse. C. pediatric patients have a proportionately larger volume of blood. D. pediatric patients have more surface area relative to total body mass.

D. pediatric patients have more surface area relative to total body mass.

Which of the following musculoskeletal injuries would pose the greatest threat to a patient's life? A. an amputated extremity B. bilateral femur fractures C. nondisplaced long bone fractures D. pelvic fracture with hypotension

D. pelvic fracture with hypotension

The _________ nervous system consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves. A. central B. somatic C. autonomic D. peripheral

D. peripheral

When a person is exposed to a cold environment: A. sweat is produced and is warmed when the vessels constrict. B. blood vessels dilate and divert blood to the core of the body. C. the skin becomes flushed secondary to peripheral vasodilation. D. peripheral vessels constrict and divert blood away from the skin.

D. peripheral vessels constrict and divert blood away from the skin.

Autism is MOST accurately defined as a: A. psychiatric condition related to an imbalance of serotonin in the brain. B. mental disability caused by insufficient cognitive development of the brain. C. congenital condition caused by factors such as malnutrition or birth complications. D. pervasive developmental disorder characterized by impairment of social interaction.

D. pervasive developmental disorder characterized by impairment of social interaction.

Before positioning an infant or child's airway, you should: A. put padding behind his or her head. B. thoroughly suction his or her airway. C. rule out an injury to the spinal cord. D. place him or her on a firm surface.

D. place him or her on a firm surface.

When immobilizing a child on a long backboard, you should: A. secure the head prior to securing the torso and legs. B. defer cervical collar placement to avoid discomfort. C. place the child's head in a slightly extended position. D. place padding under the child's shoulders as needed.

D. place padding under the child's shoulders as needed.

A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: A. nitroglycerin for her chest pain. B. ventilations with a bag-mask device. C. oxygen at 4 L/min via nasal cannula. D. placing her in an upright position.

D. placing her in an upright position.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for: A. heart failure. B. bronchitis. C. emphysema. D. pneumonia.

D. pneumonia.

The MOST reliable indicator of an underlying fracture is: A. guarding. B. severe swelling. C. obvious bruising. D. point tenderness.

D. point tenderness.

When caring for an elderly patient who is hearing-impaired, you should: A. speak directly into his or her ear with an elevated tone. B. remember that most hearing-impaired patients can read lips. C. request that he or she communicates with you by writing on paper. D. recall that elderly patients have difficulty hearing high-frequency sounds.

D. recall that elderly patients have difficulty hearing high-frequency sounds.

General techniques for communicating with hearing-impaired patients include: A. exaggerating your lip movements to ensure the patient understands. B. speaking directly into the patient's ear with an increased voice pitch. C. removing any hearing aids and using pen and paper to ask questions. D. positioning yourself approximately 18″ directly in front of the patient.

D. positioning yourself approximately 18″ directly in front of the patient.

In relation to the chest, the back is: A. ventral. B. inferior. C. anterior. D. posterior.

D. posterior.

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because: A. iron makes the blood clot faster, which protects the mother from excessive bleeding during delivery. B. the blood naturally thins during pregnancy, which predisposes the mother to severe bleeding. C. white blood cells decrease during pregnancy, which increases the mother's risk of an infection. D. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

D. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

The purpose of a ventricular peritoneum shunt is to: A. divert excess cerebrospinal fluid to the ventricles of the brain. B. monitor pressure within the skull in patients with a head injury. C. remove fluid from the abdomen of patients with right heart failure. D. prevent excess cerebrospinal fluid from accumulating in the brain.

D. prevent excess cerebrospinal fluid from accumulating in the brain.

Aspirin is beneficial to patients suspected of having a heart attack because it: A. reduces the associated chest pain. B. dissolves the coronary artery clot. C. causes direct coronary vasodilation. D. prevents the aggregation of platelets.

D. prevents the aggregation of platelets.

When assessing a patient who experienced a blast injury, it is important to remember that: A. secondary blast injuries are usually the least obvious. B. primary blast injuries are typically the most obvious. C. solid organs usually rupture from the pressure wave. D. primary blast injuries are the most easily overlooked.

D. primary blast injuries are the most easily overlooked.

Factors that increase the risk for developing methicillin-resistant Staphylococcus aureus (MRSA) include: A. prior exposure to Mycobacterium tuberculosis. B. failure to be vaccinated against any strain of hepatitis. C. a history of a respiratory illness within the past 6 to 8 weeks. D. prolonged hospitalization, especially in an intensive care unit.

D. prolonged hospitalization, especially in an intensive care unit.

Status epilepticus is characterized by: A. generalized seizures that last less than 5 minutes. B. an absence seizure that is not preceded by an aura. C. profound tachycardia and total muscle flaccidity. D. prolonged seizures without a return of consciousness.

D. prolonged seizures without a return of consciousness.

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: A. rewarm his foot in 100°F to 105°F (38°C to 40°C) water. B. administer oxygen via a nonrebreathing mask. C. cover his foot with chemical heat compresses. D. protect the affected part from further injury.

D. protect the affected part from further injury.

If a newborn's heart rate is less than 60 beats/min following delivery, you should: A. flick the soles of its feet. B. begin chest compressions. C. re-suction the mouth only. D. provide ventilations for 30 seconds.

D. provide ventilations for 30 seconds.

A "hip" fracture is actually a fracture of the: A. pelvic girdle. B. femoral shaft. C. pubic symphysis. D. proximal femur.

D. proximal femur.

In relation to the wrist, the elbow is: A. distal. B. medial. C. lateral. D. proximal.

D. proximal.

Which of the following arteries does NOT carry highly oxygenated blood? A. aorta B. renal C. femoral D. pulmonary

D. pulmonary

Which of the following blood vessels transports oxygenated blood? A. superior vena cava B. pulmonary arteries C. inferior vena cava D. pulmonary veins

D. pulmonary veins

Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should: A. quickly begin the triage process. B. assist with vehicle stabilization. C. report to the incident commander. D. put on high-visibility safety vests.

D. put on high-visibility safety vests.

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? A. intravenous fluid administration B. early administration of oxygen C. elevation of the lower extremities D. rapid transport to a trauma center

D. rapid transport to a trauma center

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you reanalyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to: A. obtain a blood pressure and apply the pulse oximeter. B. place him in the recovery position and apply oxygen. C. transport at once and reanalyze his rhythm en route. D. reassess airway and breathing and treat accordingly.

D. reassess airway and breathing and treat accordingly.

A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should: A. give her high-flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport. B. assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions. C. transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin. D. recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs.

D. recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs.

You are en route to an emergency call when you approach a slow-moving vehicle on a two-way road. You can see oncoming traffic in the other lane. The driver has his windows up and does not realize that you are behind him. You should: A. use your public address (PA) system to alert the driver. B. quickly pass the vehicle on the left side. C. pass the driver on the right-hand shoulder. D. remain at a safe distance until it is safe to pass.

D. remain at a safe distance until it is safe to pass.

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: A. administer oxygen via a nonrebreathing mask. B. ask the child's father to try to locate the dog. C. advise the child that he will need rabies shots. D. report the incident to the appropriate authorities.

D. report the incident to the appropriate authorities.

You and your partner respond to the scene of a 49-year-old male with acute abdominal pain. As you enter his residence, you find him lying on the floor in severe pain. He is conscious and alert. The patient appears to weigh in excess of 350 lb. Your FIRST action should be to: A. request the fire department if one attempt to move him fails. B. encourage the patient to walk himself to the awaiting ambulance. C. assess him and then move him to the stretcher with a direct carry. D. request additional personnel before making any attempts to lift him.

D. request additional personnel before making any attempts to lift him.

Which of the following is MOST characteristic of adequate breathing in an adult? A. use of the accessory muscles in the neck and cyanosis B. respirations of 30 breaths/min and reduced tidal volume C. cool, clammy skin and retractions above the clavicles D. respirations of 20 breaths/min and bilateral chest movement

D. respirations of 20 breaths/min and bilateral chest movement

End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with: A. a headache. B. abdominal pain. C. high blood pressure. D. respiratory distress.

D. respiratory distress.

Which of the following conditions would MOST likely affect the entire brain? A. blocked cerebral artery in the frontal lobe B. reduced blood supply to the left hemisphere C. ruptured cerebral artery in the occipital lobe D. respiratory failure or cardiopulmonary arrest

D. respiratory failure or cardiopulmonary arrest

Your ability to remain awake is a function of the: A. cerebellum. B. limbic system. C. pons and medulla. D. reticular activating system.

D. reticular activating system.

Defibrillator pads are placed on the patient's chest with one pad to the: A. left of the upper sternum and the other pad just to the right of the left nipple. B. right of the upper sternum and the other pad just to the right of the right nipple. C. left of the upper sternum and the other pad just to the right and below the left nipple. D. right of the upper sternum and the other pad just to the left and below the left nipple.

D. right of the upper sternum and the other pad just to the left and below the left nipple.

What types of motor vehicle collisions present the greatest potential for multiple impacts? A. lateral and rollover B. frontal and rotational C. Rear-end and rotational D. rotational and rollover

D. rotational and rollover

Common complications associated with central venous catheters include all of the following, EXCEPT: A. a local infection. B. clotting of the line. C. bleeding around the line. D. rupture of a central vein.

D. rupture of a central vein.

When assessing a patient with a head injury, you note the presence of thin, bloody fluid draining from his right ear. This indicates: A. fractures to the internal structures of the ear following direct trauma. B. a linear skull fracture and a significant increase in intracranial pressure. C. significant pressure and bleeding in between the skull and dura mater. D. rupture of the tympanic membrane following diffuse impact to the head.

D. rupture of the tympanic membrane following diffuse impact to the head.

When immobilizing an injured child in a pediatric immobilization device, you should: A. secure the head before the torso. B. slide the device under the child. C. pad underneath the child's head. D. secure the torso before the head.

D. secure the torso before the head.

You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement "He has a gun!" Your MOST appropriate action should be to: A. continue into the apartment using extreme caution. B. proceed into the apartment and apprehend the gunman. C. get in your ambulance and leave the scene immediately. D. seek a safe place and request law enforcement assistance.

D. seek a safe place and request law enforcement assistance.

What set of nerves is responsible for carrying information from the body to the central nervous system? A. motor B. cranial C. vertebral D. sensory

D. sensory

The risk of bleeding in the skull, which increases with age, is MOST directly related to: A. blood vessel dilation. B. a decrease in neurons. C. meningeal deterioration. D. shrinkage of the brain.

D. shrinkage of the brain.

Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A. in a supine position. B. in a prone position. C. in a recumbent position. D. sitting up at a 45° angle.

D. sitting up at a 45° angle.

What type of muscle contracts and relaxes to control the movement of the contents within its structures? A. cardiac B. skeletal C. striated D. smooth

D. smooth

An important aspect in the assessment of a patient who experienced a previous brain injury involves: A. presuming that he or she has cognitive impairment until proven otherwise. B. contacting the patient's physician to determine the extent of the brain injury. C. recalling that most patients with a brain injury have other organ dysfunction. D. speaking with the patient and family to establish what is considered normal for the patient.

D. speaking with the patient and family to establish what is considered normal for the patient.

Significant trauma to the face should increase the EMT's index of suspicion for a(n): A. airway obstruction. B. displaced mandible. C. basilar skull fracture. D. spinal cord injury.

D. spinal cord injury.

Which organ lies in the lateral and posterior portion of the left upper quadrant (LUQ) of the abdomen? A. liver B. stomach C. cecum D. spleen

D. spleen

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should: A. apply manual stabilization to both of her femurs. B. administer oxygen and perform a rapid assessment. C. assess for a carotid pulse and assist her ventilations. D. stabilize her head and perform a primary assessment.

D. stabilize her head and perform a primary assessment.

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should: A. encourage him to cough as forcefully as he can. B. deliver up to five back blows and reassess him. C. place him in a supine position and open his airway. D. stand behind him and administer abdominal thrusts.

D. stand behind him and administer abdominal thrusts.

The EMT's role at the scene of a search and rescue attempt is to: A. accompany search team members and provide care. B. reassure the family members of the missing person. C. report to a location where the patient will be carried. D. stand by at the command post until the person is located.

D. stand by at the command post until the person is located.

When determining the frequency of contractions, you should time the contractions from the: A. end of one to the start of the next. B. start of one to the end of the next. C. end of one to the end of the next. D. start of one to the start of the next.

D. start of one to the start of the next.

While en route to a call for a patient in cardiac arrest, you approach a stopped school bus with its red warning lights flashing. You should: A. pass the bus only after all the children have exited. B. back up and take an alternate route to the scene. C. slowly and carefully pass the bus on the left side. D. stop and wait until the warning lights stop flashing.

D. stop and wait until the warning lights stop flashing.

A crackling sound produced by air bubbles under the skin is called: A. crepitus B. rhonchi. C. Korotkoff sounds. D. subcutaneous emphysema.

D. subcutaneous emphysema.

How is nitroglycerin usually given by the EMT? A. orally B. inhaled C. injected D. sublingually

D. sublingually

The MOST serious consequence of drug or alcohol abuse among EMS personnel is: A. punitive action and the loss of a job. B. low morale and frequently missed shifts. C. tension among coworkers and supervisors. D. substandard or inappropriate patient care.

D. substandard or inappropriate patient care.

After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: A. place him or her in the recovery position. B. provide positive-pressure ventilatory assistance. C. assess respiratory rate, depth, and regularity. D. suction as needed and insert an airway adjunct.

D. suction as needed and insert an airway adjunct.

A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should: A. begin immediate ventilatory assistance. B. visualize her mouth for obvious wounds. C. apply oxygen via a nonrebreathing mask. D. suction her oropharynx for 15 seconds.

D. suction her oropharynx for 15 seconds.

Which of the following clinical signs is MOST suggestive of a ruptured cerebral artery? A. unilateral hemiparesis B. confusion and weakness C. nasal discharge of blood D. sudden, severe headache

D. sudden, severe headache

Common signs of a skull fracture include all of the following, EXCEPT: A. mastoid process bruising. B. ecchymosis around the eyes. C. noted deformity to the skull. D. superficial scalp lacerations.

D. superficial scalp lacerations.

Trendelenburg's position is MOST accurately defined as a: A. recumbent position with the head lower than the legs. B. supine position with the legs elevated approximately 6" to 12". C. recumbent position with the head elevated at a 25° to 45° angle. D. supine position with the legs elevated 6" to 12" higher than the head.

D. supine position with the legs elevated 6" to 12" higher than the head.

While drinking beer with his friends near a creek, a 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: A. applying ice to the wound and transporting quickly. B. transporting only with close, continuous monitoring. C. elevating the lower extremities and giving antivenin. D. supine positioning, splinting the leg, and transporting.

D. supine positioning, splinting the leg, and transporting.

Your primary concern when arriving at the scene of a motor vehicle crash is: A. gaining access to the patient(s). B. requesting additional resources. C. immediately beginning triage. D. surveying the area for hazards.

D. surveying the area for hazards.

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)? A. bradypnea B. confusion C. stiff muscles D. tachycardia

D. tachycardia

When caring for a patient who is visually impaired, it is important to: A. allow a service dog to remain with the patient at all times, even if the patient is critically ill. B. stand to the side of the patient when speaking if his or her peripheral vision is impaired. C. leave items such as canes and walkers at the residence if the patient will be carried on a gurney. D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

While on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should: A. tell your partner to quit kidding around and focus on his or her job. B. warn your partner that you will report him or her if it happens again. C. notify law enforcement personnel and have your partner arrested. D. tell your partner to stop and report the incident to your supervisor.

D. tell your partner to stop and report the incident to your supervisor.

According to the CDC, recommended immunizations and tests include a: A. smallpox vaccine every 5 years. B. TB skin test every 6 months. C. two-shot hepatitis A vaccination series. D. tetanus-diphtheria booster every 10 years.

D. tetanus-diphtheria booster every 10 years.

A unique consideration when dealing with a hybrid vehicle is that: A. you must locate the ignition switch and cut it to prevent a fire. B. cutting the battery cables often results in an explosion or fire. C. rescue teams should disconnect the positive battery cable first. D. the battery has higher amperes than a traditional vehicle battery.

D. the battery has higher amperes than a traditional vehicle battery.

After the first 60 minutes of experiencing a significant injury: A. the patient's blood pressure elevates significantly. B. the patient's injuries will most likely be irreparable. C. most patients will die secondary to internal bleeding. D. the body's ability to compensate for shock decreases.

D. the body's ability to compensate for shock decreases.

When forming your general impression of a patient with a medical complaint, it is important to remember that: A. the majority of medical patients you encounter are also injured. B. it is during the general impression that assessment of the ABCs occurs. C. most serious medical conditions do not present with obvious symptoms. D. the conditions of many medical patients may not appear serious at first.

D. the conditions of many medical patients may not appear serious at first.

Ventricular tachycardia causes hypotension because: A. the volume of blood returning to the atria increases. B. the right ventricle does not adequately pump blood. C. blood backs up into the lungs and causes congestion. D. the left ventricle does not adequately fill with blood.

D. the left ventricle does not adequately fill with blood.

An open fracture is MOST accurately defined as a fracture in which: A. bone ends protrude through the skin. B. a large laceration overlies the fracture. C. a bullet shatters the underlying bone. D. the overlying skin is no longer intact.

D. the overlying skin is no longer intact.

When immobilizing a trauma patient's spine, the EMT manually stabilizing the head should not let go until: A. an appropriately sized cervical collar has been applied. B. the patient has been secured to the ambulance stretcher. C. the head has been stabilized with lateral immobilization. D. the patient has been completely secured to the backboard.

D. the patient has been completely secured to the backboard.

In which of the following circumstances can the EMT legally release confidential patient information? A. a police officer requests a copy to place on file B. the family requests a copy for insurance purposes C. a media representative inquires about the patient D. the patient is competent and signs a release form

D. the patient is competent and signs a release form

You and your partner arrive at the scene of a house fire where fire fighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with: A. treating him for hypothermia. B. preventing the risk of infection. C. estimating the extent of his burns. D. the potential for airway swelling.

D. the potential for airway swelling.

Cardiac output may decrease if the heart beats too rapidly because: A. a rapid heart beat causes a decrease in the strength of cardiac contractions. B. the volume of blood that returns to the heart is not sufficient with fast heart rates. C. as the heart rate increases, more blood is pumped from the ventricles than the atria. D. there is not enough time in between contractions for the heart to refill completely.

D. there is not enough time in between contractions for the heart to refill completely.

Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: A. they are protective of the abuser. B. they do not want to be bothersome. C. most elderly patients have dementia. D. they fear retribution from the abuser.

D. they fear retribution from the abuser.

Your BEST protection against legal liability when a competent patient refuses EMS care and transport is to: A. advise medical control of the situation. B. err on the side of caution and transport. C. ensure that the family is aware of the risks. D. thoroughly document the entire event.

D. thoroughly document the entire event.

Successful treatment of a stroke depends on whether: A. surgical intervention is performed to remove obstructive clots. B. medications are given to restore the function of infarcted cells. C. the stroke occurs within the left or right hemisphere of the brain. D. thrombolytic therapy is given within 3 hours after symptoms began.

D. thrombolytic therapy is given within 3 hours after symptoms began.

Most of the serious injuries associated with scuba diving are caused by: A. water temperature lower than 70°F (21°C). B. too rapid of a descent. C. alcohol consumption. D. too rapid of an ascent.

D. too rapid of an ascent.

Which of the following medication routes delivers a drug through the skin over an extended period of time, such as a nitroglycerin or nicotine patch? A. sublingual B. intraosseous C. subcutaneous D. transcutaneous

D. transcutaneous

What is the function of the fallopian tubes? A. connect both ovaries together B. supply blood to the uterine lining C. produce progesterone and estrogen D. transport a mature egg to the uterus

D. transport a mature egg to the uterus

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should: A. request an ALS ambulance to transport the infant to the hospital. B. advise the mother to observe her son and call 9-1-1 again if necessary. C. administer high-flow oxygen and observe for a drop in oxygen saturation. D. transport the infant to the hospital and bring the apnea monitor with you.

D. transport the infant to the hospital and bring the apnea monitor with you.

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The MOST appropriate method for treating this injury is to: A. remove the kickstand in a circular motion and apply a dry, sterile dressing. B. cut the kickstand off just above the skin, and stabilize it with sterile dressings. C. leave the kickstand attached to the bike until the physician can remove it safely. D. unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

D. unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: A. always take oral medications to maintain normal blood glucose levels. B. do not present with slurred speech or weakness to one side of the body. C. are typically alert and attempt to communicate with health care providers. D. usually have an altered mental status or decreased level of consciousness.

D. usually have an altered mental status or decreased level of consciousness.

The body's natural protective mechanisms against heat loss are: A. shivering and vasodilation. B. vasodilation and respiration. C. respiration and vasoconstriction. D. vasoconstriction and shivering.

D. vasoconstriction and shivering.

Which of the following cardiac arrhythmias has the greatest chance of deteriorating into a pulseless rhythm? A. sinus tachycardia B. sinus bradycardia C. extra ventricular beats D. ventricular tachycardia

D. ventricular tachycardia

Which of the following is a function of the upper airway? A. relaxes bronchiole smooth muscle B. exchanges oxygen and carbon dioxide C. creates sound from vocal cord vibration D. warms and humidifies inhaled air

D. warms and humidifies inhaled air

The sebaceous glands produce sebum, a material that: A. facilitates shedding of the epidermis. B. pulls the hair erect when you are cold. C. discharges sweat onto the skin's surface. D. waterproofs the skin and keeps it supple.

D. waterproofs the skin and keeps it supple.

An infant is considered to be premature if it: A. is born before 38 weeks' gestation or weighs less than 6 lb. B. weighs less than 5.5 lb or is born before 37 weeks' gestation. C. is born before 40 weeks' gestation or weighs less than 7 lb. D. weighs less than 5 lb or is born before 36 weeks' gestation.

D. weighs less than 5 lb or is born before 36 weeks' gestation.

Gloves, a mask, eye protection, and a face shield should be used: A. any time you touch non-intact skin. B. during routine cleaning of the ambulance. C. while handling needles or other sharps. D. when performing endotracheal intubation.

D. when performing endotracheal intubation.

Supplemental oxygen via nonrebreathing mask should be administered to patients: A. who are semiconscious with shallow respirations. B. with rapid respirations and a reduced tidal volume. C. who have accessory muscle use and slow breathing. D. with difficulty breathing and adequate tidal volume.

D. with difficulty breathing and adequate tidal volume.

A patient with spontaneous respirations is breathing: A. at a normal rate. B. with shallow depth. C. without difficulty. D. without assistance.

D. without assistance.

The carpal bones form the: A. foot. B. ankle. C. hand. D. wrist.

D. wrist.

Palpating the carotid pulse is not recommended in infants because: A. the pulse rate is usually too fast to count. B. a decrease in cerebral perfusion may occur. C. the carotid artery is more anterior in infants. D. you may inadvertently compress the trachea.

D. you may inadvertently compress the trachea.

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that: A. you are actively infected with tuberculosis and should be treated immediately. B. the disease is dormant in your body, but will probably never cause symptoms. C. you contracted the disease by casual contact instead of exposure to secretions. D. you were exposed to another infected person prior to treating the 34-year-old patient.

D. you were exposed to another infected person prior to treating the 34-year-old patient.

The EMT is assisting the paramedic with endotracheal intubation. A 7.0-mm endotracheal tube has been prepared, and the BVM and suction devices are immediately available. Which of the following additional pieces of equipment would be the MOST important to have available?

Supraglottic airway device

Which of the following is an example of closed loop communication?

The team leader assigns the EMT a task and the EMT repeats the request back to the team leader.

Which of the following would MOST likely facilitate an accurate and effective verbal handoff report at the hospital?

Use of a mutually agreed-upon handoff format.

You are attending to an elderly female patient complaining of chest pain. The patient is in a public park and there are several bystanders. As you begin your assessment and provide the patient with oxygen, another unit arrives and one of the other EMTs tells you that you should "forget all that stuff and just take her to the hospital." Your best course of action would be to:

acknowledge the comment and request that they discuss this further after the call.

The process of using techniques and procedures to help ensure that pathogens are not introduced into the body during an invasive procedure is called:

aseptic technique.

Health care providers who infrequently work together can function effectively as a team if they work in an environment that supports and promotes:

collaboration.

During a resuscitation attempt, the team leader asks the EMT to ventilate the patient at a rate of 20 breaths/min, and the EMT replies, "Actually, sir, the correct ventilation rate is 10 breaths/min." This is an example of:

constructive intervention.

You are at the scene of a patient in cardiac arrest. In order for the resuscitation team to work successfully:

each provider knows what is expected of him or her.

When positioning a patient for endotracheal intubation, the EMT should:

ensure that the patient's ear canal is level with the sternal notch.

While preparing to intubate a patient, the paramedic asks the EMT to perform apneic oxygenation of the patient. This means that:

high-flow oxygen via nasal cannula is provided during intubation.

You are organizing a group of EMTs to provide triage in a mass-casualty exercise. In order for the group to be successful, it is essential that:

individuals have an understanding of how the group will accomplish its goals.

You are attending to a patient who has fallen at a local sporting event. The patient appears to have sustained an injury to his lower left leg. You are met by a first responder at the scene who wishes to provide you with a patient care report. Your best course of action is to:

maintain eye contact and listen to the report.

You are attending to an unresponsive trauma patient who was the driver of a vehicle involved in a motor vehicle collision. As you extricate the patient and immobilize her with a cervical collar and backboard, an Advanced Life Support (ALS) provider arrives on scene and the transfer of care is made. The decision is made to intubate the patient; however, the ALS provider cannot visualize the vocal cords and asks you to open the collar. Based on this information, you should:

open the collar and maintain cervical spine immobilization as required.

The concept of continuum of care is best demonstrated when:

providers work as a unified team.

If the paramedic's intubation attempt is unsuccessful, the EMT should:

resume ventilation with a BVM.

While providing care to a patient, the EMT informs her partner that a shotgun is leaning against the wall in the corner of the room. In making this observation, the EMT has demonstrated:

situational awareness.

You are at the scene of a motor vehicle collision with a critical trauma patient, and there are several EMS providers present. A system of Crew Resource Management (CRM) allows for:

the team leader to listen to critical information and incorporate it into his or her decision-making.

In contrast to a health care group, a health care team:

works interdependently.

During a HazMat incident, you are working in the treatment area. As patients are removed from the danger zone, you should: A. remain where you are and have the patients brought to you. B. quickly decontaminate the patients and begin assessing them. C. perform a rapid assessment and then have them decontaminated. D. retrieve patients from the decontamination area and begin treatment.

A. remain where you are and have the patients brought to you.

Which of your senses can be safely used to identify a HazMat incident? A. sight and sound B. sound and smell C. smell and sight D. sight and touch

A. sight and sound

Command functions under the ICS include all of the following, EXCEPT: A. triage officer. B. safety officer. C. liaison officer. D. public information officer

A. triage officer.

Historically, the weak point at most major incidents has been: A. accountability. B. lack of personnel. C. incident briefing. D. communication.

D. communication.

A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is: A. 10. B. 12. C. 13. D. 14.

C. 13.

In preparing for a disaster, EMS systems should have enough supplies for at least a ______ period of selfsufficiency. A. 24-hour B. 48-hour C. 72-hour D. 96-hour

C. 72-hour

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min? A. Administer high-flow oxygen. B. Triage the patient as delayed. C. Assess for bilateral radial pulses. D. Assess his or her neurologic status.

C. Assess for bilateral radial pulses.

The JumpSTART triage system is intended to be used for children younger than _____ years or who appear to weigh less than _____. A. 5, 50 lb B. 6, 70 lb C. 7, 90 lb D. 8, 100 lb

D. 8, 100 lb

Which of the following patients should be assigned an immediate (red tag) category? A. 22-year-old male with blunt abdominal trauma, tachycardia, pallor, and diaphoresis B. 29-year-old female with a back injury and numbness and tingling in her extremities C. 31-year-old male with an open fracture of the forearm and minimal external bleeding D. 36-year-old female with an open brain injury, agonal breathing, and a slow pulse rate

A. 22-year-old male with blunt abdominal trauma, tachycardia, pallor, and diaphoresis

According to the START triage system, what should you do if you encounter an unresponsive patient who is not breathing? A. Open the airway and reassess breathing status. B. Assign the patient in the "immediate" category. C. Ventilate the patient for 2 minutes and reassess. D. Triage the patient as "expectant" and move on.

A. Open the airway and reassess breathing status.

Which of the following is probably NOT a mass-casualty incident? A. a motor vehicle crash with two critically injured patients and two ambulances B. a loss of power to a hospital or nursing home with ventilator-dependent patients C. an apartment fire with one patient and the possibility of others trapped in the building D. a rollover crash of a school bus with eight children who have injuries of various severity

A. a motor vehicle crash with two critically injured patients and two ambulances

Which of the following patients does NOT have an altered mental status? A. a patient with an acute allergic reaction and dizziness B. a diabetic who opens his eyes when you ask questions C. a patient with a head injury who is slow to answer questions D. a patient who overdosed and moans when he is touched

A. a patient with an acute allergic reaction and dizziness

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should: A. begin some form of positive-pressure ventilation. B. ask a fire fighter what the patient was exposed to. C. administer 100% oxygen via a nonrebreathing mask. D. perform a rapid assessment to locate critical injuries.

A. begin some form of positive-pressure ventilation.

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: A. ensure that the patient can see you approaching him. B. approach him from behind and ask him not to move. C. stand behind him and immediately stabilize his head. D. assess his mental status by having him move his head.

A. ensure that the patient can see you approaching him.

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then: A. establish command. B. begin the triage process. C. call for additional resources. D. quickly identify the walking wounded.

A. establish command.

The term used when individual units or different organizations make independent and often inefficient decisions regarding an incident is called: A. freelancing. B. undermining. C. logistical chaos. D. single command.

A. freelancing.

Unlike a mass-casualty incident, a natural disaster: A. often requires personnel to remain on scene for several days. B. exists when there are more than 100 critically injured patients. C. is typically short-lived and does not require as much manpower. D. usually does not require the ICS process.

A. often requires personnel to remain on scene for several days.

The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to: A. perform a careful and thorough assessment. B. establish the patient's medical history early. C. take note of the patient's general appearance. D. ask if bystanders are familiar with the patient.

A. perform a careful and thorough assessment.

The development of an incident action plan is the responsibility of the: A. planning section. B. logistics section. C. operations section. D. finance section.

A. planning section.

The function of the National Incident Management System (NIMS) is to: A. prepare for, prevent, respond to, and recover from domestic incidents. B. facilitate a standard method of incident command for natural disasters. C. prepare for the potential of a nuclear attack against the United States. D. educate city and county governments regarding foreign terrorist attacks.

A. prepare for, prevent, respond to, and recover from domestic incidents.

Which of the following is NOT a responsibility of the treatment supervisor? A. primary assessment B. secondary triage C. patient packaging D. communication with the medical branch director

A. primary assessment

Level _____ hazardous materials would cause irritation on contact but only mild residual injury, even without treatment. A. 0 B. 1 C. 2 D. 3

B. 1

Which of the following statements regarding transport of patients from a mass-casualty incident or disaster site is correct? A. Delayed-priority patients should be transported five at a time. B. Immediate-priority patients should be transported two at a time. C. Walking wounded patients should be taken to the closest hospitals. D. Patients who are in cardiac arrest should clearly be transported first.

B. Immediate-priority patients should be transported two at a time.

Which of the following statements regarding storage containers and hazardous materials is correct? A. Red phosphorus from a drug laboratory is found in a blue container that is clearly labeled. B. In most cases, there is no correlation between the color of the container and the possible contents. C. Steel utility drums are used to contain acids, bases, and other corrosive chemicals and substances. D. The Emergency Response Guidebook tells you the type and color of container used to store hazardous materials.

B. In most cases, there is no correlation between the color of the container and the possible contents.

Which of the following statements regarding hazardous materials is correct? A. Most hazardous materials are odorless and colorless, even when a substantial leak or spill has occurred. B. Some substances are not hazardous by themselves, but become toxic when mixed with another chemical. C. Identifying the presence of a hazardous material is generally very easy because of the consistent use of placards. D. A package or truck need only contain small quantities of a hazardous chemical before it must bear a placard or label.

B. Some substances are not hazardous by themselves, but become toxic when mixed with another chemical.

Which of the following statements regarding the mechanism of injury (MOI) is correct? A. A nonsignificant MOI rules out the possibility of serious trauma. B. The MOI may allow you to predict the severity of a patient's injuries. C. The exact location of a patient's injuries can be determined by the MOI. D. A significant MOI always results in patient death or permanent disability.

B. The MOI may allow you to predict the severity of a patient's injuries.

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category? A. a 50-year-old male with an open head injury and no pulse B. a 49-year-old female with diabetes and difficulty breathing C. a 36-year-old female with back pain and numb extremities D. a 29-year-old male with bilaterally closed femur deformities

B. a 49-year-old female with diabetes and difficulty breathing

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min, you should: A. look for posturing. B. assess for a distal pulse. C. assess neurologic status. D. assign an immediate category.

B. assess for a distal pulse.

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has points to his severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should: A. quickly bind his legs together to stabilize the fracture, and continue triaging. B. assign him a delayed (yellow) category and continue triaging the other patients. C. evacuate him to a designated area and assign him a minimal (green) category. D. apply high-flow oxygen, obtain baseline vital signs, and continue triaging.

B. assign him a delayed (yellow) category and continue triaging the other patients.

While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should: A. ask the dispatcher if he or she knows the location of the perpetrator. B. confirm this information with law enforcement personnel at the scene. C. request law enforcement personnel if the scene is unsafe upon arrival. D. proceed to the scene as usual but exercise extreme caution upon arrival.

B. confirm this information with law enforcement personnel at the scene.

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should: A. decontaminate the patient as they would any other patient and then move him to the area where EMTs are waiting. B. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can. C. defer the decontamination procedure and bring the patient directly to awaiting EMS personnel for immediate treatment. D. request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment of the patient.

B. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

You and your partner are the first to arrive at the scene of a motor vehicle accident. As you approach the scene, you can see multiple patients, some walking and others who are still in their vehicles. You should: A. establish an incident command post until you are relieved of your duties. B. declare a mass-casualty incident and request additional resources. C. begin rapidly triaging all patients before requesting additional help. D. immediately move all ambulatory patients to a designated area.

B. declare a mass-casualty incident and request additional resources.

Which of the following is NOT a role of the EMT at the scene of a HazMat incident? A. rehabilitation B. decontamination C. transportation D. triage and treatment

B. decontamination

The process of removing or neutralizing and properly disposing of a hazardous material is called: A. neutralization. B. decontamination. C. antidotal treatment. D. chemical containment.

B. decontamination.

During a motor vehicle collision involving multiple patients, the IC would MOST likely: A. maintain responsibility for all of the command functions. B. designate a safety officer, but retain other command functions. C. delegate all of the command functions to the appropriate personnel. D. relinquish command when a senior EMS provider arrives at the scene.

B. designate a safety officer, but retain other command functions.

The purpose of the incident command system (ICS) is to: A. reduce overall mortality and morbidity from large-scale mass-casualty incidents and to restore key infrastructure. B. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources. C. quickly and efficiently respond to natural disasters and terrorist incidents, regardless of the complexity of the incident. D. protect the public from the effects of large- and small-scale disasters and to minimize the financial impact from such incidents.

B. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.

Which of the following findings indicates that your patient has a patent airway? A. audible breathing B. forceful coughing C. inspiratory stridor D. unresponsiveness

B. forceful coughing

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, EXCEPT: A. severe medical problems. B. fractures of multiple long bones. C. any airway or breathing difficulty. D. uncontrolled or severe hemorrhage.

B. fractures of multiple long bones.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A. tongue-jaw lift B. jaw-thrust maneuver C. head tilt-chin lift D. head tilt-neck lift

B. jaw-thrust maneuver

In order to accomplish the goal of primary triage, it is important to: A. take no more than 2 minutes to determine the patient's status. B. keep the triage assessment brief and the patient categories basic. C. begin life-saving care immediately upon detecting critical injuries. D. perform a rapid assessment on all patients who appear to be unstable.

B. keep the triage assessment brief and the patient categories basic.

An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score? A. opens eyes in response to voice, makes incomprehensible sounds, localizes pain B. opens eyes in response to pain, uses inappropriate words, withdraws from pain C. opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion D. eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

B. opens eyes in response to pain, uses inappropriate words, withdraws from pain

At a very large incident, the __________ section is responsible for managing the tactical operations usually handled by the IC on routine EMS calls. A. logistics B. operations C. planning D. finance

B. operations

Observations made when forming a general impression of a patient would include all of the following, EXCEPT: A. appearance. B. pulse strength. C. race and gender. D. level of distress.

B. pulse strength.

Which of the following actions would NOT be performed during the scene size-up? A. asking a neighbor to secure the patient's dog B. rapidly assessing a patient's respiratory status C. notifying the dispatcher to send fire personnel D. noting the position of a crashed motor vehicle

B. rapidly assessing a patient's respiratory status

When victims involved in a mass-casualty incident are moved to the treatment area: A. definitive care is provided and preparations for transport will be made. B. secondary triage is performed and the appropriate treatment is rendered. C. they will be rapidly assessed and prioritized according to their injuries. D. all uninjured patients are placed in a holding area and closely observed.

B. secondary triage is performed and the appropriate treatment is rendered.

A critical function of the safety officer is to: A. determine the most efficient approach to extricate a victim. B. stop an emergency operation whenever a rescuer is in danger. C. monitor emergency responders for signs of stress and anxiety. D. brief responders during the demobilization phase of an incident.

B. stop an emergency operation whenever a rescuer is in danger.

After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, EXCEPT: A. the total number of patients that have been triaged. B. the recommended transport destination for each patient. C. recommendations for movement to the treatment area. D. the number of patients that are in each triage category.

B. the recommended transport destination for each patient.

According to the START triage system, which of the following patients should be triaged as an immediate priority (red tag)? A. conscious with a respiratory rate of 24 breaths/min B. unresponsive with a respiratory rate of 34 breaths/min C. apneic, despite manually opening the airway D. conscious, in severe pain, with radial pulses present

B. unresponsive with a respiratory rate of 34 breaths/min

When is it MOST appropriate to consider requesting additional ambulances at an accident scene? A. after you have triaged all the critical patients B. when you determine there are multiple patients C. after noncritical patients have been identified D. when all the deceased patients are accounted for

B. when you determine there are multiple patients

You are approaching an overturned tanker truck to assess the driver, who appears to be unconscious. As you get closer to the vehicle, you note the smell of noxious fumes and find that you are in the midst of a vapor cloud. What should you do? A. Remain where you are and perform a visual assessment of the patient. B. Cover your face with your shirt and quickly extricate the injured driver. C. Exit the area immediately and gather information for the HazMat team. D. Realize that you are in the danger zone and prevent others from entering.

C. Exit the area immediately and gather information for the HazMat team.

Which of the following questions is of LEAST pertinence when the EMT is determining whether or not to declare a mass-casualty incident and activate the ICS? A. What will happen if there are more than two patients that require emergency care? B. How long will it take for additional resources to arrive at the scene once requested? C. How many paramedics are able to respond to the scene and provide advanced care? D. How many seriously injured patients can be effectively cared for in my ambulance?

C. How many paramedics are able to respond to the scene and provide advanced care?

Which of the following statements regarding stridor is MOST correct? A. It is a whistling sound heard in the lower airway. B. It is caused by incorrect airway positioning. C. It is a high-pitched, crowing upper airway sound. D. It suggests the presence of fluid in the lungs.

C. It is a high-pitched, crowing upper airway sound.

A tour bus has overturned, resulting in numerous patients. When you arrive, you are immediately assigned to assist in the triage process. Patient 1 is a middle-aged male with respiratory distress, chest pain, and a closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert, but has bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you assign to these patients? A. Patient 1, immediate (red); Patient 2, minimal (green); Patient 3, delayed (yellow); Patient 4, expectant (black) B. Patient 1, delayed (yellow); Patient 2, immediate (red); Patient 3, delayed (yellow); Patient 4, immediate (red) C. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black) D. Patient 1, delayed (yellow); Patient 2, delayed (yellow); Patient 3, minimal (green); Patient 4, immediate (red)

C. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)

Which of the following conditions would be LEAST likely to cause an altered level of consciousness? A. drug overdose B. inadequate perfusion C. acute anxiety D. poisoning

C. acute anxiety

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. a physician arrives at the scene. B. the number of patients is known. C. all the patients have been triaged. D. area hospitals have been notified.

C. all the patients have been triaged.

Upon arriving at the scene of a possible hazardous materials (HazMat) incident involving several patients, you should: A. retrieve all critical patients. B. rope off the entire perimeter. C. carefully assess the situation. D. divert traffic away from the scene.

C. carefully assess the situation.

Which of the following activities occurs in the warm zone? A. command B. personnel staging C. decontamination D. medical monitoring

C. decontamination

A supervisor who has more than seven people reporting to him or her: A. is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can accomplish more tasks. B. should regularly report to the incident commander (IC) to inform him or her of the functions that his or her team is performing. C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person. D. should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the tasks were carried out.

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.

The FIRST step in the START triage system is to: A. focus on the patients who are unconscious. B. scan the area for patients with severe bleeding. C. move all walking patients to a designated area. D. get a quick head count of all the patients involved.

C. move all walking patients to a designated area.

Which of the following conditions would MOST likely cause the pupils to remain significantly constricted? A. severe cerebral hypoxia B. intracranial hemorrhaging C. overdose of an opiate drug D. oculomotor nerve pressure

C. overdose of an opiate drug

You have a critically injured patient in the back of your ambulance, ready to be transported. There are other injured patients at the scene and it will be approximately 10 minutes before other ambulances will arrive. Law enforcement personnel are at the scene. You should: A. transport the critically injured patient to a trauma center. B. direct a police officer to monitor the patients as you transport. C. remain at the scene until at least one other ambulance arrives. D. assign the least injured patient the task of caring for the others.

C. remain at the scene until at least one other ambulance arrives.

According to the JumpSTART triage system, infants or children not developed enough to walk or follow commands, including children with special needs: A. are treated immediately in the primary triage area and then transported. B. are initially triaged on the basis of whether or not they have distal pulses. C. should be taken to the treatment area for immediate secondary triage. D. are the first to be transported, regardless of the severity of their injuries.

C. should be taken to the treatment area for immediate secondary triage.

Which of the following pupillary changes would indicate depressed brain function? A. Both pupils dilate when a bright light is removed. B. Both pupils constrict when a bright light is introduced. C. Both pupils react briskly to light instead of sluggishly. D. Both pupils dilate with introduction of a bright light.

D. Both pupils dilate with introduction of a bright light.

Which of the following statements regarding communications at a disaster or mass-casualty incident is correct? A. Each command group should utilize a separate radio frequency. B. Ten-codes or signals should be used when communicating via radio. C. When possible, all communication should occur via two-way radio. D. If possible, use face-to-face communications to minimize radio traffic.

D. If possible, use face-to-face communications to minimize radio traffic.

Your work uniform is an example of what level of protection? A. Level A protection B. Level B protection C. Level C protection D. Level D protection

D. Level D protection

Which of the following statements regarding the unified command system is correct? A. The unified command system is one in which one person is in charge, even if multiple agencies respond to a disaster or mass-casualty incident. B. Ideally, the unified command system is used for short-duration, limited incidents that require the services of a single agency from one jurisdiction. C. In a unified command system, there are separate ICs for fire, police, EMS, and any other agencies that respond to the incident. D. Under the unified command system, plans are drawn up in advance by all cooperating agencies that assume a shared responsibility for decision making.

D. Under the unified command system, plans are drawn up in advance by all cooperating agencies that assume a shared responsibility for decision making.

Which of the following scenarios does NOT involve the presence of any symptoms? A. a 44-year-old male with abdominal pain and severe dizziness B. a 49-year-old female with blurred vision and ringing in the ears C. a 55-year-old male with a severe headache and 2 days of nausea D. a 61-year-old female who is unconscious with facial cyanosis

D. a 61-year-old female who is unconscious with facial cyanosis

Interoperability, an important feature of the NIMS, refers to the ability of: A. the federal government to intervene during any large- or small-scale incident involving terrorism. B. EMS systems and fire departments in the same jurisdiction to effectively work as a team. C. county and state law enforcement agencies to acquire information and pass it along to EMS personnel. D. agencies of different types or from different jurisdictions to communicate with each other.

D. agencies of different types or from different jurisdictions to communicate with each other.

An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: A. obtaining baseline vital signs. B. gathering medical history data. C. providing immediate transport. D. airway, breathing, and circulation.

D. airway, breathing, and circulation.

Which of the following MOST accurately describes a mass-casualty incident? A. an incident that involves more than five critically injured or ill patients B. an incident where patients have been exposed to hazardous materials C. an incident in which at least half of the patients are critically injured D. an incident that greatly taxes or depletes a system's available resources

D. an incident that greatly taxes or depletes a system's available resources

You and your partner arrive at the scene where a truck has crashed into a small building, injuring eight people. You immediately request additional ambulances and begin the triage process. The first patient that you triage is a young female who is unconscious and apneic. She has an open head injury and her pulse is weak and thready. You should: A. assess the severity of her open head injury. B. place a red tag on her and continue triaging. C. begin ventilating her with a bag-mask device. D. assign her a low priority and continue triaging.

D. assign her a low priority and continue triaging.

Upon arriving at a potentially unsafe scene, you should: A. remove all bystanders. B. request another ambulance. C. move the patient to safety. D. ensure that you are safe.

D. ensure that you are safe.

Which of the following duties or responsibilities does NOT fall within the realm of the medical branch of the ICS? A. triage B. transport C. treatment D. extrication

D. extrication

Placards and labels on a storage container are intended to: A. advise responders of the appropriate neutralizing measures. B. broadly classify chemicals as being explosive or non-explosive. C. provide specific information about the chemical being carried. D. give a general idea of the hazard inside that particular container.

D. give a general idea of the hazard inside that particular container.

The goal of the primary assessment is to: A. determine if the patient's problem is medical or trauma. B. identify patients that require transport to a trauma center. C. determine the need to perform a head-to-toe assessment. D. identify and rapidly treat all life-threatening conditions.

D. identify and rapidly treat all life-threatening conditions.

You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should: A. assist her breathing with a bag-mask device. B. quickly insert an oropharyngeal airway. C. assess the rate and quality of her pulse. D. immediately suction her oropharynx.

D. immediately suction her oropharynx.

General principles for approaching a potential HazMat incident include: A. parking the ambulance in a location that is upwind and downhill. B. taking standard precautions before entering any HazMat scene. C. asking for wind direction from dispatch and entering downwind. D. maintaining a safe distance and viewing the scene with binoculars.

D. maintaining a safe distance and viewing the scene with binoculars.

You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should: A. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance. B. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured. C. document the presence of the weapon, including its specific location, and continue your assessment of the patient. D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

A Level 4 hazardous material: A. causes temporary damage or injury unless prompt medical care is provided. B. requires protective gear to ensure that no part of the skin's surface is exposed. C. is mildly toxic but still requires the use of a self-contained breathing apparatus (SCBA). D. requires specialized gear designed for protection against that particular hazard.

D. requires specialized gear designed for protection against that particular hazard.

You are triaging patients at the scene of a multiple vehicle crash when you encounter a young male who is unresponsive and is not breathing. After you open his airway, he begins to breathe at a rapid rate. According to the START triage system, you should: A. assist his ventilations with a bag-mask device and perform a rapid scan of his entire body. B. move him to the treatment area so he can receive a more comprehensive assessment of his status. C. move to the other patients, but reassess him in 5 minutes to determine if he is still breathing. D. tag him as immediate (red), place him in the recovery position, and move to the next patient.

D. tag him as immediate (red), place him in the recovery position, and move to the next patient.