EMT Quiz 15
While using the AED to treat a patient in cardiac arrest, your partner informs you that he can feel a carotid pulse. Which of the following should you do immediately?
A.* Assess the patient's breathing. This is the correct answer. B. Reanalyze the patient's heart rhythm. C. Insert an oropharyngeal airway. D. Obtain a blood pressure.
As you approach a patient, you observe a 1 dash -inch circle of dark blood on his shirt. He appears confused, pale, and diaphoretic. Which one of the following should you do first?
. Apply oxygen. B. Treat for shock. C.* Assess his airway. This is the correct answer. D. Cut his shirt.
You have been called for an elderly male patient who suddenly collapsed. On scene you find an 82 dash -year dash -old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. Which one of the following should you do immediately?
. Apply the AED. B. Start cardiopulmonary resuscitation. C.* Check for a carotid pulse. This is the correct answer. D. Determine the "down time."
As you arrive at a metal scrap yard for an unknown medical emergency, you observe a male supine on the ground with AED electrodes on his chest. The AED operator has just ordered coworkers to clear the patient because the AED is going to shock. Within seconds, the AED delivers a shock without the operator pressing a "shock" button. The EMT should recognize what type of AED?
. Biphasic B.* Fully automated This is the correct answer. C. Manual D. Semi dash -automated
How does the body prolong the effects of the sympathetic nervous system during shock?
. By promoting fluid reabsorption in the kidneys B.* By releasing hormones from the adrenal glands This is the correct answer. C. By constantly providing nervous stimuli to the heart and adrenal glands D. By increasing the intravascular volume by creating more blood During the initial stages of a shock syndrome, the sympathetic nervous system initially stimulates the heart and blood vessels to react through direct nerve stimulation to cause an immediate effect. To prolong this effect, the body also stimulates the adrenal medulla to release epinephrine and norepinephrine into the bloodstream. The release of the hormones is what causes the ongoing sustained effects of the sympathetic nervous system. While the kidneys will reabsorb volume during shock, this is not the mechanism by which the body propagates the sympathetic effect (it is actually an effect of it).
You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient collapsed less than a minute earlier. An AED is located less than a minute from your location. The nearest EMT is 5 minutes from your location. Which one of the following should you do immediately?
. Call for assistance and start CPR. B. Start CPR and wait for the AED. C.* Run to retrieve the nearby AED. This is the correct answer. D. Take manual in dash -line spinal stabilization.
What two care interventions are MOST likely to contribute to the successful resuscitation of a patient who is in ventricular fibrillation?
. Compressions and rapid transport B. Airway maintenance and ventilatory support C. Early ALS care and endotracheal intubation D.* CPR and defibrillation Research by the American Heart Association reinforces the necessity of early defibrillation in the management of sudden cardiac arrest due to ventricular fibrillation. However, high-quality CPR focusing on immediate chest compressions with minimal interruption was found to be even more important. Additional research has shown that high-quality chest compressions with minimal interruption and early defibrillation are the best determinants of successful cardiac arrest management.
During what phase of cardiac arrest is successful resuscitation LEAST likely, owing to widespread death of heart tissue?
. Electrical phase B. Terminal phase C. Circulatory phase D.* Metabolic phase
Which one of the following is a benefit of the automated external defibrillator?
. Elimination of the need for a primary assessment B. The need for little dash -to dash -no training C. Its ability to identify and confirm cardiac arrest D.* The ease and speed by which it can be used
In which of the following interventions may the EMT participate with ALS providers for a patient who has a return of spontaneous circulation?
. Facilitated oxygenation B. High-frequency ventilation C. Hyperbaric therapy D.* Therapeutic hypothermia
You have applied the AED's electrodes to an obese male patient in cardiac arrest. When you press the analyze button, the AED gives you a "check electrode" message. In looking at the patient, which one of the following would most likely be responsible for this message?
. History of asthma B. AED pads placed too far to the left C. Obese chest and abdomen D.* Hairy chest This is the correct answer.
When managing the patient whom you suspect is in shock, why is it important NOT to hyperventilate this patient?
. It will increase the blood pressure too dramatically. B. It will promote increased bleeding into the nervous tissue. C. It will increase the body temperature. D.* It makes the blood alkalotic and reduces off-loading of oxygen from the hemoglobin.
What is the overall goal for the EMT in managing a shock patient?
. Keep the pulse ox reading greater than 94%. B.* Maintain adequate perfusion to the core and peripheral tissues. This is the correct answer. C. Provide adequate ventilations. D. Keep the heart rate less than 100/min.
Which one of the following unresponsive patients would the EMT recognize as in cardiac arrest?
. Male with an absent radial pulse but breathing 20 times a minute B.* Female who has an occasional gasp for a breath but no palpable carotid pulse This is the correct answer. C. Male patient with a heart rate of 16 beats per minute and agonal respirations D. Female who is not breathing and has a heart rate of 24 beats per minute
You are assessing a patient that has a heart rate of 110/min, a blood pressure of 108/88, and respirations of about 14/min. If this patient also has lost blood from a traumatic event, what stage of shock would this be categorized as?
. Progressive B. Decompensated C.* Compensated This is the correct answer. D. Irreversible
During transport to the hospital of a patient who was successfully resuscitated from cardiac arrest, which of the following should the EMT do?
. Provide ventilations at 20/minute. B. Maintain a compression/ventilation ratio of 30:2. C. Do not transport the patient unless an ALS provider is in the ambulance with the EMT. D.* Leave the AED attached to the patient. Patients who have been brought out of ventricular fibrillation through use of the AED have a high likelihood of deteriorating back into that state. Monitor these patients closely, and leave the AED attached so that it is ready to be used immediately if needed. Ventilating at 20/minute is too fast, and there is no need for compressions if the patient has a pulse. Finally, having ALS available is favorable, but if that will delay delivery of the patient to the hospital, transport should be initiated immediately.
Which of the following findings generally indicates that the patient has transitioned from compensated shock to decompensated shock?
. Tachycardia B.* Hypotension This is the correct answer. C. Pale skin D. Tachypnea Although all the findings could be present in decompensated shock, the specific finding that often delineates when that has occurred is systolic hypotension. Tachycardia, tachypnea, and pale skin are present in compensated shock as well, but hypotension is not.
The EMT realizes that the best means of preventing failure of the AED is to:
. always make sure that the AED is kept clean and free of damage. B.* check the AED and its supplies at the beginning of each shift. This is the correct answer. C. obtain a second set of batteries when the original set is no longer functional. D. check the electrodes monthly and replace when expired.
An unrestrained 37 dash -year dash -old female is in cardiac arrest after striking a tree head dash -on at a high rate of speed. Assessment reveals her to have suffered massive blunt trauma to the chest and abdomen. The patient is quickly extricated from the vehicle and placed on a long board for immobilization. It is estimated that the patient has been in cardiac arrest for approximately 10 minutes, during which CPR was not performed. At this time, the EMT would:
. apply electrodes to the patient's chest and follow the AED's instructions. B.* perform CPR and contact medical command for permission to use the AED. This is the correct answer. C. administer CPR for 2 minutes prior to applying the AED. D. withhold CPR and perform a focused trauma assessment.
The EMT understands that when paramedics administer IV fluids as treatment for hemorrhagic shock, the fluids will:
. enable the lungs to better oxygenate the blood. B. stabilize the shock by restoring needed electrolytes. C.* do nothing to enable the blood to carry more oxygen to the cells. This is the correct answer. D. reverse the shock by increasing the blood pressure.
A 47 dash -year dash -old patient has been in cardiac arrest for 6 minutes. While you set up the AED, you would direct your partner to:
. perform CPR at a ratio of 30 ventilations to two compressions. B.* start cardiopulmonary resuscitation until the AED is ready. This is the correct answer. C. assist you in making sure that the AED is ready for application. D. perform a primary and secondary assessment.
Your service has a new AED. During the in dash -service on the new device, the instructor informs you that it is a semi dash -automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that:
. the EMT will not need to press a "shock" button to shock the patient. B. less energy but more shocks will be needed to treat cardiac arrest. C.* the new AED will defibrillate with lower amounts of electrical energy. This is the correct answer. D. the new AED will defibrillate with higher amounts of electrical energy.
Within two minutes of going into cardiac arrest, an AED is applied, the patient is shocked, and a pulse is restored. The EMT should recognize that the heart was in:
. ventricular fibrillation and now is in cardiac arrest. B. ventricular fibrillation and now is in asystole. C.* ventricular fibrillation and now is in an organized rhythm. This is the correct answer. D. asystole and now is in an organized rhythm.
The AED should never be applied to a patient who is not in cardiac arrest because some patients in:
. ventricular fibrillation may be conscious and alert. B.* ventricular tachycardia may have a pulse. This is the correct answer. C. ventricular fibrillation may have a pulse. D. asystole may still have a pulse.
Because of a shortage of paramedics at your ambulance service, it has been announced that there will be AEDs placed on every ambulance for use by EMT crews. Which of the following statements indicates an understanding of how this will affect the EMTs?
. "EMTs will now be able to shock all patients in cardiac arrest." B.* "The AED will let us know whether or not to shock the patient." This is the correct answer. C. "EMTs will have to learn how to interpret ECG tracings." D. "Cardiopulmonary resuscitation will no longer be needed."
You have been called to a public pool for an unresponsive patient. On arrival you find lifeguards performing CPR with a pocket mask and oxygen on a 67 dash -year dash -old male. They report that the patient was in the water and was seen clutching his chest seconds before going unresponsive. He was immediately pulled from the water and CPR was initiated. They estimate that CPR has been performed for 5 minutes. Assessment shows the man to be unresponsive, apneic, and pulseless. Which one of the following is your first response
. "Let's start ventilation with a bag dash -valve mask and oxygen." B. "We need to quickly dry him from head to toe before applying the AED." C.* "Let's take a towel and dry off his chest." This is the correct answer. D. "Stop CPR and let's apply the AED."
After two cardiac arrests, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be:
. "You will need to reanalyze the heart rhythm." B.* "The AED will automatically shock the patient." This is the correct answer. C. "You will need to press the shock button." D. "The AED will prompt you to recheck the pulse."
The major categories of shock include:
. burn, hypovolemic, distributive, and hypoxic. B.* hypovolemic, cardiogenic, obstructive, and distributive. This is the correct answer. C. hemorrhagic, distributive, hypoxic, and obstructive. D. hypoglycemic, obstructive, distributive, and hypovolemic
During management of a patient who is in shock, what abnormal metabolic process is the EMT attempting to prevent?
.* Anaerobic metabolism This is the correct answer. B. Hyponatremia C. Hypokalemia D. Aerobic metabolism A lack of oxygen in the cell from a shock syndrome causes a shift from aerobic to anaerobic metabolism. Aerobic metabolism is the creation of ATP in the presence of oxygen. When there is a lack of available oxygen, anaerobic metabolism takes place, resulting in a drastically lower production of ATP and the creation of lactic acid as a by-product. This is the initiating event that causes cellular death and eventual organ failure and system failure. Both hyponatremia (low sodium levels) and hyperkalemia (low potassium levels) are conditions, not abnormal metabolic processes.
You believe that a young male patient, who has been shot in the lower abdomen, is bleeding internally and is in the early stage of shock. Which item indicates the appropriate prehospital care of this patient?
.* Oxygen therapy and rapid transport to the hospital This is the correct answer. B. "Shock" position and administration of water by mouth C. Oxygen therapy and warm packs to the abdomen D. Semi dash -Fowler's position and direct pressure over the injury site
The patient has been in cardiac arrest for 15 minutes now, and you are still 10 more minutes away from the hospital. ALS intercept did not occur due to the ALS units all being assigned to another call. During transport, the AED analyzed the patient and gave a "No Shock Advised" message. What should the EMT do?
.* Resume compressions This is the correct answer. B. Contact medical direction to ask if a defibrillatory shock can be administered anyway. C. Decrease the oxygen flow rate in case the patient is becoming hyperoxic. D. Attempt defibrillation anyway to "start" the heart.
You are treating a patient with severe chest pain and believe she is in cardiogenic shock. As such, which of the following is most appropriate?
.* Supplemental oxygen This is the correct answer. B. Rapid transport with the patient supine C. Application of the AED D. Administration of nitroglycerin
You have arrived at a residence where a 4 dash -month dash -old baby was found in his crib in cardiac arrest. Emergency Medical Responders have been on scene for 5 minutes prior to arrival. They began CPR immediately on reaching the patient's side. You have an AED with adult pads with you, but not pediatric pads. After rechecking and confirming that the patient is in cardiac arrest, you would:
.* place the AED on the patient and follow all prompts. This is the correct answer. B. continue CPR for 2 more minutes before placing the AED. C. continue CPR and transfer to the stretcher for transport. D. discuss with the parents if they want to proceed with use of the AED.
Not only should the EMT provide a 30:2 ratio of compressions to ventilations to an adult patient in cardiac arrest, the EMT should also:
.* push hard and push fast. This is the correct answer. B. remain on scene with the arrested patient until ALS arrives. C. provide a large ventilation with each squeeze of the bag-valve-mask device. D. pause compressions for 30 seconds while assessing for a pulse. The American Heart Association advocates "push hard and push fast" to provide effective chest compressions. Doing this helps to ensure that the compressions are delivered at a rate of at least 100/minute, which has been shown to provide suitable blood flow to essential organs during cardiac arrest. Delivering large ventilations using a bag-valve-mask device can be detrimental, as can delaying compressions for 30 seconds while assessing for a pulse. Finally, do not wait on scene with an arrested patient if arrival of ALS is delayed. Instead, consider allowing them to intercept with you en route to the hospital.
What assessment parameter is the EMT interpreting if the patient's pulse pressure is determined to be narrowing?
A.* Blood pressure This is the correct answer. B. Pulse oximeter C. Heart rate D. Respiratory rate
It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock could:
A.* cause the beating heart to go into cardiac arrest. This is the correct answer. B. cause the patient to lose his eyesight. C. produce full thickness burns and lead to a deadly infection. D. cause the patient extreme pain.
You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?
A. ***Ensure that no rescuer is touching the stretcher. This is the correct answer. B. Withhold all shocks because metal will conduct the shock into the ambulance. C. Move the patient from the metal stretcher to a nonmetal surface. D. Stop the ambulance and have all rescuers exit prior to shocking with the AED
Proper care of cardiac arrest for a 6 dash -year dash -old pediatric patient when there are no available pediatric AED pads would include
A. 2 EMTs providing a 30:2 ratio of compressions to ventilations. B. CPR with no AED placement due to lack of pediatric pads. C.* placement and use of the adult pads with adult energy levels. This is the correct answer. D. compressing the chest to a maximum of 1½ inches in depth.
You have been asked to describe the American Heart Association's Chain of Survival to a group of Emergency Medical Responder students. What description is best?
A. A treatment plan, that if followed, guarantees the survival of cardiac arrest B. A sequence of care that provides instructions on how to use an AED C.* A sequence of events that, if enacted quickly, gives the best chance for surviving cardiac arrest Your answer is correct. D. A treatment plan that helps to prevent and treat cardiac arrest in the general population
A 7 dash -year dash -old boy choked on a grape at school. By the time the obstruction was removed, assessment revealed him to be in cardiac arrest. When you arrive, teachers are performing CPR. The school nurse informs you that CPR has been in progress for 6 minutes. You have an AED, but do not have a pediatric conversion device that reduces the energy of defibrillation from that of an adult to that of a child. Which one of the following should you do immediately?
A. A.* Place the electrodes on the boy's chest and follow the AED's prompts. This is the correct answer. B. Instruct the teachers to continue CPR for 2 additional minutes before applying the AED. C. Perform five abdominal thrusts and then 1 minute of CPR before using the AED. D. Continue CPR and transfer the boy to the stretcher for immediate transport.
You get a call for cardiac arrest. Upon your arrival, you find out that the family did CPR for about 3 minutes before the pulse returned and the patient awoke. The patient is now conscious and has a chief complaint of heart palpitations and dyspnea. She has a very fast pulse and feels dizzy. What should you do?
A. Analyze the rhythm with the AED. B. Administer one shock, and start chest compressions. C.* Administer oxygen, and call for ALS. This is the correct answer. D. Lay her down in Trendelenburg position.
You have been called for a 57 year old female who is choking on a large pill. On arrival you find the patient collapsed and unresponsive on the floor with family by her side attempting to remove the obstruction. After you quickly verify the airway is still occluded and confirming the pulse is still present, you should immediately?
A. Apply the AED and hit the? "analyze" button. B.* Start chest compressions. This is the correct answer. C. Perform five abdominal thrusts. D. Open the airway and attempt ventilation.
What cardiac arrest rhythm is the AED designed to shock?
A. Asystole B.* Ventricular fibrillation This is the correct answer. C. Bradycardia D. Pulseless electrical activity
Which of the following mechanisms have been found to cause distributive shock in a patient?
A. Cardiac valve failure B.* Blood infection This is the correct answer. C. Pulmonary embolism D. Blood loss
A confused and anxious patient fell 20 feet from a ladder. What sign suggests that the patient is in shock?
A. Constricted pupils Your answer is not correct. B. Contusion to his head C. Deformity to the left arm D.* Heart rate of 110
Which type of shock results from cardiac insufficiency, that is, the inability of the heart to pump an adequate amount of blood?
A. Distributive B. Circulatory C.* Cardiogenic This is the correct answer. D. Obstructive
Upon arrival for a patient who was found unresponsive by neighbors, you note that the skin is cool with mottling, the smaller joints of the hands are stiff, and the jaw seems to be locked into position. There are no environmental extremes in the ambient environment. What should you infer from this presentation?
A. The patient has arthritis. B. The patient is hyperthermic. C.* The patient has rigor. This is the correct answer. D. The patient just went into arrest. Rigor is a condition in which the joints of the body start to stiffen from changes due to prolonged cardiac arrest. This is a finding that occurs hours after arrest, so this serves as a condition to not start resuscitation on the patient. Hyperthermia is caused by an increased core temperature and is not consistent with stiff joints. Arthritis can cause stiff joints but not cold and mottled skin.
You are treating a patient whom you suspect has a tension pneumothorax. The patient has no external hemorrhage or suspected internal hemorrhage, yet he is hypotensive. What type of shock is most likely causing the drop in blood pressure?
A. Distributive shock B.* Obstructive shock This is the correct answer. C. Cardiogenic shock D. Hypovolemic shock Obstructive shock results from a condition that obstructs forward blood flow. The volume is adequate, the heart is not damaged, and the vessels are of a normal size with adequate resistance. However, an obstruction is not allowing the blood to move forward. For example, a large clot that obstructs blood flow in the lungs (pulmonary embolism) will prevent an adequate amount of blood from getting to the left atrium and, subsequently, the left ventricle. Two other conditions that are often associated with injury and can lead to obstructive shock are tension pneumothorax and pericardial tamponade.
What is the first link in the American Heart Association's Chain of Survival?
A. Early CPR B. Early ALS C. Early defibrillation D.* Recognition and activation
You arrive on the scene of an unconscious middle-aged male patient. On assessment, you find that the patient is in cardiac arrest. The witness states that she saw him fall and called for help. She did NOT initiate chest compressions. What should you do NEXT?
A. Give the patient two full breaths and then begin chest compressions. B. Immediately apply the AED and shock the patient. C.* Begin chest compressions at the rate of at least 100 per minute. This is the correct answer. D. Compress the chest 1.5 to 2 inches for two minutes.
Which one of the following actions performed by the EMT indicates appropriate care with the AED when treating a patient in cardiac arrest?
A. He applies one electrode over the top of the power source for a pacemaker located on the patient's chest. B. He intentionally withholds a shock on a patient in cardiac arrest who has an implantable defibrillator. C. He places the AED pads two inches away from a transdermal medication patch on the patient's chest. D.* He places, then quickly removes, a set of electrodes in an attempt to remove hair from a patient's chest.
A 52 dash -year dash -old male has collapsed on his front porch and his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. Which one of the following should you do immediately?
A. Hold CPR so that the AED can be checked and applied for use. B.* Start CPR while the AED is being prepared for use. This is the correct answer. C. Contact medical direction for permission to use the AED given the downtime. D. Perform five cycles of CPR at a ratio of 15 compressions to two ventilations (single rescuer CPR).
If the body's cells exist too long with insufficient oxygen during a shock syndrome, what metabolic process will start to prevail?
A. Hypoxic drive B.* Anaerobic metabolism This is the correct answer. C. Hypercapnic drive D. Aerobic metabolism
What is the BEST reason for the EMT to have extra batteries available for the AED on each shift?
A. In case the medical director is on scene and wants to ensure that you are following protocol B.* In case the batteries in the machine fail This is the correct answer. C. In case you have two patients at one scene D. Because it is mandated by federal law Scheduled maintenance of the AED is crucial for ensuring that the machine functions properly. Follow your local protocols and the manufacturer's directions when maintaining the AED. AED failure is most commonly attributed to improper maintenance, especially battery failure. Typically, if two arrested patients are on scene, you will have two ambulances and two AEDs. State law, not federal law, dictates equipment types.
In what locations are cardiac pacemakers MOST often implanted that may interfere with AED pad placement?
A. In the upper left quadrant of the abdomen B. In the upper right quadrant of the abdomen C. Directly in front of the heart on the anterior chest D.* Beneath the clavicles Cardiac pacemakers are usually positioned beneath one of the clavicles. They form a visible lump and can be palpated. If you detect a pacemaker in a cardiac arrest patient, you can still use the AED. However, be sure not to place an adhesive pad directly over the pacemaker.
Which one of the following statements about the heart rhythm of ventricular fibrillation is true?
A. "The AED is designed to identify ventricular fibrillation and give a 'No Shock Advised' message when it is present." B. "Ventricular fibrillation occurs when the heart rate is so slow and weak that a pulse cannot be felt." C.* "When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body." This is the correct answer. D. "The most effective treatment for converting ventricular fibrillation to a healthy heart rhythm is CPR."
The EMT knows that the cause underlying distributive shock is:
A.* dilation of the blood vessels. This is the correct answer. B. poor fluid intake. C. loss of blood volume. D. damaged heart with poor contractility.
The change in which body process is the primary reason that the patient will progress through the stages of shock and eventually die?
A. Increasing heart rate B.* Lack of adequate perfusion This is the correct answer. C. Diminishing respirations D. Decreasing alveolar ventilation The primary change of the body that causes death in a shock syndrome is a lack in organ perfusion. With a lack of perfusion, cells, tissues, and organs become ischemic and start failing. A drop in perfusion to the heart results in its failure, and a drop in perfusion to the lungs results in ongoing hypoxia and hypercapnia. An increasing heart rate is a compensatory mechanism initially, and the changes to the respiratory rate and alveolar ventilation are the result of a failing pulmonary system, not the cause of the failing pulmonary system. Eventually, everyone dies when the heart rate stops, but the stopping of the heart is a consequence of the failing perfusion pressure.
Why does the American Heart Association advocate "push hard and push fast" in performing CPR?
A. It ensures that the EMT will stop to give ventilations. B. It decreases the likelihood of causing a rib fracture from the compressions. C.* It provides more effective blood flow. This is the correct answer. D. It increases the amount of oxygen in the alveoli for the body
You have been dispatched to a residence for a male patient with a cardiac history who is complaining of chest pain. On scene you find a 52 dash -year dash -old male patient sitting in a chair. He is alert and oriented and states that his chest pain feels like the last time he had a heart attack. He also states that in the hospital his heart stopped and they had to shock him twice before it restarted. He is breathing adequately and has a strong radial pulse. Which one of the following would be appropriate in the care of this patient?
A. Open the airway using the head dash -tilt, chin dash -lift maneuver. B. Provide positive pressure ventilation with high dash -concentration oxygen. C.* Obtain the heart rate, respiratory rate, and blood pressure. This is the correct answer. D. Apply the AED to the patient but do not turn it on.
You are teaching your local police department how to use an AED, as they just recently equipped each of their police cruisers with one. Beyond teaching them when and how to use the device, what other point would you emphasize about the most common cause of AED failure?
A. Outdated electrodes B. Electrode cable breakage or separation C.* Battery failure This is the correct answer. D. Complex instructions for operation
You are transporting a 57 dash -year dash -old male who went into cardiac arrest at home. After two shocks and CPR, he regained a pulse, but remains unresponsive and in respiratory arrest. During transport, your reassessment reveals the absence of a carotid pulse. Which one of the following should you do first?
A. Provide five cycles of CPR prior to using the AED. B.* Stop the ambulance and analyze the heart rhythm with the AED. This is the correct answer. C. Start CPR and continue emergency transport. D. Reapply the AED and analyze the heart rhythm
A patient has just gone into cardiac arrest. His heart is most likely in what rhythm?
A. Pulseless electrical activity B. Ventricular tachycardia C. Asystole D.* Ventricular fibrillation
What structures within the cell, after becoming released as a result of failure of the sodium/potassium pump, start to autodigest the cell?
A. Sodium molecules B. ATP C.* Lysozymes This is the correct answer. D. Carbon dioxide
You are caring for an 8-year-old male patient who was thrown from a car during a collision. The child has a blood pressure of 90/systolic, a heart rate of 98/min, and respirations of 20/min. How would you characterize the patient's shock state?
A. The child is in irreversible shock. B. The child is hypotensive. C. The child is tachycardic. D.* The child's blood pressure is acceptable Normal vital sign findings vary with age for pediatric patients. For children younger than 10 years of age, a systolic blood pressure of 70 mmHg plus two times the age in years is a lower limit of normal. A systolic blood pressure less than the lower limit would be considered hypotensive. Hypotension is a late finding in pediatric patients and often leads to cardiac arrest. In this patient, the low systolic value calculates to 86 mmHg. This means that the blood pressure is above the minimally acceptable value that would represent hypotension.
A "No Shock Advised" message is provided by the AED. The EMT understands that this could mean:
A.* the patient has regained a pulse. This is the correct answer. B. the electrodes may be loose. C. the patient is in ventricular fibrillation. D. CPR is no longer needed.
While you are caring for a patient with a heart attack, the patient is becoming tachycardic and hypotensive. Your partner asks you why this might be happening. What would be a logical explanation?
A. The patient is suffering from massive vasodilation secondary to the heart attack. B. The use of oxygen causes vasodilation, which will drop the blood pressure and cause the heart rate to increase. C. The patient's lungs are no longer able to oxygenate the blood because of alveolar damage. D.* The patient's stroke volume is probably diminished. The heart is the pump that is responsible for generating the force necessary to move the blood throughout the body. If the pump fails, regardless of the blood volume, the delivery of oxygen and glucose to cells will be decreased. Pump function failure may result from an injury to the heart that reduces its ability to generate contractions strong enough to push the blood forward throughout the body. For example, a heart attack (myocardial infarction) deadens a portion of the heart muscle. Like any other muscle, a portion that is dead doesn't contribute to the force of contraction. If the heart attack has affected a large enough area of heart muscle, the pump will fail and lead to a shock state.
A driver was ejected from his vehicle in a rollover dash -type collision. Assessment findings reveal the patient to be unresponsive with bruising to the abdominal and pelvic areas along with an open femur fracture. The patient has an open airway and is breathing 32 times per minute. His skin is cool and clammy and the radial pulses weak. Manual in dash -line spinal stabilization is being maintained. The EMT's next intervention would be to:
A. examine the fracture site. B.* assist respirations. This is the correct answer. C. apply a cervical collar. D. obtain a blood pressure.
An EMT has just received a "Shock Advised" message from the AED. Just before delivering the shock, the EMT must:
A. hold the patient's head to avoid injury when shocking. B. press the analyze button once more. C. remove the oral airway to prevent possible choking. D.* ensure that all rescuers are clear of the patient.
A patient has fallen down a flight of stairs and has suffered a scalp laceration with minimal venous bleeding. You find him to be restless and confused. The airway is open, and he is adequately breathing 22 times per minute. He has a radial pulse of 92 beats per minute and is moderate in strength. Emergency Medical Responders are maintaining manual in-line spinal stabilization. Your next priority action would be to:
A. immobilize the patient with a cervical collar and long spine board. B.* apply oxygen at 15 liters per minute via nonrebreather face mask. This is the correct answer. C. check the blood pressure and assess for injuries causing blood loss. D. insert an oral airway and start positive pressure ventilation with oxygen.
When a patient's heart stops, the patient goes into cardiac arrest. There are three phases after cardiac arrest that lead to biological death. The phases include each of the following EXCEPT:
A. metabolic phase. B. circulatory phase. C. electrical phase. D.* sudden death.
After analyzing a cardiac arrest patient's heart rhythm, the AED provides a "Deliver Shock" message. After clearing the patient, the EMT's next step should be to:
A. press the shock button, and then allow the AED to analyze the heart rhythm. B.* press the shock button, and then perform CPR for 2 minutes. This is the correct answer. C. check for a pulse, and then press the shock button if a pulse is not present. D. press the shock button, and then check for the return of a pulse.
The AED has just been applied to a female cardiac arrest patient. After analyzing the heart rhythm, it provides a "No Shock Advised" message. The EMT should immediately:
A. reanalyze the patient's heart rhythm. B. check the patient for a pulse and blood pressure. C.* resume cardiopulmonary resuscitation. This is the correct answer. D. check the electrodes for proper placement.
Your unresponsive trauma patient has a rapidly dropping blood pressure. This indicates the patient:
A. will not survive his injuries. B. is compensating adequately. C. has internal bleeding. D.* is in a state of decompensation
A 28 dash -year dash -old male was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and breathing shallowly at 28 times per minute. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual in dash -line cervical spine stabilization. His respirations are snoring. Based on these assessment findings, which one of the following instructions would you provide to the EMRs?
A. "He has snoring respirations, so let's go ahead and open the airway with the head dash -tilt, chin dash -lift." B. "Do not cover him with a blanket because that will cause his blood vessels to dilate and drop his BP." C.* "Let's take off the oxygen mask and start positive pressure ventilation to assist his breathing." This is the correct answer. D. "Let's go ahead and elevate his legs 8 to 12 inches so more blood gets to his vital organs."
Which one of the following statements best indicates an understanding of the prehospital role in caring for the patient in shock?
A. "If shock is in the compensatory or early stage, it is not yet life dash -threatening and the EMT can take his time in assessing and treating the patient." B. "Because shock is a life dash -threatening condition, it is important that the EMT identify the exact cause so the proper care can be given." C. "The job of the EMT is to recognize that a person is in shock and get him or her to the hospital so treatment can be started." D.* "Since shock is best treated in the hospital, the EMT should provide care to maintain perfusion to the vital organs and transport." This is the correct answer.
You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of the following instructions is appropriate at this time?
A. "Stop CPR but continue to check for a pulse." B. "Stop chest compressions but continue ventilation." C.* "Stop CPR and clear the patient." This is the correct answer. D. "Continue CPR until we see if a shock is advised."
When should the EMT transport the cardiac arrest patient?
A.* After three "No Shock Advised" messages are received This is the correct answer. B. After one shock has been delivered and the patient remains in cardiac arrest C. Immediately upon determining that the patient is in cardiac arrest D. Before delivering the first shock when a "Shock Advised" message is received
Which one of the following statements about the AED and its use in the treatment of cardiac arrest is true?
A. "To use an AED, the EMT must be able to identify some basic cardiac arrest heart rhythms so that he or she can tell the AED to shock or not shock the patient." B.* "Research has shown that the first shock delivered by an AED is often faster than the first shock delivered by a manual defibrillator." This is the correct answer. C. "The AED is advantageous in that it will determine if a patient is in cardiac arrest and whether or not to shock." D. "AEDs have simplified the treatment of cardiac arrest to the point where the EMT does not have to be worried about inappropriately shocking a patient."
Which one of the following statements made by a patient's family member would cause the EMT to suspect that a patient is suffering from hypovolemic shock?
A. A.* "He cannot stop throwing up." This is the correct answer. B. "He has had a rash for the past three days." C. "He got up this morning and was having a hard time breathing." D. "He has been taking an antibiotic for a chest cold."
The cardiac arrest rhythms for which defibrillation is appropriate include:
A.* ventricular tachycardia. This is the correct answer. B. pulseless electrical activity. C. asystole. D. bradycardia.
Your patient has a blood pressure of 88/46, shallow respirations of 38/min, a heart rate of 68/min, and a pulse ox reading of 96 percent on high-flow oxygen. Given these vital signs, what type of shock is this patient most likely experiencing?
A.* Distributive shock from a spinal cord injury This is the correct answer. B. Cardiogenic shock from a heart attack C. Obstructive shock from a thoracic injury D. Hypovolemic shock from blood loss With a spinal cord injury, the blood vessels may dilate from a lack of sympathetic tone causing hypotension. Additionally, because of the lack of sympathetic tone, the heart rate will be in the slow to normal range and not tachycardic. Hypovolemic shock, obstructive shock, and cardiogenic shock all result in narrowing pulse pressure and tachycardia.
During the initial stages of shock, the skin becomes pale and the heart rate increases. These findings are due to what hormone(s)?
A.* Epinephrine and norepinephrine This is the correct answer. B. Epinephrine and glucagon C. Norepinephrine, epinephrine, and glycogen D. Norepinephrine
You are treating a patient who is hypotensive and unresponsive. The ALS partner with whom you are working states that the patient is having a massive heart attack according to the 12-lead ECG findings. Why might this cause a hypotensive patient?
A.* Inadequate pump function This is the correct answer. B. Inadequate vessel tone C. Inadequate oxygen levels D. Inadequate blood volume
What is an advantage of a load-distributing band CPR device or vest CPR device?
A.* It improves coronary and cerebral blood flow in comparison to traditional CPR. This is the correct answer. B. It allows for a 100% successful resuscitation rate. C. It eliminates the need to ventilate the patient. D. It eliminates the need to intubate the patient or place any other advanced airway. Although some research shows that the devices are better at providing cerebral and coronary perfusion than is traditional CPR, the available evidence still cannot support routine use of these devices.
The EMT would recognize which of the following as the most probable case of cardiogenic shock?
A.* Myocardial infarction This is the correct answer. B. Systemic infection C. Gastrointestinal bleed D. Severe vomiting and diarrhea
To prevent a shift to anaerobic metabolism, the body needs to ensure adequate perfusion to the tissues of glucose as well as what other substance?
A.* Oxygen This is the correct answer. B. Platelets C. White blood cells D. Carbon dioxide To prevent the development of anaerobic metabolism, the body needs not only to have good perfusion to deliver glucose to the cells and remove carbon dioxide and other wastes from the cells, but also to deliver adequate amounts of oxygen so that aerobic metabolism can occur. White blood cells are part of the immune system and do not play a role in adenosine triphosphate (ATP) development, nor do platelets.
What is an important difference between the pediatric Chain of Survival and the adult Chain of Survival?
A.* Prevention of arrest This is the correct answer. B. Bystander CPR C. Rapid transport to the hospital D. Post-arrest care The American Heart Association pediatric Chain of Survival also has five links; however, the first three links emphasize slightly different elements of emergency cardiac care from those recommended for adults. This is based on the difference in the physiology and typical etiology of cardiac arrest in the pediatric patient. The steps of the pediatric Chain of Survival are prevention of arrest, early high-quality CPR, rapid activation of EMS, effective ALS care and transport, and integrated post-cardiac-arrest care.
After you apply the AED to a cardiac arrest patient, it delivered a shock. Immediately after the shock, the EMT should do which one of the following?
A.* Provide 2 minutes of CPR, and then check the patient for a pulse. This is the correct answer. B. Check the patient for a pulse and start CPR if no pulse can be located. C. Provide five cycles of single dash -rescuer CPR with a ratio of 15 compressions to two ventilations. D. Check the patient for a pulse and reanalyze the rhythm if no pulse is present.
What is one reason the EMT should summon ALS to the scene of a cardiac arrest patient who experienced return of spontaneous circulation (ROSC)?
A.* The ALS interventions may prevent arrest from recurring. This is the correct answer. B. Only ALS providers can adequately ventilate a patient once an advanced airway is in place. C. State law requires ALS on every cardiac arrest. D. After one shock by the EMT, any additional shocks must be performed by the ALS provider.
What is the relationship between AED use and the conversion of ventricular fibrillation?
A.* The earlier the shock is applied, the higher the conversion rate. This is the correct answer. B. The higher the energy level that is used to shock, the lower the conversion rate. C. The lower the energy level that is used to shock, the higher the conversion rate. D. The later the shock is applied, the higher the conversion rate.
Which of the following scenarios would be MOST unsafe for the EMT who is about to deliver a shock with an AED?
A.* The patient is lying on a metal surface. This is the correct answer. B. The patient has an implanted defibrillator. C. The patient is lying outside in the yard. D. The patient is lying on a hotel room floor. When you are using an AED, you are operating a device that delivers an electric shock. That shock can save the life of a cardiac arrest patient, but it can injure others who come into contact with it. Such shocks are unlikely to be lethal, but they should be avoided. Metal is a good conductor of electricity. Be careful with patients who are in contact with metal flooring, catwalks, stretchers, and other items with metal components. Before you administer a shock, either remove the patient from this surface or ensure that no one else is directly in contact with metal that is touching the patient.
What is the likelihood of successful resuscitation and survival of a patient who has been in cardiac arrest for 10 minutes before the onset of resuscitation efforts?
A.* Unlikely This is the correct answer. B. Certain C. Very good D. Impossible
How are AEDs designed to help prevent malfunction from dead batteries?
A.* With a system self-check indicator This is the correct answer. B. With batteries that cannot be replaced C. With batteries that never expire D. With batteries that will never discharge
What statement regarding care for the adult patient in cardiac arrest is NOT true?
A.* "It is important to always check for a pulse immediately after the AED has delivered a shock." This is the correct answer. B. "When using an AED, the machine should be turned on before applying the electrodes." C. "If two EMTs are performing CPR, a ratio of 30 compressions to two ventilations can be used." D. "The sternum should be compressed about 2 ½ inches with each compression."
You have arrived at a residence for a 66 dash -year dash -old female who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which one of the following statements should you make at this time?
A.* "Let's stop CPR so I can check the airway, breathing, and circulation." This is the correct answer. B. "Let's stop CPR so I can put the electrodes of the AED on her chest." C. "Let's continue CPR while I talk with the family to see if they want us to continue." D. "Let's continue CPR for another 2 minutes, and then I will put the AED on."
You are instructing a first dash -aid class at a local chemical plant. The course includes instruction regarding an AED that is to be placed in the plant. What point would you emphasize about the most common cause of AED failure?
A.* "The batteries must be checked regularly." This is the correct answer. B. "An extra set of electrodes should be kept in the AED." C. "The AED should be kept clean and undamaged." D. "Always check the electrode wires for cracks."
When assessing the patient whom you suspect has hypoperfusion, the early effects of norepinephrine can be seen as:
A.* pale, cool skin. This is the correct answer. B. pupillary constriction. C. tachycardia. D. increased urine output.
If a patient is found to be hypotensive after a stabbing to the thigh, what is the most likely type of shock?
Obstructive shock B.* Hypovolemic shock This is the correct answer. C. Cardiogenic shock D. Respiratory shock