Chapter 15 - Respiratory Emergencies, Chapter 34 - Pediatric Emergencies, Chapter 33 - Obstetrics and Neonatal Care, Chapter 23 - Gynecologic Emergencies, Chapter 22 - Psychiatric Emergencies, Chapter 21 - Toxicology, Chapter 20 - Immunologic Emergen...

21. Which of the following conditions would MOST likely lead to PID if left untreated? A. chlamydia B. ovarian cysts C. genital herpes D. ectopic pregnancy

A. chlamydia

22. 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.

4. 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.

46. 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.

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

A. 3

58. 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.

25. 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.

29. 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.

15. You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? A. Ask the patient if she has developed a suicidal plan. B. Leave the scene and have a neighbor check in on her. C. Have law enforcement place her in protective custody. D. Encourage the patient to remain quiet during transport.

A. Ask the patient if she has developed a suicidal plan.

14. Which of the following statements regarding fire ants is correct? A. Fire ants often bite a person repeatedly. B. Fire ant bites rarely cause anaphylaxis. C. Fire ant bites typically occur on the face. D. Most people are allergic to fire ant toxin.

A. Fire ants often bite a person repeatedly.

Common names for activated charcoal include all of the following, EXCEPT: A. Fructose. B. Actidose. C. LiquiChar. D. InstaChar.

A. Fructose.

36. Which of the following statements regarding inhaled poisons is correct? A. Lung damage may progress after the patient is removed from the environment. B. Carbon monoxide is very irritating to the upper airway and may cause swelling. C. Burns around the eyes are the most common indication of an inhalation poisoning. D. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema.

A. Lung damage may progress after the patient is removed from the environment.

5. Which of the following statements regarding gonorrhea is correct? A. Most men who are infected with gonorrhea do not experience symptoms. B. Painful urination is a common symptom of gonorrhea in men and women. C. Symptoms of gonorrhea usually appear within 3 months after being infected. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

A. Most men who are infected with gonorrhea do not experience symptoms.

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.

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.

Which of the following statements regarding the hypoxic drive is MOST correct? A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.

A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

10. 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.

61. 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.

During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have multiple needle tracks on them. This patient's clinical presentation is MOST consistent with: A. a heroin overdose. B. alcohol intoxication. C. a closed head injury. D. an overdose of diazepam (Valium).

A. a heroin overdose.

Hyperventilation could be associated with all of the following, EXCEPT: A. a narcotic overdose. B. a respiratory infection. C. an overdose of aspirin. D. high blood glucose levels.

A. a narcotic overdose.

26. 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

5. 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.

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

A. a shuffling gait when walking

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.

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

A. alcohol.

15. The foreign substance responsible for causing an allergic reaction is called a(n): A. allergen. B. antibody. C. histamine. D. leukotriene.

A. allergen.

In what area of the lungs does respiration occur? A. alveoli B. trachea C. bronchi D. capillaries

A. alveoli

3. Which of the following MOST accurately defines an allergic reaction? A. an exaggerated immune system response to any substance B. destruction of the immune system by an external substance C. a release of erythrocytes in response to a foreign substance D. a direct negative effect on the body by an external substance

A. an exaggerated immune system response to any substance

40. In general, injected poisons are impossible to dilute or remove because they: A. are usually absorbed quickly into the body. B. are usually fatal within 30 minutes of exposure. C. absorb slowly into the body, despite their potency. D. react with the blood, which increases their toxicity.

A. are usually absorbed quickly into the body.

22. 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.

4. You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should: A. ask her if she has prescribed epinephrine. B. obtain a complete set of baseline vital signs. C. ascertain if she has a family history of allergies. D. ask her when her last allergic reaction occurred.

A. ask her if she has prescribed epinephrine.

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.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: A. assist her ventilations with a bag-mask device. B. apply a pulse oximeter and obtain vital signs. C. administer oxygen via a nonrebreathing mask. D. obtain a complete list of all of her medications.

A. assist her ventilations with a bag-mask device.

27. You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient will include: A. assisted ventilation, naloxone (Narcan), and rapid transport. B. oxygen via a nonrebreathing mask and rapid transport. C. assisted ventilation, flumazenil (Romazicon), and rapid transport. D. oxygen via a nasal cannula, atropine, and rapid transport.

A. assisted ventilation, naloxone (Narcan), and rapid transport.

45. 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.

37. As you enter the residence of a patient who has possibly overdosed, you should: A. be alert for personal hazards. B. look for drug paraphernalia. C. observe the scene for drug bottles. D. quickly gain access to the patient.

A. be alert for personal hazards.

9. When assessing a patient with a behavioral crisis, you should: A. be direct and clearly state your intentions. B. frisk the patient for the presence of weapons. C. spend as little time with the patient as possible. D. ask the police to handcuff the patient for safety.

A. be direct and clearly state your intentions.

11. 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.

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

28. 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.

69. 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.

25. 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

Alkalosis is a condition that occurs when: A. blood acidity is reduced by excessive breathing. B. dangerous acids accumulate in the bloodstream. C. the level of carbon dioxide in the blood increases. D. slow, shallow breathing eliminates too much carbon dioxide.

A. blood acidity is reduced by excessive breathing.

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.

When assessing a patient who is displaying bizarre behavior, the EMT should: A. consider that an acute medical illness may be causing the patient's behavior. B. avoid asking questions about suicide because this may give the patient ideas. C. check his or her blood glucose level only if he or she has a history of diabetes. D. carefully document his or her perception of what is causing the patient's behavior.

A. consider that an acute medical illness may be causing the patient's behavior.

17. A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. In addition to administering oxygen, you should: A. contact medical control and administer oral glucose. B. assist him with his insulin injection and reassess him. C. request a paramedic ambulance to administer IV glucose. D. transport only with close, continuous monitoring en route.

A. contact medical control and administer oral glucose.

56. 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.

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

A. cystitis

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.

12. In contrast to a behavioral crisis, a psychiatric emergency occurs when a person: A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others. B. experiences feelings of sadness and despair for longer than a month. C. exhibits impaired functioning due to a chemical or genetic disturbance. D. experiences a sudden attack of panic secondary to a stressful situation.

A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others.

17. In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to: A. diffuse and control the situation and safely transport the patient. B. diagnose the patient's problem and provide definitive treatment. C. transport the patient directly to a specialized psychiatric facility. D. determine the underlying cause of the problem and offer advice.

A. diffuse and control the situation and safely transport the patient.

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.

6. Diabetes is MOST accurately defined as a(n): A. disorder of carbohydrate metabolism. B. abnormally high blood glucose level. C. mass excretion of glucose by the kidneys. D. lack of insulin production in the pancreas.

A. disorder of carbohydrate metabolism.

8. 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.

11. Common side effects of epinephrine include all of the following, EXCEPT: A. drowsiness. B. tachycardia. C. headache. D. dizziness.

A. drowsiness.

20. 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 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

17. Whenever possible, a female sexual assault victim should be: A. given the option of being treated by a female EMT. B. encouraged to take a shower and change her clothes. C. thoroughly assessed, even if no signs of injury exist. D. asked to provide a brief description of the perpetrator.

A. given the option of being treated by a female EMT.

35. 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.

7. 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.

23. When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A. has gathered patient history information. B. has obtained a complete set of vital signs. C. ascertains if the patient was ever pregnant. D. has formed a general impression of the patient.

A. has gathered patient history information.

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.

18. 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.

30. 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

9. As a woman approaches menopause: A. her menstrual periods may become irregular and vary in severity. B. she cannot become pregnant because of fluctuating hormone levels. C. she usually experiences abdominal cramping without vaginal bleeding. D. her risk of developing PID lowers significantly.

A. her menstrual periods may become irregular and vary in severity.

22. Urticaria is the medical term for: A. hives. B. burning. C. swelling. D. a wheal.

A. hives.

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

A. hypoglycemia.

20. When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: A. if he or she has had any recent illnesses or excessive stress. B. approximately how much water the patient drank that day. C. if there is a family history of diabetes or related conditions. D. the name of the physician who prescribed his or her insulin.

A. if he or she has had any recent illnesses or excessive stress.

Asthma is caused by a response of the: A. immune system. B. endocrine system. C. respiratory system. D. cardiovascular system.

A. immune system.

31. A hypnotic drug is one that: A. induces sleep. B. prevents amnesia. C. increases the pulse. D. increases the senses.

A. induces sleep.

14. Most poisonings occur via the __________ route. A. ingestion B. injection C. inhalation D. absorption

A. ingestion

20. You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: A. initiate ventilatory assistance. B. contact the poison control center. C. perform a rapid head-to-toe exam. D. apply oxygen via a nonrebreathing mask.

A. initiate ventilatory assistance.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: A. instruct him to hold his breath for as long as he comfortably can. B. immediately reapply the oxygen mask and reassess his condition. C. advise him to exhale forcefully to ensure medication absorption. D. allow him to breathe room air and assess his oxygen saturation.

A. instruct him to hold his breath for as long as he comfortably can.

65. 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.

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: A. is significantly hyperglycemic. B. has a low blood glucose level. C. has a urinary tract infection. D. has overdosed on her insulin.

A. is significantly hyperglycemic.

40. 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.

11. 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.

16. 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.

6. The physical examination of a sexual assault victim should be: A. limited to a brief survey for life-threatening injuries. B. performed in the presence of at least two police officers. C. as detailed as possible so all injuries can be documented. D. deferred until the patient can be evaluated by a physician.

A. limited to a brief survey for life-threatening injuries.

25. An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause: A. liver failure. B. gastric ulcers. C. kidney failure. D. central nervous system (CNS) depression.

A. liver failure.

2. People at risk for suicide include all of the following, EXCEPT: A. married males older than 30 years. B. those with a recent diagnosis of a serious illness. C. children with parents addicted to alcohol. D. substance abusers.

A. married males older than 30 years.

7. In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. may be relatively painless. B. is typically not as severe. C. can be controlled in the field. D. often presents with acute pain.

A. may be relatively painless.

47. 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.

22. Before giving activated charcoal, you should: A. obtain approval from medical control. B. have the patient drink a glass of milk. C. mix it with an equal amount of water. D. mix the suspension by stirring the bottle.

A. obtain approval from medical control.

2. 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.

A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unconscious and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: A. open the patient's airway and assess his respirations. B. ask the police to handcuff the patient for safety purposes. C. provide care after determining what Dilaudid is used for. D. wait for the police to examine him before providing care.

A. open the patient's airway and assess his respirations.

35. Heroin is an example of a(n): A. opioid. B. hypnotic. C. cholinergic. D. sympathomimetic.

A. opioid.

23. 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.

12. Airborne substances are diluted with: A. oxygen. B. syrup of ipecac. C. activated charcoal. D. an alkaline antidote.

A. oxygen.

7. 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.

22. 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.

27. 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.

20. 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.

43. 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.

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

A. poisoning

8. Excessive eating caused by cellular "hunger" is called: A. polyphagia. B. polydipsia. C. dysphasia. D. dyspepsia.

A. polyphagia.

21. Immediately after giving an epinephrine injection, you should: A. properly dispose of the syringe. B. record the time and dose given. C. reassess the patient's vital signs. D. notify medical control of your action.

A. properly dispose of the syringe.

25. 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.

11. 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.

14. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. advise her that she cannot clean herself up because this will destroy evidence. C. ask her if there is anyone you can contact, such as a friend or relative. D. perform a limited hands-on assessment to detect life-threatening injuries.

A. provide emotional support and visually assess her for obvious trauma.

20. 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.

4. 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.

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.

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

A. right atrium.

14. 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.

49. 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

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

A. she is capable of becoming pregnant.

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

A. shins

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

A. stridor.

28. 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.

13. 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.

63. 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.

Insulin shock will MOST likely develop if a patient: A. takes too much of his or her prescribed insulin. B. markedly overeats and misses an insulin dose. C. eats a regular meal followed by mild exertion. D. misses one or two prescribed insulin injections.

A. takes too much of his or her prescribed insulin.

68. 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.

47. 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.

21. 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.

15. 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.

42. 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.

19. Epinephrine is indicated for patients with an allergic reaction when: A. wheezing and hypotension are present. B. the patient is anxious and tachycardic. C. a paramedic is present at the scene. D. the reaction produces severe urticaria.

A. wheezing and hypotension are present.

62. 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.

24. The effects of epinephrine are typically observed within _________ following administration. A. 30 seconds B. 1 minute C. 30 minutes D. 1 hour

B. 1 minute

When administering epinephrine via auto-injector, you should hold the injector in place for: A. 5 seconds. B. 10 seconds. C. 15 seconds. D. 20 seconds.

B. 10 seconds.

36. 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

6. Most patients who die of anaphylaxis do so within the first __________ following exposure. A. 5 minutes B. 30 minutes C. 60 minutes D. 90 minutes

B. 30 minutes

67. 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.

73. 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.

55. 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.

21. The normal blood glucose level, as measured by a glucometer, is between: A. 60 and 80 mg/dL. B. 80 and 120 mg/dL. C. 130 and 150 mg/dL. D. 160 and 200 mg/dL.

B. 80 and 120 mg/dL.

Which of the following statements regarding anaphylaxis is correct? A. Patients with asthma are at lower risk of developing anaphylaxis. B. Anaphylaxis is characterized by airway swelling and hypotension. C. Most anaphylactic reactions occur within 60 minutes after exposure. D. The signs of anaphylaxis are caused by widespread vasoconstriction.

B. Anaphylaxis is characterized by airway swelling and hypotension.

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

23. ____________ is what you can see of a person's response to the environment. A. Affect B. Behavior C. Neurosis D. Psychosis

B. Behavior

25. Which of the following statements regarding diabetic coma is correct? A. Diabetic coma can be prevented by taking smaller insulin doses. B. Diabetic coma typically develops over a period of hours or days. C. Patients with low blood glucose levels are prone to diabetic coma. D. Diabetic coma rapidly progresses once hyperglycemia develops.

B. Diabetic coma typically develops over a period of hours or days.

51. 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.

12. Glipizide, a non-insulin-type medication, is another name for: A. Glucophage. B. Glucotrol. C. Micronase. D. Diabinese.

B. Glucotrol.

Which of the following statements regarding sickle cell disease is correct? A. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. C. The red blood cells of patients with sickle cell disease are round and contain hemoglobin A. D. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

B. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. The most severe cases of PID occur in women who are not sexually active. B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. C. PID most commonly affects women who have had an ectopic pregnancy in the past. D. The most common presenting symptom of PID is generalized upper abdominal pain.

B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

18. Which of the following statements regarding rape is correct? A. The EMT should try to determine if rape occurred. B. Rape is a legal diagnosis, not a medical diagnosis. C. Rape causes more physical harm than emotional harm. D. Only a licensed physician can make a diagnosis of rape.

B. Rape is a legal diagnosis, not a medical diagnosis.

16. 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

24. Organic brain syndrome is MOST accurately defined as: A. bizarre behavior secondary to a chemical imbalance or disturbance in the brain. B. a dysfunction of the brain caused by abnormal physical or physiological function. C. a disorder that cannot be traced to the abnormal structure or function of an organ. D. a change in behavior or mental status secondary to inadequate cerebral blood flow.

B. a dysfunction of the brain caused by abnormal physical or physiological function.

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.

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.

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 auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A. normal breath sounds. B. abnormal breath sounds. C. diminished breath sounds. D. an absence of breath sounds.

B. abnormal breath sounds.

77. 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.

18. A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop: A. severe insulin shock. B. acidosis and dehydration. C. complete renal failure. D. hypoxia and overhydration.

B. acidosis and dehydration.

23. 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.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: A. an obstructed airway. B. adequate air exchange. C. respiratory difficulty. D. respiratory insufficiency.

B. adequate air exchange.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. C. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. D. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma.

B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

17. 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.

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: A. position her legs well above the level of her heart. B. administer oxygen and transport her to the hospital. C. request a paramedic unit to administer epinephrine. D. advise her to see her physician as soon as possible.

B. administer oxygen and transport her to the hospital.

5. The MOST commonly abused drug in the United States is: A. cocaine. B. alcohol. C. codeine. D. marijuana.

B. alcohol.

15. 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.

40. 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.

12. 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.

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

25. Which of the following conditions or factors would be the LEAST likely to result in a change in behavior? A. low blood glucose levels B. antihypertensive medications C. exposure to excess heat or cold D. inadequate blood flow to the brain

B. antihypertensive medications

5. The term "behavioral crisis" is MOST accurately defined as: A. a sudden, violent outburst of an otherwise mentally stable person toward a family member. B. any reaction that interferes with activities of daily living or is deemed unacceptable by others. C. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people. D. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.

B. any reaction that interferes with activities of daily living or is deemed unacceptable by others.

12. 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.

37. Muscle control and body coordination are controlled by the: A. cerebrum. B. cerebellum. C. brain stem. D. cerebral cortex.

B. cerebellum.

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration. C. force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.

B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

13. You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include: A. administering one to two tubes of oral glucose. B. applying a nonrebreathing mask at 15 L/min. C. assisting the patient with his diabetic medication. D. performing a rapid exam and obtaining vital signs.

B. applying a nonrebreathing mask at 15 L/min.

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.

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

11. A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of: A. cocaine. B. aspirin. C. Tylenol. D. ibuprofen.

B. aspirin.

16. During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: A. perform a rapid secondary assessment. B. assist her ventilations with a bag-mask device. C. assess her blood pressure and elevate her legs. D. perform a visual assessment of her vaginal area.

B. assist her ventilations with a bag-mask device.

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include: A. thoroughly suctioning her oropharynx. B. assisted ventilation with a bag-mask device. C. performing a rapid secondary assessment. D. requesting a paramedic to give her atropine.

B. assisted ventilation with a bag-mask device.

76. 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.

34. Your priority in caring for a patient with a surface contact poisoning is to: A. move the patient to a safe area. B. avoid contaminating yourself. C. decontaminate the patient's skin. D. obtain and maintain a patent airway.

B. avoid contaminating yourself.

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.

19. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. thins and begins to separate. B. becomes engorged with blood. C. diverts blood flow to the vagina. D. sheds and is expelled externally.

B. becomes engorged with blood.

24. The onset of menstruation is called menarche and usually occurs in women who are: A. between 12 and 14 years of age. B. between 11 and 16 years of age. C. between 25 and 35 years of age. D. between 45 and 50 years of age.

B. between 11 and 16 years of age.

13. Activated charcoal is given to patients who have ingested certain substances because it: A. induces vomiting and empties the stomach. B. binds to the substance and prevents absorption. C. decreases absorption of poisons into the lungs. D. is a direct antidote for many toxic substances.

B. binds to the substance and prevents absorption.

50. 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 respiratory distress that accompanies emphysema is caused by: A. repeated exposure to cigarette smoke. B. chronic stretching of the alveolar walls. C. massive constriction of the bronchioles. D. acute fluid accumulation in the alveoli.

B. chronic stretching of the alveolar walls.

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.

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

23. 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

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.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. slow and deep. B. deep and rapid. C. slow and shallow. D. rapid and shallow.

B. deep and rapid.

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

6. Signs of agitated delirium include: A. pallor, hypotension, and constricted pupils. B. diaphoresis, tachycardia, and hallucinations. C. slurred speech, bradycardia, and a high fever. D. subdued behavior, crying, and suicidal thoughts.

B. diaphoresis, tachycardia, and hallucinations.

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

14. 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.

8. Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: A. abdominal cramps. B. drying of the eyes. C. flushing of the skin. D. persistent dry cough.

B. drying of the eyes.

33. A patient whose speech is slurred and difficult to understand is experiencing: A. aphasia. B. dysarthria. C. dysphagia. D. paraplegia.

B. dysarthria.

12. 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.

15. The anterior aspect of the cerebrum controls: A. touch. B. emotion. C. movement. D. vision.

B. emotion.

19. Insulin functions in the body by: A. producing new glucose as needed. B. enabling glucose to enter the cells. C. increasing circulating blood glucose. D. metabolizing glucose to make energy.

B. enabling glucose to enter the cells.

10. 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.

30. 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.

4. Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: A. assessing the patient's mental status. B. ensuring the absence of a gag reflex. C. checking the medication's expiration date. D. requesting permission from medical control.

B. ensuring the absence of a gag reflex.

15. Patients with uncontrolled diabetes experience polyuria because: A. they drink excess amounts of water due to dehydration. B. excess glucose in the blood is excreted by the kidneys. C. low blood glucose levels result in cellular dehydration. D. high blood sugar levels cause permanent kidney damage.

B. excess glucose in the blood is excreted by the kidneys.

7. Anaphylaxis is MOST accurately defined as a(n): A. moderate allergic reaction that primarily affects the vasculature. B. extreme allergic reaction that may affect multiple body systems. C. severe allergic reaction that typically resolves without treatment. D. allergic reaction that causes bronchodilation and vasoconstriction.

B. extreme allergic reaction that may affect multiple body systems.

74. 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

24. 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.

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

21. 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.

17. 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.

37. 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.

24. 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)

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

B. hyperglycemia, ketoacidosis, and dehydration.

59. 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.

39. The MOST significant risk factor for a hemorrhagic stroke is: A. severe stress. B. hypertension. C. heavy exertion. D. diabetes mellitus.

B. hypertension.

Common side effects of nitroglycerin include all of the following, EXCEPT: A. bradycardia. B. hypertension. C. hypotension. D. severe headache.

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

34. 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

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.

52. 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

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.

22. A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should: A. transport the patient to a psychiatric facility. B. inquire about the possibility of head trauma. C. conclude that the patient's blood sugar is high. D. allow the patient to refuse transport if she wishes.

B. inquire about the possibility of head trauma.

The two processes that occur during respiration are: A. ventilation and diffusion. B. inspiration and expiration. C. diffusion and oxygenation. D. oxygenation and ventilation.

B. inspiration and expiration.

50. 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.

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that: A. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures. B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot. C. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones. D. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol.

B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

8. If a woman with vaginal bleeding reports syncope, the EMT must assume that she: A. is pregnant. B. is in shock. C. has an infection. D. has an ectopic pregnancy.

B. is in shock.

45. 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.

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.

14. 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

23. A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should: A. perform a detailed secondary assessment. B. maintain his airway and assist his ventilations. C. ask his wife if he has any known allergies. D. apply the automated external defibrillator (AED) in the event that cardiac arrest occurs.

B. maintain his airway and assist his ventilations.

39. Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient: A. might become violent. B. may vomit and aspirate. C. may experience a seizure. D. is severely hypoglycemic.

B. may vomit and aspirate.

60. 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.

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.

5. 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.

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.

3. Glutose is a trade name for: A. glucotrol. B. oral glucose. C. micronase. D. glucophage.

B. oral glucose.

29. Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A. ecstasy. B. oxycodone (Percocet). C. amphetamine sulfate (Benzedrine). D. crack cocaine.

B. oxycodone (Percocet).

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? A. assisted ventilation with a bag-mask device and a head-to-toe exam B. oxygen via nonrebreathing mask and a focused secondary assessment C. positive-pressure ventilations and immediate transport to the closest hospital D. oxygen via a nasal cannula, vital signs, and prompt transport to the hospital

B. oxygen via nonrebreathing mask and a focused secondary assessment

23. 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.

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.

16. 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.

55. 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.

A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: A. have her breathe into a paper or plastic bag. B. provide reassurance and give oxygen as needed. C. request a paramedic to give her a sedative drug. D. position her on her left side and transport at once.

B. provide reassurance and give oxygen as needed.

33. 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.

31. 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.

8. You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient's central nervous system? A. an irregular pulse B. rapid eye movement C. excessive tearing or crying D. consistent eye contact

B. rapid eye movement

16. The EMT's primary responsibility to the patient who has been poisoned is to: A. administer the appropriate antidote. B. recognize that a poisoning occurred. C. administer 25 g of activated charcoal. D. contact poison control immediately.

B. recognize that a poisoning occurred.

20. 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.

19. You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should: A. ask the husband to attempt to reason with his wife. B. remain in a safe place and request law enforcement. C. get in your ambulance and leave the scene immediately. D. go upstairs with caution and attempt to talk to the patient.

B. remain in a safe place and request law enforcement.

When the level of arterial carbon dioxide rises above normal: A. the brain stem inhibits respirations. B. respirations increase in rate and depth. C. exhalation lasts longer than inhalation. D. respirations decrease in rate and depth.

B. respirations increase in rate and depth.

79. 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.

34. 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.

Which of the following conditions would LEAST likely result in hypoxia? A. pleural effusion B. severe anxiety C. pulmonary edema D. prolonged seizures

B. severe anxiety

13. 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

18. 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.

19. 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.

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.

12. Which of the following sounds indicates swelling of the upper airway? A. rales B. stridor C. rhonchi D. wheezing

B. stridor

Harsh, high-pitched inspiratory sounds are characteristic of: A. rales. B. stridor. C. rhonchi. D. wheezing.

B. stridor.

32. Signs and symptoms of a sympathomimetic drug overdose include: A. sedation. B. tachycardia. C. hypotension. D. slurred speech.

B. tachycardia.

32. 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.

8. 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.

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.

13. 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.

54. 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.

23. Hypoglycemic crisis tends to develop more often and more severely in children because: A. they have larger glucose stores than adults do. B. they do not always eat correctly and on schedule. C. their cells do not uptake glucose as fast as adults' do. D. their low activity levels cause rapid glucose depletion.

B. they do not always eat correctly and on schedule.

3. 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.

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.

14. From what internal female organ is the fetus expelled during delivery? A. vagina B. uterus C. cervix D. perineum

B. uterus

3. 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.

25. 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.

80. 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%

3. Which of the following drugs is NOT a sedative-hypnotic? A. secobarbital (Seconal) B. diazepam (Valium) C. cocaine D. flunitrazepam (Rohypnol)

C. cocaine

30. 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?"

6. 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

39. 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

21. Common causes of acute psychotic behavior include all of the following, EXCEPT: A. intense stress. B. schizophrenia. C. Alzheimer's disease. D. mind-altering substance use.

C. Alzheimer's disease.

53. 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.

38. 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.

24. 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.

38. 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.

19. 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 pulse oximetry is correct? A. The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. B. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common. C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood. D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80%.

C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.

5. Which of the following statements regarding glucose is correct? A. Most cells will function normally without glucose. B. Blood glucose levels decrease in the absence of insulin. C. The brain requires glucose as much as it requires oxygen. D. The brain requires insulin to allow glucose to enter the cells.

C. The brain requires glucose as much as it requires oxygen.

41. 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.

39. 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?

5. Which of the following patients would MOST likely have a delayed onset of an allergic reaction? A. a 21-year-old female who inhaled pollen B. a 30-year-old male who was stung by a bee C. a 45-year-old male who ingested penicillin D. a 50-year-old male who was exposed to latex

C. a 45-year-old male who ingested penicillin

38. Activated charcoal administration is contraindicated in patients who have ingested: A. ibuprofen. B. acetaminophen (Tylenol). C. acids or alkalis. D. steroid drugs.

C. acids or alkalis.

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

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with: A. acute pulmonary edema. B. right-sided heart failure. C. acute pulmonary embolism. D. spontaneous pneumothorax.

C. acute pulmonary embolism.

10. A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. assist her ventilations with a bag-mask device, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

4. A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent distress. After contacting medical control, you should: A. induce vomiting with syrup of ipecac. B. transport the child for definitive care. C. administer up to 25 g of activated charcoal. D. give the child cold milk to absorb the Tylenol.

C. administer up to 25 g of activated charcoal.

52. 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.

33. 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

29. 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.

42. 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.

18. 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.

4. 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

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

C. be homicidal as well.

26. In contrast to insulin shock, diabetic coma: A. is rapidly reversible if oral glucose is given. B. commonly results in excess water retention. C. can only be corrected in the hospital setting. D. is a rapidly developing metabolic disturbance.

C. can only be corrected in the hospital setting.

3. General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: A. supplemental oxygen and lower extremity elevation. B. refraining from placing any dressings into the vagina. C. carefully removing any foreign bodies from the vagina. D. treating external lacerations with moist, sterile compresses.

C. carefully removing any foreign bodies from the vagina.

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.

16. 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.

31. 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.

12. 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

28. 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

33. A 3-year-old female ingested several leaves from a plant in the living room. The child's mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial assessment of the child, you should: A. administer 25 g of activated charcoal. B. induce vomiting with syrup of ipecac. C. contact the regional poison control center. D. immediately transport the child to the hospital.

C. contact the regional poison control center.

20. The first step in assessing a patient with a behavioral emergency is to: A. take vital signs. B. restrain the patient. C. ensure your safety. D. obtain proper consent.

C. ensure your safety.

It is not uncommon for young females who experience their first menstrual period to: A. have a falsely positive home pregnancy test result. B. lose up to 500 mL of blood within the first 24 hours. C. experience abdominal cramping, which may be misinterpreted. D. become so emotionally distraught that they contemplate suicide.

C. experience abdominal cramping, which may be misinterpreted.

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.

Risk factors for AMI that cannot be controlled include: A. excess stress. B. hyperglycemia. C. family history. D. lack of exercise.

C. family history.

27. Ketone production is the result of: A. acidosis when blood glucose levels are low. B. blood glucose levels higher than 120 mg/dL. C. fat metabolization when glucose is unavailable. D. rapid entry of glucose across the cell membrane.

C. fat metabolization when glucose is unavailable.

7. Hemoglobin is: A. the fluid portion of the blood that transports cells throughout the body. B. essential for the formation of clots, such as when vessel damage occurs. C. found within the red blood cells and is responsible for carrying oxygen. D. a key component of the blood and is produced in response to an infection.

C. found within the red blood cells and is responsible for carrying oxygen.

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

C. gallbladder

8. 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.

11. Which of the following conditions does NOT typically present with vaginal discharge? A. chlamydia B. gonorrhea C. genital herpes D. PID

C. genital herpes

26. 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.

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 dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: A. insert an oropharyngeal airway and perform oral suctioning. B. apply oxygen via a nonrebreathing mask and transport at once. C. insert a nasopharyngeal airway and begin assisted ventilation. D. place her in the recovery position and monitor for vomiting.

C. insert a nasopharyngeal airway and begin assisted ventilation.

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

C. insulin.

59. 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.

18. 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.

13. 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.

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.

13. Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should: A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained. B. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren. C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay.

C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

15. When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. determine the underlying cause of her problem. B. ask questions related to her gynecologic history. C. maintain her ABCs and transport without delay. D. keep assessment and treatment to a minimum.

C. maintain her ABCs and transport without delay.

70. 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.

2. Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it: A. has been linked to hypotension. B. does not effectively induce vomiting. C. may result in aspiration of vomitus. D. has toxic effects on the myocardium.

C. may result in aspiration of vomitus.

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.

18. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: A. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine. B. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine. C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine. D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.

C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

2. While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates: A. rapid swelling of the upper airway tissues. B. a significant amount of fluid in the alveoli. C. narrowing of the bronchioles in the lungs. D. enlargement of the bronchioles in the lungs.

C. narrowing of the bronchioles in the lungs.

7. Atropine sulfate and pralidoxime chloride are antidotes for: A. lysergic acid diethylamide (LSD). B. diphenhydramine (Benadryl). C. nerve gas agents. D. anticholinergic drugs.

C. nerve gas agents.

53. 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.

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.

72. 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.

58. 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.

48. 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.

51. 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.

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

C. provide ventilatory support.

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

6. 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

25. You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: A. monitor her en route to the hospital and call medical control if she worsens. B. crush up an antihistamine tablet and place it in between her cheek and gum. C. request permission from medical control to give another dose of epinephrine. D. administer a nebulized bronchodilator to improve the status of her breathing.

C. request permission from medical control to give another dose of epinephrine.

22. Early signs of respiratory distress in the child include: A. cyanosis. B. bradycardia. C. restlessness. D. decreased LOC.

C. restlessness.

16. A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: A. try to gain the patient's trust by telling him that you see the vampires too. B. request that the police officers arrest him and take him to the hospital. C. restrain the patient with appropriate force in order to treat his injuries. D. approach the patient and calm him by placing your hand on his shoulder.

C. restrain the patient with appropriate force in order to treat his injuries.

Which of the following veins is located inferior to the trunk? A. cephalic B. axillary C. saphenous D. subclavian

C. saphenous

14. Which of the following is an example of a functional behavioral disorder? A. head trauma B. drug addiction C. schizophrenia D. Alzheimer's disease

C. schizophrenia

44. 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.

9. 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.

he 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.

24. 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

9. 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.

32. 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.

16. Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? A. the patient's family history B. the patient's general physical appearance C. the environment in which the patient is found D. the time of season in which the exposure occurred

C. the environment in which the patient is found

40. 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.

31. 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.

Acute pulmonary edema would MOST likely develop as the result of: A. right-sided heart failure. B. severe hyperventilation. C. toxic chemical inhalation. D. an upper airway infection.

C. toxic chemical inhalation.

21. 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.

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.

54. 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.

15. 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.

18. You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient: A. is a heroin abuser. B. is acutely intoxicated. C. was given flunitrazepam (Rohypnol). D. is abusing marijuana.

C. was given flunitrazepam (Rohypnol).

9. The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg. A. 0.1, 0.01 B. 0.01, 0.1 C. 0.03, 0.3 D. 0.3, 0.15

D. 0.3, 0.15

3. 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.

27. 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

15. The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult patient. A. 5 g, 10 g B. 10 g, 20 g C. 12.5 g, 25 g D. 25 g, 50 g

D. 25 g, 50 g

44. 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.

21. A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is MOST likely experiencing: A. acute hypovolemia. B. alcohol intoxication. C. acute schizophrenia. D. DTs.

D. DTs.

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 severe acute respiratory syndrome (SARS) is correct? A. Multiple bacteria have been identified as being the cause of SARS. B. SARS is most commonly transmitted by direct contact with blood. C. The onset of SARS is typically marked by acute, severe pneumonia. D. SARS is a viral infection that often begins with flulike symptoms.

D. SARS is a viral infection that often begins with flulike symptoms.

6. Which of the following statements regarding the Salmonella bacterium is correct? A. Refrigeration of food will prevent salmonellosis. B. Symptoms of salmonellosis appear within 12 hours. C. The Salmonella bacterium produces toxins that cause food poisoning. D. The Salmonella bacterium itself causes food poisoning.

D. The Salmonella bacterium itself causes food poisoning.

8. Which of the following questions would be of LEAST pertinence during the initial questioning of a patient who ingested a substance? A. How much of the substance was taken? B. How long ago was it taken? C. What type of substance was taken? D. Why was the substance ingested?

D. Why was the substance ingested?

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.

14. To which of the following diabetic patients should you administer oral glucose? A. an unconscious 33-year-old male with cool, clammy skin B. a conscious 37-year-old female with nausea and vomiting C. a semiconscious 40-year-old female without a gag reflex D. a confused 55-year-old male with tachycardia and pallor

D. a confused 55-year-old male with tachycardia and pallor

9. 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.

66. 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.

48. 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.

6. 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.

37. 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.

10. You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should: A. apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once. B. apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport. C. assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable. D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

78. 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.

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.

35. 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.

17. Which of the following medications blocks the release of histamines? A. albuterol (Ventolin) B. epinephrine C. acetaminophen (Tylenol) D. diphenhydramine (Benadryl)

D. diphenhydramine (Benadryl)

10. Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? A. pupillary constriction B. excessive lacrimation C. a fall in blood pressure D. dry mucous membranes

D. dry mucous membranes

You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: A. requesting a paramedic to administer naloxone (Narcan). B. assisting his ventilations with a bag-mask device. C. asking law enforcement to place handcuffs on the patient. D. attempting to calm him and giving him oxygen if tolerated.

D. attempting to calm him and giving him oxygen if tolerated.

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.

60. 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.

11. General guidelines for managing a patient with a behavioral emergency include: A. firmly identifying yourself as an EMS provider. B. placing the patient between yourself and an exit. C. allowing the patient to be alone if he or she wishes. D. being prepared to spend extra time with the patient.

D. being prepared to spend extra time with the patient.

34. The vagina and the neck of the uterus comprise the: A. womb. B. cervix. C. fundus. D. birth canal.

D. birth canal.

36. Which of the following is NOT a component of the Apgar score? A. pulse B. activity C. grimace D. body size

D. body size

57. The MOST ominous sign of impending cardiopulmonary arrest in infants and children is: A. pallor. B. retractions. C. nasal flaring. D. bradycardia.

D. bradycardia.

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: A. approach the patient with caution. B. quickly tend to the bleeding wound. C. tell the patient that you want to help. D. calmly identify yourself to the patient.

D. calmly identify yourself to the patient.

19. 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.

17. 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.

2. Assessment of a patient with hypoglycemia will MOST likely reveal: A. sunken eyes. B. hyperactivity. C. warm, dry skin. D. combativeness.

D. combativeness.

17. 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.

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

A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should: A. place her in a recumbent position to facilitate breathing. B. contact medical control and administer an antihistamine. C. call medical control and ask how to proceed with treatment. D. determine if she has been prescribed a beta-agonist inhaler.

D. determine if she has been prescribed a beta-agonist inhaler.

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.

19. 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.

2. 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.

6. 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.

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: A. audible stridor. B. rales and rhonchi. C. profound cyanosis. D. expiratory wheezing.

D. expiratory wheezing.

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

35. 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.

21. 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.

20. Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: A. the bee venom itself. B. adrenaline and histamines. C. leukocytes and epinephrine. D. histamines and leukotrienes.

D. histamines and leukotrienes.

26. 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.

10. Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed: A. within the first few minutes after making patient contact. B. at least every 5 minutes in order to detect signs of shock. C. only if you will be transporting the patient to the hospital. D. if doing so will not worsen his or her emotional distress.

D. if doing so will not worsen his or her emotional distress.

30. Diabetic ketoacidosis occurs when: A. blood glucose levels rapidly fall. B. the cells rapidly metabolize glucose. C. the pancreas produces excess insulin. D. insulin is not available in the body.

D. insulin is not available in the body.

When documenting a call in which a female was sexually assaulted, you should: A. only use quotation marks when recording any statements made by witnesses. B. translate the patient's words or statements using proper medical terminology. C. record your opinion only if you have reasonable proof to justify the statement. D. keep the report concise and record only what the patient stated in her own words.

D. keep the report concise and record only what the patient stated in her own words.

19. Substance abuse is MOST accurately defined as: A. knowingly selling illicit drugs in order to buy more drugs. B. willfully using a therapeutic drug to treat a medical illness. C. unwillingly and unknowingly consuming drugs or alcohol. D. knowingly misusing a substance to produce a desired effect.

D. knowingly misusing a substance to produce a desired effect.

5. 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.

2. 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.

20. Which of the following clinical presentations is MOST consistent with PID? A. left lower quadrant pain, referred pain to the left shoulder, and fever B. pain around the umbilicus, low-grade fever, and generalized weakness C. upper abdominal cramping, severe headache, and heavy vaginal bleeding D. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

D. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

32. 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.

29. 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.

43. 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

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.

64. 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.

4. 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″.

49. 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.

2. Potentially life-threatening consequences of PID include: A. ovarian cysts and gonorrhea. B. bacterial vaginosis and chlamydia. C. uterine rupture with severe bleeding. D. ovarian abscess and ectopic pregnancy.

D. ovarian abscess and ectopic pregnancy.

In order for efficient pulmonary gas exchange to occur: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

4. When caring for a female patient who has been sexually assaulted, you should: A. ask the patient for a concise, detailed report of what happened to her. B. allow law enforcement to take her statement before you begin treatment. C. advise her that she will not be allowed to shower or change her clothes. D. place any bloodstained clothing or other articles in separate paper bags.

D. place any bloodstained clothing or other articles in separate paper bags.

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.

36. 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.

5. 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. resuction the mouth only. D. provide ventilations for 30 seconds.

D. provide ventilations for 30 seconds.

11. When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: A. patient's mental status. B. rate of the patient's pulse. C. presence of a medical identification tag. D. rate and depth of breathing.

D. rate and depth of breathing.

3. A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said, is called: A. active listening. B. passive listening. C. intuitive listening. D. reflective listening.

D. reflective listening.

38. 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

29. You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: A. calm him down so you can assess him. B. be assertive and talk the patient down. C. contact medical control for instructions. D. retreat at once and call law enforcement.

D. retreat at once and call law enforcement.

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

46. 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.

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be MOST alert for: A. acute respiratory depression. B. a sudden outburst of violence. C. an increase in her blood pressure. D. seizures and cardiac arrhythmias.

D. seizures and cardiac arrhythmias.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. B. pay special attention to the exhalation phase since this is when you will likely hear rales or rhonchi. C. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.

D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.

57. 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.

24. A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

Common signs and symptoms of acute hyperventilation syndrome include: A. altered mental status and bradycardia. B. unilateral paralysis and slurred speech. C. anxiety, dizziness, and severe bradypnea. D. tachypnea and tingling in the extremities.

D. tachypnea and tingling in the extremities.

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.

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.

28. Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because: A. water makes these chemicals impossible to remove. B. severe swelling will occur when mixed with water. C. this will eliminate the chances of you being exposed. D. these chemicals may ignite upon contact with water.

D. these chemicals may ignite upon contact with water.

2. 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.

23. A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing a(n): A. addiction. B. dependence. C. withdrawal. D. tolerance.

D. tolerance.

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.

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

56. 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.