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C. Coagulation

According to Jackson's theory of thermal wounds, which of the following zones has suffered the greatest damage?

Your patient is a 24-year-old female with a history of asthma . She is in severe respiratory distress. She states that she started having difficulty breathing 6 hours ago that initially responded to her albuterol and Atrovent metered dose inhalers (MDI). However, her breathing has worsened over the past 4 hours and is not responsive to her MDIs. She can speak in 4- to 5-word sentences. Her skin is pale and diaphoretic, and she is using accessory muscles, has expiatory wheezing in all lung fields, and diminished air movement in the bases. HR = 142, BP = 132/78, RR = 30, SaO2 = 88%. In addition to 100% oxygen and an IV of normal saline, which of the following is the best course of prehospital treatment?

Albuterol and ipratropium (Atrovent) via nebulizer, IV corticosteroids.

D. more, liquefaction

Alkalis generally cause ________ extensive burns because they result in ________ necrosis of the tissue.

D. myocardial contusion.

All of the following injuries are commonly associated with penetrating thoracic trauma EXCEPT:

D. Bronchiolar smooth muscle relaxation.

All of the following result from the Beta-1 actions of epinephrine in response to shock EXCEPT:

D. full-thickness

An area of burned tissue that is not painful is most likely a ________ burn injury.

distributive

Anaphylactic shock is a form of ________ shock.

A. sucking chest wound.

Another name for an open pneumothorax is:

A. Disruption of arterial blood supply to the anterior cord

Anterior cord syndrome is caused by which of the following mechanisms?

Bridge abutment

Applying Newton's second law of motion to a vehicle traveling 70 miles per hour, crashing into which of the following would transfer the most force to the patient?

increases.

As a bullet tumbles, its potential to inflict damage:

D. providing surgical interventions to stop hemorrhage.

As a paramedic, your role in trauma care consists of all of the following EXCEPT:

D. contracts, decreases

As the diaphragm ________, the intrathoracic pressure ________.

Negative pressure is generated inside the cavity, drawing debris into the wound.

As the energy from a medium or high-velocity projectile pushes tissue from its path, which of the following occurs?

The amount of energy increases.

As the mass of an object increases, which of the following occurs?

Which of the following statements comparing asthma and emphysema is TRUE?

Asthma is characterized by reversible airway obstruction, emphysema by irreversible airway obstruction.

Frontal with an up-and-over pathway

Axial loading is most likely to occur in which type of impact?

A 24-year-old female complains of a sudden onset of right-sided abdominal pain. It began as a cramping sensation, but it is steady and severe now. She is pale and cool, and her vital signs are BP, 104/76 mm Hg; P, 128 beats/min; R, 20 breaths/min; and SaO2, 97%. She takes no medicines on a daily basis. She has spotty vaginal bleeding and states her last normal menstrual period was 8 weeks ago. You initiate an IV of normal saline. Which intervention should you perform next? A) b. Measure her blood glucose level. B) a. Administer oxygen 15 L/min by nonrebreather mask. C) c. Place her in the modified Trendelenburg position. D) d. Give morphine 2 to 4 mg slow IV for pain relief.

A 33-year-old female patient has been shot in the right side of her chest with a handgun. An entry wound is visible above her right nipple, and an exit wound is seen in the middle of her right scapula at about the third rib, midaxillary line. There is minimal bleeding. What critical system are you most worried about? A) a. Circulatory B) d. Respiratory C) b. Gastrointestinal D) c. Nervous

A bone break common in children, in which the bone is bent but only broken on the outside of the bend, is called a: A) b. Comminuted fracture B) c. Greenstick fracture C) a. Closed fracture D) d. Stress fracture

A grade 2 sprain usually results in: A) d. Vascular compromise B) c. Immediate pain and swelling C) a. A dislocated joint D) b. An unstable joint

A lucid interval is associated with a(n): A) c. Subarachnoid hemorrhage B) b. Epidural hematoma C) a. Diffuse axonal injury D) d. Subdural hematoma

A major risk for both an expectant mother and her fetus following a serious traumatic event is A) d. Preecclampsia B) a. Abruptio placentae C) b. HELLP syndrome D) c. Placenta previa

A neonate who is postarrest is now exhibiting twitching, limpness, irregular respirations, and eye rolling. Based on these findings, what should you suspect? A) b. Hyperglycemia B) c. Hypoglycemia C) a. Heart disease D) d. Hypothermia

A newborn has pallor and a pulse rate of 120 beats/min, grimaces, and has active motion and a slow and irregular respiratory effort. What would be the Apgar score for this infant? A) a. 5 B) b. 6 C) d. 9 D) c. 8

A newborn has pink skin, a pulse rate of 110 beats/min, a vigorous cry, and active motion with a slow and irregular respiratory effort. What would be the Apgar score for this infant? A) c. 8 B) d. 9 C) a. 6 D) b. 7

A newborn is coughing and crying. She also has active motion of her extremities. She has a pulse rate of 120 beats/min and has blue extremities. Her torso is pink. What is her Apgar score? A) a. 5 B) d. 9 C) b. 6 D) c. 7

A partial dislocation of a vertebra that causes impingement on the spinal cord is known as: A) a. Axial loading B) d. Subluxation C) c. SCIWORA D) b. Distraction

A patient hit a brick lane divider while riding his motorcycle. You find that he has cyanosis around his face, a weak and thready pulse, and hypotension. Which of the following is critical to the initial management of this patient? A) a. BLS transport B) d. Rapid transport C) b. Complete assessment before transport D) c. Declare patient deceased on scene

A patient was in a significant motor vehicle crash in which she was ejected from the vehicle. She has an obvious fracture of her right femur and is complaining of weakness in both legs, but denies any pain in her legs. Which of the following best describes the possible cord lesion? A) c. Cord concussion B) a. Anterior cord syndrome C) d. Posterior cord syndrome D) b. Brown-Séquard syndrome

A patient's nose is bleeding. You have taken full spinal precautions and placed the patient on a long backboard. To control the loss of blood and promote coagulation: A) c. Pack the nostrils with sterile gauze B) d. Place external pressure on the anterior nares C) a. Elevate the foot of the backboard D) b. Have the patient sit up, lean forward, and pinch the bridge of his nose

A pregnant patient cannot remember how many weeks she is into her pregnancy. On examination, you feel the fundus of the uterus at the level of the umbilicus, leading you to conclude that she has been pregnant for: A) a. 12 weeks B) d. 30 weeks C) c. 24 weeks D) b. 20 weeks

A serious systemic bacterial infection most commonly causes what type of shock? A) a. Anaphylactic shock B) d. Septic shock C) b. Hypovolemic shock D) c. Psychogenic shock

A spinal injury in which compression forces squeeze the vertebrae together is known as: A) c. Hyperextension B) a. Axial loading C) b. Distraction D) d. Hyperrotation

Advancing an umbilical catheter too far may cause infusion of medication directly into which structure? A) c. Lungs B) b. Liver C) d. Spleen D) a. Heart

Air trapped in the pleural cavity under pressure is known as: A) a. Complete pneumothorax B) d. Tension pneumothorax C) c. Simple pneumothorax D) b. Open pneumothorax

An 81-year-old female presents with lower back pain. She states she has suffered no injury and that she has pain with flexion and feels a catching in her back. She denies lifting anything heavy or doing any strenuous exercise. Which of the following is the most likely cause of her pain? A) a. Cord compression B) b. Degenerative disk disease C) d. Tumor D) c. Trauma

An abdominal evisceration is managed in the field by: A) A. Replacing the contents into the abdominal cavity and keeping the patient warm B) B. Covering the abdominal contents with moist dressing C) C. Cooling the patient to reduce metabolism D) D. Administering oral fluids and pain medication

An epidural hematoma is characterized by bleeding: A) c. Between the epidura and dura mater B) b. Between the skull and the dura mater C) d. Below the pia mater D) a. Above the arachnoid mater

An injury victim with which of the following conditions would be at the highest risk for infection and complications? A) a. Chiari's malformation B) c. Rheumatoid arthritis C) b. Osteogenesis imperfecta D) d. Sickle cell anemia

As a rule, fractures and dislocated joints should be: A) c. Reduced in the field B) a. Immobilized in anatomic position and in a position of comfort C) b. Immobilized with a soft splint D) d. Repositioned in the field

Assessment of a newly born infant 1 minute after delivery reveals the infant is crying vigorously on light tapping of the foot. Her heart rate is 130 beats/min and some flexion of the extremities is note. Ventilations are regular at approximately 40 breaths/min. Her body is pink and extremities are blue. You would assign an Apgar score of: A) 7 B) 8 C) 9 D) 10

Because of the pain associated with rib fractures, the patient may not breathe deeply, in an attempt to splint the injury. This may result in which of the following complications? A) a. Adult-onset asthma B) b. Atelectasis C) c. Bronchitis D) d. COPD

Cerebral palsy, mental retardation, and learning disabilities are all examples of conditions that may occur in newborns who survive: A) d. Newborn hypoxia B) c. Newborn asphyxia C) b. Hypoglycemia D) a. Bradycardia

Children with special healthcare needs are particularly susceptible to which of the following medical problems? A) c. Lower extremity contractures B) a. Airway, breathing, and circulation C) b. Gastronomy tube complications D) d. Upper extremity contractures

During the assessment of a patient with a facial injury, you notice significant asymmetry including facial drooping on the affected side. Such facial drooping can be caused by: A) c. Laceration of the trigeminal nerve B) a. Laceration of the facial nerve C) d. Laceration of the vagus nerve D) b. Laceration of the hypoglossal nerve

Following a head-on motor vehicle crash, the unbelted 35-year-old male driver has the imprint of the steering wheel on his chest. He appears pale but tells you he feels fine. He should be evaluated: A) d. By his primary care physician in the next few days B) b. At the closest trauma center C) a. At a local hospital D) c. By EMTs or a paramedic and then released

Following successful resuscitation of a 32-week neonate delivered in cardiac arrest, an appropriate next step is to: A) b. Assume chest compressions caused a pneumothorax and perform chest decompression B) c. Check and maintain a normal body temperature C) a. Administer long-term paralytics D) d. Hand the neonate to the mother to hold during transport to the hospital

For the treatment of an adult electrical burn victim, fluids should be infused at which rate/volume? A) c. 2000 mL/hr B) b. 1000 mL/hr C) a. 500 mL/hr D) d. 3000 mL/hr

Gender is differentiated during the _____ month of gestation. A) a. Third B) c. Sixth C) b. Fifth D) d. Seventh

Hydrofluoric acid burn leads to which of the following? A) d. Hypomagnesemia B) c. Hypocalcemia C) a. Hypercalcemia D) b. Hypermagnesemia

Hypothermia is present when the neonate has which core body temperature? A) d. Less than 99° F B) a. Less than 95° F C) b. Less than 96° F D) c. Less than 97° F

If the structure identified in this scenario is severely injured, the greatest concern is: A) A. Pneumothorax B) B. Rapid and significant blood loss C) C. Spillage of digestive enzymes into the abdominal cavity D) D. Leakage of urine and uric acid into the abdominal cavity

If you determine the musculoskeletal injury is isolated, then you can perform a(n): A) d. Head-to-toe assessment B) a. Focused assessment C) b. Ongoing assessment D) c. Rapid trauma assessment

In a sprain, which of the following is injured? A) d. Tendon B) b. Ligament C) c. Muscle D) a. Bone

In providing care for the patient with ocular injuries, you should: A) b. Cover the injured eye with a loose dressing and leave the other eye uncovered B) a. Cover both eyes with a loose dressing to reduce eye movement C) d. Put tight dressings over the affected eye and loose dressing over the other eye D) c. Instruct the patient to blow his or her nose to reduce the pressure in the orbit

In which of the following areas would a wound have the highest risk for infection? A) b. Elbow B) c. Feet C) a. Cheek D) d. Knee

Incomplete closure of the hard and/or soft palate of the mouth is: A) a. Choanal atresia B) c. Cleft palate C) b. Cleft lip D) d. Pierre Robin syndrome

Increased pressure precedes muscle death in what soft tissue injury? A) d. Crush syndrome B) b. Compartment syndrome C) a. Compartment injury D) c. Crush injury

Inhalation exposure of phenol can cause methemoglobinemia. Which of the following is the most appropriate treatment for this condition? A) d. Sodium bicarbonate B) b. Methylene blue C) a. Activated charcoal D) c. Polyethylene glycol

Injury to the cerebellum may result in problems associated with: A) c. Heart rate or blood pressure B) b. Fine movement and balance C) d. Involuntary muscle movement D) a. Defecation or urination

Leakage of urine into the abdominal cavity will result in a painful presentation known as: A) A. Urethritis B) B. Peritonitis C) C. Incontinence D) D. Pyelonephritis

Methylprednisolone works in spinal cord injury by: A) c. Reducing cord bleeding through vasoconstriction B) d. Reducing swelling C) a. Prohibiting the release of histamines D) b. Protecting severed nerve endings

Of the following treatments, which is the most correct first treatment to be rendered to a patient with suspected internal bleeding? A) b. Provide IV access before any other care. B) a. Provide airway and ventilatory support. C) d. Provide supportive care, and do not transport. D) c. Provide only rapid transport.

On 1-minute evaluation of a newborn, you note the infant has blue arms and legs, a pink trunk, and a heart rate of 120 beats/min. He is crying loudly and moving all extremities. The patient sneezes when stimulated. This patient's Apgar score is: A) a. 7 B) c. 9 C) b. 8 D) d. 10

Paramedics are treating a patient who fell through a glass coffee table. The patient presents with multiple lacerations and avulsions to the lower leg. What is the most appropriate treatment for the avulsed areas? A) a. Cover the avulsed areas with moist, sterile dressing. B) d. Return tissue to its normal position and cover the avulsed areas. C) b. Irrigate and apply ice to the avulsed areas. D) c. Irrigate and cover the avulsed areas with dry dressing.

Primarily, what causes cardiac arrest in newborns? A) c. Dehydration B) d. Hypoxia C) a. Bradycardia D) b. Cardiac problems

Prolonged expiration suggests what type of airway obstruction? A) a. Complete B) b. Lower C) d. Upper D) c. Partial

Removing a patient's helmet is controversial. Which of the following considerations must be present to remove the patient's helmet? A) a. Airway accessible with no restrictions B) c. Limited or no access to the airway C) d. Little or no movement of the head D) b. Immobilization with helmet in place

Secondary apnea means that the neonate: A) b. Has an apneic event that occurs 24 hours after birth B) d. Has gasping respirations that become weaker and then stop, and does not respond to stimulation C) c. Stops breathing after resuscitation, but begins again spontaneously D) a. Has a self-limited condition that is common after birth

Serious apnea is defined as a cessation of breathing for longer than how many seconds? A) a. 10 B) b. 20 C) c. 30 D) d. 40

Small children who have larger heads and occipital regions must have what elevated to keep the head/airway in the neutral position? A) a. Chest B) d. Torso C) b. Head D) c. Legs

Sprains are categorized according to the: A) b. Number of cartilages damaged B) a. Extent of ligament damage C) c. Type of tendons damaged D) d. Type of tissue involved

The best definition of shock is: A) A. Dilation of blood vessels or inadequate blood volume B) B. Dilation of blood vessels, pump failure, or inadequate blood volume C) C. Pelvis fracture D) D. Pump failure

The blood loss of 15% to 30% is associated with the ________ stage of shock and is classified as class _____. A) A. Early/1 B) B. Early/2 C) C. Late/3 D) D. Irreversible/4

The foramen magnum is best described as: A) b. An opening in the skull for the optic nerves B) d. The opening in the base of the skull C) c. The dome of the top of the cranium D) a. An opening in the skull for the acoustic nerves

The management and treatment of a patient in any stage of shock must be directed to: A) c. Maintaining mental status B) d. Managing oxygenation and perfusion of organs C) b. Maintaining a pulse pressure of at least 30 mm Hg D) a. Increasing systolic blood pressure

The most common causes of spinal cord trauma are: A) c. Penetrating injuries caused by violent acts B) b. Motor vehicle crashes C) a. Falls D) d. Sports injuries

The patient is a 22-year-old woman complaining of the sudden onset of blurred vision in her right eye. She also states that she is seeing flashes of light. Based on her symptoms, the paramedic suspects: A) c. Hyphema B) d. Retinal detachment C) b. Eye infection D) a. Corneal abrasion

The patient sustained an injury to the skull resulting in multiple bone fragments. This is a _________________ skull fracture. A) A. Basilar B) B. Comminuted C) C. Compound D) D. Depressed

The patient was involved in an motor vehicle collision and is showing signs and symptoms of internal bleeding. The best initial treatment for this patient is: A) A. Bilateral IVs and rapidly infusing fluids B) B. High-flow oxygen C) C. Placing the patient supine with the legs elevated D) D. Using the PASG, all compartments

The pattern caused when lightning travels across the skin is called: A) A. Distributive shock B) B. Ferning or Lichtenberg flowers C) C. Partial-thickness burn D) D. Superficial burn

The proper steps to control external hemorrhage are to: A) A. Add a tourniquet immediately. B) B. Apply a direct pressure dressing, add more dressing if hemorrhage is not controlled, and apply a tourniquet. C) C. Apply a direct pressure dressing, add more dressing if hemorrhage is not controlled, raise the extremity and apply pressure point, and apply a tourniquet. D) D. Apply direct pressure, apply pressure point, and never apply a tourniquet.

The protrusion of abdominal organs into the umbilical cord is known as which of the following? A) Fistula B) Omphocele C) Meningocele D) Choanal atresia

The purpose of the eustachian tube is to: A) c. Promote bacterial growth in the ear for homeostasis B) b. Equalize pressure between air outside the ear and air within the middle ear C) a. Drain cerumen from the ear canal to reduce infection D) d. Promote equilibrium and balance to prevent falling

The stagnant phase of shock is also known as: A) A. Compensated shock B) B. Decompensated shock C) C. Dissociative shock D) D. Irreversible shock

The three classic signs of cardiac tamponade include JVD, muffled heart sounds, and: A) A. Hypertension B) B. Hypotension C) C. Pulmonary embolism D) D. Tension pneumothorax

The withdrawal symptoms of neonatal abstinence syndrome usually occur within how many hours of birth? A) c. 24 to 36 B) d. 48 to 72 C) a. 4 to 6 D) b. 4 to 9

These burns have a dry appearance, and the patient is less likely to be able to discern sharp from dull touch. A) d. Third degree B) c. Superficial partial thickness C) a. Deep partial thickness D) b. First degree

This chemical is an alkali most commonly found in powder form that when combined with water creates a chemical reaction. A) A. Hydrogen fluoride B) B. Lime C) C. Phenol D) D. Phosphorus

Thoracic injuries account for what percentage of trauma-related deaths? A) d. 90% B) a. 25% C) c. 75% D) b. 50%

Vasoconstriction that allows the clotting process to stop continues for how long? A) d. Up to 60 minutes B) c. Up to 30 minutes C) a. Up to 10 minutes D) b. Up to 20 minutes

Water and sodium leaking into cells, potassium leaking out of cells, and cellular swelling typically occur in which phase of shock? A) d. Chemical B) c. Irreversible C) a. Early D) b. Late

What are the most appropriate actions to deal with a wound dressing that has become saturated with blood? A) b. Place the saturated dressing in a biohazard bag. B) a. Add additional dressing material over the saturated dressing. C) d. Remove the saturated dressing to apply new dressing material. D) c. Reconsider the use of direct pressure to the wound.

What borders the abdomen superiorly? A) A. Abdominal wall B) B. Diaphragm C) C. Skeletal structures D) D. Vertebral column

What disease is characterized by inflammation and infection of the lower airway and lungs caused by a viral, bacterial, parasitic, or fungal organism? A) b. Bronchiolitis B) d. Pneumonia C) a. Asthma D) c. Croup

What does vomiting in a newborn who is 18 hours old suggest? A) b. Haemophilus influenzae B) a. Gastrointestinal obstruction C) c. Hypoglycemia D) d. Increased intracranial pressure

What happens as shock progresses from early to late? A) d. The precapillary sphincters relax, and the postcapillary sphincters remain open. B) c. The precapillary sphincters relax, and the postcapillary sphincters remain closed. C) b. The precapillary sphincters close, and the postcapillary sphincters remain open. D) a. The precapillary sphincters close, and the postcapillary sphincters remain closed.

What is an appropriate endotracheal tube size for a newborn weighing less than 1000 g? A) d. 3.5 mm B) b. 2.5 mm C) c. 3.0 mm D) a. 2.0 mm

What is an appropriate endotracheal tube size for a newborn weighing more than 3000 g? A) a. 2.0 to 3.0 mm B) d. 3.5 to 4.0 mm C) c. 3.0 to 4.0 mm D) b. 2.5 to 3.5 mm

What is the appropriate depth of compressions in a newborn? A) b. 1 to 2 inches B) d. one-third the depth of the chest C) a. {1/2} to 1 inch D) c. one-fourth the depth of the chest

What is the appropriate rate at which to ventilate a newborn? A) a. 10 to 20 breaths/min B) c. 40 to 60 breaths/min C) d. 60 to 80 breaths/min D) b. 20 to 40 breaths/min

What is the condition called when the spinal cord is intact, but one or more vertebrae fail to close in the lumbosacral area? A) a. Hydrocephalus B) d. Spina bifida occulta C) b. Meningomyelocele D) c. Omphalocele

What is the electrical current in a residential home? A) c. 100 Hz B) b. 60 Hz C) a. 40 Hz D) d. 500 Hz

What is the initial dose of epinephrine for a neonate weighing 5.5 lb? A) b. 0.25 mg B) c. 0.055 mg C) a. 0.025 mg D) d. 0.55 mg

What is the most commonly used narcotic for the control of acute burn pain? A) b. Meperidine B) c. Morphine sulfate C) a. Fentanyl D) d. Versed

What is the name of the congenital anomalies that involve the incomplete development of the brain, spinal cord, or their protective coverings? A) d. Omphalocele B) c. Neural tube defect C) b. Diaphragmatic hernia D) a. Choanal atresia

What pediatric dysrhythmia can be caused by suctioning, increased intracranial pressure, hypothermia, hyperkalemia, and ingestion of calcium channel blockers? A) b. Atrial flutter B) c. Secondary bradycardia C) a. Atrial fibrillation D) d. Sinus tachycardia

What sign, indicative of a ruptured spleen, is described as ecchymosis around the umbilicus? A) A. Battle's sign B) B. Cullen's sign C) C. Grey-Turner's sign D) D. Kehr's sign

What size bag-mask device is most appropriate for a 13-year-old adolescent? A) c. 1000 mL B) d. 1200 mL C) a. 450 mL D) b. 500 mL

What term is associated with cuts, bruises, and scars attributed to the child's fragile skin? A) d. von Willebrand's disease B) a. Ehlers-Danlos syndrome C) b. Hemophilia D) c. Mongolian spots

What type of burn has a moist and pink appearance, is painful, and is discernable by the patient as a specific shape, as opposed to dull pain? A) b. First degree B) c. Superficial partial thickness C) a. Deep partial thickness D) d. Third degree

What type of fracture typically happens in children because their bones are softer? A) A. Comminuted B) B. Greenstick C) C. Oblique D) D. Transverse

What type of shock can be caused by carbon monoxide poisoning? A) A. Cardiogenic B) B. Dissociative C) C. Distributive D) D. Obstructive

What would you expect to find during your assessment of a patient you believe may have internal abdominal traumatic injuries? A) a. A soft abdomen B) d. Tenderness C) c. Obvious external blood loss D) b. Early development of a rigid and distended abdomen

When a joint is forced beyond its normal range of motion and results in excessive stretching of the ligaments that form the joint, this is called: A) A. A hematoma B) B. A sprain C) C. A strain D) D. Tendonitis

When arriving on scene of an EMS call, what is the first action you should take? A) b. Primary survey B) c. Scene size-up C) d. Secondary survey D) a. Body substance isolation

When assessing the skin surface on a pediatric, you grasp the skin of the abdomen between your thumb and index finger, pull the skin taut and quickly release, and notice 'tenting.' This is a sign of: A) A. Abdominal trauma B) B. Dehydration C) C. Evisceration D) D. Meningitis

When should you assess circulation when splinting an elbow? A) A. After the splint B) B. Before and after the splint C) C. Before the splint D) D. Only check if there is cardiovascular compromise

When treating a patient with an injury to the sternum following a blow to the chest, you should be concerned that the patient may have an associated: A) a. Diaphragmatic rupture B) c. Myocardial contusion C) d. Open pneumothorax D) b. Laceration of the spleen

When using a bulb syringe to suction the secretions of an infant just delivered, which of the following should be suctioned first? A) d. Trachea B) a. Mouth C) b. Nose D) c. Pharynx

Which abdominal organ would most likely be affected by the primary phase of a blast injury? A) A. Kidney B) B. Large intestine C) C. Liver D) D. Spleen

Which area is most commonly affected in a patient who has epiglottitis? A) b. Below the trachea B) d. Supraglottic C) a. Below the glottis D) c. Subglottic

Which disease is described as edema below the area of the glottis, with inflamed mucosa that is associated with inspiratory stridor? A) a. Asthma B) c. Croup C) b. Bacterial tracheitis D) d. Epiglottitis

Which laryngoscope blade is most commonly used in a neonate? A) a. 0 curved B) b. 0 straight C) d. 2 straight D) c. 2 curved

Which layer of the skin is a portal for vessels and nerves and acts as insulation? A) c. Fascia B) d. Subcutaneous C) b. Epidermis D) a. Dermis

Which of the following assessment findings would be seen in a patient with pericardial tamponade? A) b. Hypertension B) d. Muffled heart tones C) c. Increased heart tones D) a. Decreased lung sounds

Which of the following best describes the term hyphema? A) d. Open injury to the globe of the eye with seepage of vitreous fluid B) b. Blunt trauma to the eye with bleeding into the anterior chamber C) a. Blunt trauma to the eye with avulsion of the cornea D) c. Open injury to the eye with hemorrhage into the posterior chamber

Which of the following head injuries is the most common cause of death in sports-related head injuries? A) b. Acute epidural B) d. Acute subdural C) a. Acute arachnoid D) c. Acute subarachnoid

Which of the following injuries can be caused by a shearing mechanism following abdominal trauma? A) a. Bladder perforation B) d. Liver injury C) c. Kidney tearing at the ligamentum teres D) b. Intestinal tearing along the aorta

Which of the following injuries may result in death if left untreated in the prehospital setting? A) d. Rib fracture B) a. Cardiac tamponade C) b. Contusion D) c. Hematoma

Which of the following is a cause of external bleeding? A) d. Splenic rupture B) c. Lower gastrointestinal bleeding C) b. Intracranial bleeding D) a. Bowel perforation

Which of the following is a function of the placenta? A) b. Transport of fertilized egg B) d. Exchanges nutrients and wastes for the fetus C) c. Transfer of hormones D) a. Elimination of hormones

Which of the following is a primary pharmacologic intervention in the treatment of the pediatric seizure? A) d. Succinimides B) c. Benzodiazepines C) a. Amphetamines D) b. Barbiturates

Which of the following is considered a form of closed soft tissue trauma? A) c. Pneumothorax B) b. Contusion C) d. Traumatic asphyxia D) a. Avulsion

Which of the following is considered a normal heart rate for an infant (1 to 12 months old)? A) b. 80 to 140 beats/min B) d. 100 to 160 beats/min C) a. 70 to 120 beats/min D) c. 90 to 150 beats/min

Which of the following is considered to be an antepartum risk factor? A) c. Prolapsed cord B) a. Multiple gestation C) b. Placenta previa D) d. Uterine tetany

Which of the following is considered to be an open soft tissue trauma? A) b. Hematoma B) c. Sucking chest wound C) d. Traumatic asphyxia D) a. Contusion

Which of the following is the final process of wound healing? A) b. Potentiation B) d. Remodeling C) c. Reconstruction D) a. Inflammation

Which of the following is the most common type of skull fracture in a child? A) c. Displaced B) d. Linear C) b. Depressed D) a. Comminuted

Which of the following is true about mechanism of abdominal injury? A) A. Shootings and stabbings are the primary cause of abdominal injury. B) B. Motor vehicle trauma is involved in as much as 75% of blunt abdominal trauma. C) C. Penetrating abdominal trauma has a higher mortality rate than blunt abdominal trauma. D) D. More than 75% of patients with penetrating abdominal trauma exsanguinate on scene.

Which of the following most accurately defines epiglottitis? A) A. Bacterial infection, affects the lower airway, can occur at any age B) B. Bacterial infection, affects the upper airway, can occur at any age C) C. Viral infection, affects the lower airway, affects patients younger than 3 years old D) D. Viral infection, affects the upper airway, affects patients older than7 years of age

Which of the following signs are associated with secondary apnea? A) Pink skin, increasing heart rate, normal blood pressure B) Cyanotic skin, falling heart rate, falling blood pressure C) Pink skin, falling heart rate, falling blood pressure D) Cyanotic skin, increasing heart rate, normal blood pressure

Which of the following statements most accurately describes how a paramedic should obtain intravenous (IV) access for the patient with a large blood loss? A) b. One small-gauge IV is needed. B) d. Patient transport should not be delayed to start an IV line. C) a. No IV access is needed. D) c. Patient transport should be delayed for IV access.

Which of the following statements most accurately describes the proper treatment to be rendered to a patient with internal bleeding? A) a. Provide rapid transport to any care facility. B) b. Provide rapid transport to the nearest facility with emergency surgical capability. C) d. Transport to the facility that the patient requests. D) c. Transport only after establishing IV access.

Which procedure can be used to minimize gastric distention? A) c. Positive-pressure ventilation B) a. Cricoid pressure C) d. Suctioning D) b. Intubation

Which radioactive particles are the most dangerous of all particles? A) a. Alpha B) c. Gamma C) d. Roentgens D) b. Beta

Which seizures are characterized by rhythmic contractions alternating with the relaxation of muscle groups? A) d. Tonic B) a. Clonic C) b. Multifocal D) c. Myoclonic

Which seizures are characterized by stiffening and extension of the limbs? A) b. Multifocal B) d. Tonic C) a. Clonic D) c. Myoclonic

While assessing a 29-year-old male patient who was blown to the ground during an explosion at a paper plant, you palpate subcutaneous emphysema across the anterior chest and over the right shoulder. He is in obvious respiratory distress and speaking four to five words at a time. In addition to high-flow oxygen, appropriate care for this patient includes: A) d. Routine transport to the local community hospital B) b. Rapid transport to the closest trauma center C) a. Bilateral chest decompression, and then routine transport to the trauma center D) c. Rapid transport to the local community hospital

While evaluating a young male who was in a motor vehicle crash, you notice that he has weakness in his left leg. He denies any numbness or tingling in either lower extremity. He has complaints of low back pain. Which of the following should be part of your field impression? A) c. Psychosomatic complaint B) d. Spinal cord injury C) b. Contusion D) a. Concussion

With larger burns, the paramedic can expect to administer how much morphine in the first hour of care? A) c. 20 to 25 mg B) b. 10 to 20 mg C) d. 25 to 35 mg D) a. 5 to 10 mg

Within the burn community, which percentage of all burns may be cared for in the outpatient setting? A) b. 50% B) d. 90% C) a. 30% D) c. 60%

Within which layer are the sebaceous glands? A) b. Epidermis B) a. Dermis C) d. Stratum corneum D) c. Germinativum

You are assessing a 12-month-old infant who is the victim of suffocation. He has a tiny pinpoint rash on the upper area of the neck and face. What is the correct name for this particular rash? A) c. Purpura B) b. Petechiae C) a. Macular D) d. Vesicular

You are assessing a 2-year-old. Which of the following is considered a normal heart rate for this patient? A) a. 70 to 120 beats/min B) c. 90 to 150 beats/min C) d. 100 to 160 beats/min D) b. 80 to 140 beats/min

You are called to the ski patrol headquarters of a ski resort because there has been a skiing accident. When you arrive, you find a 23-year-old male patient immobilized and in obvious pain. He reportedly lost control on the mogul run and tumbled down the side, eventually striking a tree. During your assessment, his abdomen is slightly rigid with rebound tenderness. There is no abdominal bruising; it just appears slightly red. His pulse rate is 82 beats/min, his respiratory rate is 18 breaths/min, his blood pressure is 136/72 mm Hg, his skin is normal, and he rates his pain as a 10 out of 10. Based on these findings, you suspect: A) b. Pelvis fracture B) c. Potential intestinal rupture C) a. Massive internal hemorrhage D) d. Spleen rupture

You are dispatched to a day-care center to treat a 3-year-old girl who has placed a small toy in her left nostril. She is crying but otherwise in no distress. You can see the distal end of the toy inside her nose. To solve this problem, you should: A) a. Deliver back blows and chest thrusts until the object is freed or you arrive at the hospital B) c. Leave the object in place unless the airway is compromised C) d. Remove the object with sterile tweezers or pediatric Magill forceps D) b. Gently infuse petroleum jelly into the nose and instruct the patient to blow forcefully

You are evaluating a 16-year-old male patient who was playing hockey with his friends at an outdoor skating rink when he slammed against his hockey stick, driving the handle deep into his epigastric region. He believes he fell on top of the stick and it caught under his ribs. He is also in obvious respiratory distress, and his abdomen appears slightly sunken; he seems unable to take a full breath. Which of the following interventions is contraindicated in this patient? A) d. Performing rapid sequence intubation B) c. Inflating a pneumatic antishock garment C) a. Performing bag-mask ventilations without an ETT in place D) b. Having the patient lie supine

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare for a rapid extrication, you are worried that she may have experienced: A) b. Femoral artery laceration B) a. Abruptio placentae C) c. Liver laceration D) d. Premature labor

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare to extricate the patient, you advise everyone on scene that you are going to immobilize the patient: A) d. With padding underneath her right hip and pelvis only to elevate the right side of her pelvis B) b. On her left side on the backboard with padding in the spaces C) a. In a traditional manner D) c. With padding under her feet and legs supine on the backboard

You are evaluating a 45-year-old male patient who was shot in the center of the chest. While removing his clothing, you notice that his legs seem dusky and cold; however, your partner tells you his heart rate is 123 beats/min and his blood pressure is 134/88 mm Hg. The patient is complaining of severe pain inside his back. You suspect this patient has: A) a. A hemopneumothorax B) b. A ruptured aorta C) c. A spinal cord injury D) d. An occlusion in the femoral arteries

You are evaluating an extremity fracture of the lower arm. You find a distal pulse; however, your patient states there is numbness below the sight of the injury. Using the 6 P's of assessment, you state this is: A) d. Pressure B) c. Paresthesia C) a. Pallor D) b. Paralysis

You are managing a 34-year-old male patient who was the unrestrained driver of a pickup truck that rolled over at approximately 55 mph. During your trauma assessment, you find him awake but confused and anxious. He is speaking two to three words at a time. There is no obvious head trauma, moderate JVD, crepitus on the left lateral chest wall, and decreased breath sounds on the left side. There is tenderness in the upper right abdominal quadrant, and the rest of his exam reveals only superficial lacerations. His blood pressure is 86/40 mm Hg, his heart rate is 112 beats/min, and his respiratory rate is 30 breaths/min. Immediate care for this patient includes: A) d. Pericardiocentesis for cardiac tamponade B) c. Needle chest decompression for a tension pneumothorax C) a. IV fluids, blood ideally, for hypovolemia D) b. Use of a PASG and rapid sequence intubation

You are managing an unresponsive 50-year-old female patient who was in a car-versus-tree motor vehicle crash. She is in the driver's seat wearing a chest strap but no waist belt. Her pulse rate is 134 beats/min, her respiratory rate is 36 breaths/min, and her blood pressure is 76/52 mm Hg. The imprint of her seat belt is clearly defined across her chest and abdomen, and her abdomen is rigid and bruising. You suspect that your patient may have: A) c. A tension pneumothorax B) d. Ruptured a blood vessel C) a. A cardiac tamponade D) b. A ruptured spleen

You are on scene to treat a 29-year-old female who was thrown from a vehicle during an accident. You notice multiple deformities in her extremities, and she has a rigid abdomen. Initial vital signs indicate a blood pressure 110/80 mm Hg and a heart rate of 114 beats/min. Which of the following is an accurate statement regarding her condition? A) a. Death B) b. Early (compensated) shock C) c. Irreversible shock D) d. Late (decompensated) shock

You are on scene to treat a 6-year-old patient who is in severe respiratory distress. The patient is lethargic with urticaria, stridor, retractions, and hypotension. What is the most appropriate primary pharmacologic intervention? A) d. Methylprednisolone B) c. Epinephrine C) b. Diphenhydramine D) a. Albuterol

You are on scene with a 19-year-old male patient who has been in an auto accident. You estimate that he has lost approximately 1000 mL of blood. Which of the following is an accurate statement regarding this patient's condition? A) a. Death is imminent. B) c. This amount of blood loss is well tolerated. C) d. This is considerable hemorrhage. D) b. The location of the hemorrhage determines severity.

You are on scene with a 24-year-old female who states she is having terrible vaginal bleeding. Which of the following would be the best question to ask her during the assessment? A) d. How many sexual partners have you had? B) c. How many pads have you used today? C) b. How long have you been menstruating? D) a. Has this happened before?

You are on scene with a 32-year-old male who sustained a gunshot wound to the abdomen. Vital signs indicate a heart rate of 142 beats/min, a blood pressure of 70 mm Hg systolic, and a respiratory rate of 26 breaths/min. You attempt to gain intravenous access multiple times. Which of the following is the next appropriate initial treatment? A) d. Provide oral hydration. B) a. Attempt IO access. C) b. Consider using a PASG. D) c. Hold IV fluids.

You are on scene with a 77-year-old female in a nursing home. She feels warm to the touch. She has a blood pressure of 68 mm Hg by palpation and a heart rate of 110 beats/min. Which of the following is the cause of the patient's hypotension? A) d. Virus B) a. Bacteria C) b. Heart failure D) c. Spinal cord injury

You are on scene with a patient who was in a severe motor vehicle crash. The patient is pulseless and apneic. The patient has mottling of the skin, cyanosis of the face, distended neck veins, and distant heart tone. Which of the following conditions is most likely associated with these assessment findings? A) c. Pneumothorax B) b. Myocardial rupture C) d. Pulmonary contusion D) a. Myocardial contusion

You are on scene with a pregnant patient who states that she feels the need to push. The patient is 37 weeks' pregnant. You check for crowning and see the umbilical cord is presenting. Which of the following is the most appropriate action? A) b. Place the patient in the supine position. B) a. Place the patient in the knee-to-chest position. C) c. Prepare for delivery. D) d. Push the cord back in.

You are responding to a call to assist a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP, 174/104 mm Hg; P, 84 beats/min; and R, 20 breaths/min. If this patient developed seizures or coma, the condition would be called: A) b. Essential hypertension B) a. Eclampsia C) d. Preeclampsia D) c. Gestational hypertension

You are treating a 12-month-old patient who is febrile and lethargic, has grunting respirations, and is tachypneic at a rate of 52 breaths/min. Scattered crackles are heard throughout all lobes, with a significant decrease in the right lower lobe. What would be the most appropriate primary intervention? A) a. Administer albuterol. B) b. Administer bag-mask ventilation. C) c. Administer epinephrine. D) d. Administer O2 via simple face mask.

You are treating a patient who presents with signs of shock. No trauma is noted, and the only pertinent history is a leg fracture 6 days earlier. What type of shock do you suspect? A) b. Hypovolemic shock B) d. Obstructive shock C) a. Dissociative shock D) c. Neurogenic shock

You are treating an apneic neonate with a heart rate of 110 beats/min. Her mother is an opium addict. If apnea persists, what should you administer? A) b. Epinephrine B) d. Naloxone C) a. Dextrose D) c. Flumazenil

You are treating an intubated neonate who is in postcardiac arrest. The infant develops a sudden onset of respiratory distress, cyanosis, and bradycardia. There are no breath sounds on the right side. What is the most appropriate cause for these assessment findings? A) a. Equipment failure B) c. Pneumothorax C) b. Hypoxia D) d. Tube dislodgement

You arrive at the scene of a motor vehicle accident. Your patient, who is obviously late in her pregnancy, is still in the driver's seat. She states that she was wearing her seat belt although it is not currently in place. As you expose your patient, you find she has abrasions from the seat belt in the area of her shoulder and across her abdomen approximately 1 inch below her umbilicus. What can you infer from these markings? A) A. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at a high risk for preterm labor and delivery. B) B. The lap belt portion of the seat belt was placed too high. This potential trauma places your patient at risk of abruptio placenta and uterine rupture. C) C. Your patient was indeed wearing her seat belt and was appropriately secured. D) D. Your patient was wearing her seat belt, and although the placement was not appropriate, the large amount of abdominal fat protected her and her fetus from damage.

You arrive at the scene of a two-vehicle crash. Your patient, the unrestrained driver of a vehicle sustaining significant lateral impact, is complaining of back pain and numbness and tingling to the lower body and legs, primarily below the umbilicus. As you continue to treat this patient, he becomes progressively worse and now has no feeling below the nipple line. The fact that the patient is becoming progressively worse leads you to believe that: A) b. A tertiary injury is causing paralysis B) c. Spinal cord damage has progressed with secondary injury C) a. A large area of the spinal cord was injured with the primary injury D) d. The patient is probably under the influence of drugs or alcohol

You arrive on scene to treat a 42-year-old male who has been hit by a car while jogging. He is complaining of severe chest pain. You notice that he has absent breath sounds on the right, and his trachea is deviated toward the left. Which of the following is the most important initial management? A) d. Supplemental oxygen B) c. Needle decompression of the right chest wall C) a. Bag-mask-assisted ventilations D) b. Chest compressions

You arrive on scene to treat a patient who states that she miscarried yesterday. Her bleeding is getting worse. She states that she is weak and is passing large clots. Which of the following is the best treatment option? A) d. Provide D50. B) a. Provide oxygen and treat for shock. C) c. Place her in the left lateral recumbent position. D) b. Hold the IV until hospital contact is made.

You respond to a patient complaining of shoulder pain after falling from a bicycle and landing on his outstretched hand. As a paramedic, you know this type of MOI is classified as: A) a. Direct B) b. Indirect C) c. Penetrating D) d. Twisting

Your crew is called to a local park for a 34-year-old male who injured his shoulder while playing softball. There is swelling at the left shoulder where the clavicle meets the proximal humerus. If this is the patient's only injury, what device should you use for immobilization? A) a. Long backboard B) d. Sling and swathe C) c. Short backboard D) b. Rigid splint

Your patient is a 17-year-old male who is complaining of left-sided chest pain after being tackled in a football game. Examination reveals pain and crepitus around the 10th and 11th ribs on the left side. Which of the following may be present as an underlying injury? A) d. Mesenteric injury B) c. Injury to the spleen C) b. Injury to the liver D) a. Diaphragmatic rupture

Your patient is in labor at 34 weeks' gestation. As she is pushing, she states that the baby is coming. You notice a cord protruding from the vagina. You should: A) b. Deliver the infant as quickly as possible B) c. Place the mother in the knee-chest position C) a. Cut and clamp the cord D) d. Replace the cord into the vagina

Which of the following best describes medications that may be used in the treatment of crush injury? A) b. Sodium bicarbonate, calcium, propranolol, albuterol B) a. Albuterol, insulin, glucose, sodium bicarbonate, morphine b. Insulin, glucose, naloxone, sodium bicarbonate, albuterol C) c. Sodium bicarbonate, insulin, glucose, calcium, naloxone

B) a. Albuterol, insulin, glucose, sodium bicarbonate, morphine

The initial treatment for organophosphate poisoning would include: A) b. Diphenhydramine B) a. Atropine C) d. Naloxone D) c. Furosemide

B) a. Atropine

Your crew is called to the scene of a sports injury at a local park. A 43-year-old female injured her ankle while sliding into home base. There is gross deformity at the joint that appears consistent with a severe dislocation. She is in a tremendous amount of pain and has extreme difficulty when trying to wiggle her toes. Her distal pulse is absent. Proper intervention would include analgesics and: A) b. Attempted reduction by pulling on the toes B) a. Attempted reduction by pulling on the talus C) d. Splinting the injury in the position found, using a pillow or blanket D) c. Attempted reduction by taking the ankle through its full range of motion

B) a. Attempted reduction by pulling on the talus

The most important consideration when rewarming frostbite is to: A) c. Provide consistent, regular rubbing B) a. Avoid refreezing C) b. Keep water used for immersion rewarming at a constant temperature D) d. Rewarm as quickly as possible

B) a. Avoid refreezing

Diving illnesses represent a great example of why history taking is so critical, because decompression illness can easily be confused with: A) c. Hypoglycemia B) a. Cerebrovascular accident C) b. Heat stroke D) d. Hypothermia

B) a. Cerebrovascular accident

When responding to an incident on a farm, the paramedic must be aware of a number of hazards including: A) b. Chemicals, toxins, confined spaces, animal diseases, and hand tools B) a. Chemicals, toxic environments, confined spaces, animal diseases, and machinery C) d. Chemicals, toxins, unconfined spaces, animal diseases, and machinery D) c. Chemicals, toxins, confined spaces, animal husbandry, and machinery

B) a. Chemicals, toxic environments, confined spaces, animal diseases, and machinery

A break that involves several breaks in the bone, causing bone fragment damage, is called a(n): A) d. Spiral fracture B) a. Comminuted fracture C) c. Open fracture D) b. Greenstick fracture

B) a. Comminuted fracture

A young girl is having difficulty breathing after playing outside in the barnyard next to the animals and silo. She is coughing, gasping for air, and dizzy, and she has started to wheeze. Which of the following is the most appropriate treatment? A) c. Low-flow oxygen, bronchodilator, intravenous access, atropine B) a. High-flow oxygen, bronchodilator, prompt transport C) d. Oxygen therapy, atropine, bronchodilator, prompt transport D) b. High-flow oxygen, IV fluid challenge, atropine, 2-PAM

B) a. High-flow oxygen, bronchodilator, prompt transport

Regarding a wilderness EMS and an incident command system (ICS), which statement best describes the relationship? A) c. ICS terms are irrelevant to wilderness EMS, as teams are not trained to that level of sophisticated communication. B) a. ICS terminology and roles should be implemented to avoid confusion. C) d. ICS terms should be used unless there is a local term that is more appropriate, as the rescuers are all local. D) b. ICS terms and definitions should not be used, as they may cause confusion with other non-EMS agencies.

B) a. ICS terminology and roles should be implemented to avoid confusion.

As a rule, fractures and dislocated joints should be: A) b. Immobilized with a soft splint B) a. Immobilized in anatomic position and in a position of comfort C) c. Reduced in the field D) d. Repositioned in the field

B) a. Immobilized in anatomic position and in a position of comfort

Which of the following statements best describes the issue of cervical immobilization? A) b. In wilderness EMS, many organizations do not allow teams to 'clear' c-spine unless extrication is over flat terrain. B) a. In wilderness EMS, many organizations allow teams to 'clear' c-spine to simplify extrication. C) d. In wilderness EMS, many providers still mandate full c-spine because of the terrain needed to traverse. D) c. In wilderness EMS, many providers allow teams to 'clear' c-spine only if there is an advanced level provider present.

B) a. In wilderness EMS, many organizations allow teams to 'clear' c-spine to simplify extrication.

Which hollow organ is most commonly injured as a result of blunt force trauma? A) d. Uterus B) a. Small intestine C) b. Spleen D) c. Stomach

B) a. Small intestine

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is awake and anxious, in the tripod position, feels warm to the touch, and is coughing. While obtaining his history, you learn that he was the victim of a near-drowning event 4 days earlier and had required a brief period of positive-pressure ventilations. What do you suspect this patient has developed? A) d. Respiratory system failure B) b. Adult respiratory distress syndrome C) a. Acute asthma D) c. Congestive heart failure

B) b. Adult respiratory distress syndrome

An elderly man complains of severe pain in his upper thigh and hip after a fall. The leg on the affected side is shortened and internally rotated. Which action would be appropriate? A) d. Pad behind the knee for comfort. B) b. Apply PASG and inflate leg segments. C) c. Attempt to reduce the dislocation. D) a. Apply a traction splint.

B) b. Apply PASG and inflate leg segments.

You respond to a patient complaining of shoulder pain after falling from a bicycle and landing on his outstretched hand. As a paramedic, you know this type of MOI is classified as: A) d. Twisting B) b. Indirect C) c. Penetrating D) a. Direct

B) b. Indirect

In a sprain, which of the following is injured? A) d. Tendon B) b. Ligament C) c. Muscle D) a. Bone

B) b. Ligament

A patient has been trapped under a heavy piece of farm equipment that covered his upper abdomen, pelvis, and both legs for almost 90 minutes. The patient is complaining of severe respiratory distress. What is the paramedic's best response? A) c. Provide oxygen by nonrebreather mask at 15 L/min. B) b. Partially lift the equipment to allow chest expansion. C) d. Rapidly extricate and transport the patient. D) a. Immediately intubate and ventilate the patient.

B) b. Partially lift the equipment to allow chest expansion.

Which of the following is correct regarding the use of traction splints? A) d. Traction splints are used to reduce open, midshaft long-bone fractures. B) b. Traction splints are used for isolated midshaft femur fractures. C) c. Traction splints are used for proximal femur fractures or hip dislocations. D) a. Traction splints are used for dislocations of the knee with associated femur fracture.

B) b. Traction splints are used for isolated midshaft femur fractures.

Heat stroke occurs at: A) d. 110° F B) c. 105° F C) a. 100° F D) b. 102° F

B) c. 105° F

Which of the following best describes a confined space? A) b. A space large enough for a person to enter but not turn around B) c. A space large enough to enter but not for continuous occupancy C) a. A space large enough for a person to enter but not exit D) d. A space too small to enter or permit occupancy by a person

B) c. A space large enough to enter but not for continuous occupancy

Immobilization of an injured femur requires: A) d. Only one rescuer B) c. At least two rescuers C) b. At least three rescuers D) a. A four-person crew

B) c. At least two rescuers

A patient complains that his forearm is 'burning,' his muscles feel painful to extend, and his fingers feel cold to the touch. He states that he was trapped for a short time while operating his tractor and thinks he pulled the muscle when freeing himself. What would be the most appropriate cause for his symptoms? A) b. Bruised muscle in the left forearm B) c. Compartment syndrome C) a. Acute tendonitis of the arm and hand D) d. Overextension of the left forearm

B) c. Compartment syndrome

Which heat-dissipation mechanism is most significantly impaired in a dehydrated patient? A) a. Conduction B) c. Evaporation C) d. Radiation D) b. Convection

B) c. Evaporation

Which of the following best describes a potential mechanism of injury for an incident involving a conventional silo? A) b. External wall collapse, falling off the outside ladder, high oxygen levels inside the silo B) c. Falls inside the silo, falling off the outside ladder, entrapment by the unloader C) a. Entrapment by the silo unloader, falls inside the silo, oxygen toxicity D) d. Hypothermic oxygen load, falling off the outside latter, entrapment in the silo chute

B) c. Falls inside the silo, falling off the outside ladder, entrapment by the unloader

A bone break common in children, in which the bone is bent but only broken on the outside of the bend, is called a: A) d. Stress fracture B) c. Greenstick fracture C) b. Comminuted fracture D) a. Closed fracture

B) c. Greenstick fracture

You are managing a 36-year-old female patient who has developed a severe headache and mental status changes, and has begun vomiting regularly while attempting to climb Mount McKinley. You are awaiting her arrival at the 8000-foot base camp. What problem do you suspect this patient has, and how do you want to treat it? A) d. High-altitude cerebral edema; oxygen, diuretics, and a nasogastric tube B) c. High-altitude cerebral edema; oxygen and airway protection with intubation C) b. Acute mountain sickness; oxygen and dexamethasone D) a. Acute mountain sickness; oxygen and continue descent

B) c. High-altitude cerebral edema; oxygen and airway protection with intubation

The body's attempt to maintain a normal core body temperature and state of balance among the body systems is known as: A) b. Compensation B) c. Homeostasis C) d. Metabolism D) a. Equilibrium

B) c. Homeostasis

A critical assessment finding during your evaluation of a patient who experienced abdominal trauma is: A) d. Pain B) c. Hypovolemic shock C) b. Bruising D) a. Anxiety

B) c. Hypovolemic shock

A grade 2 sprain usually results in: A) a. A dislocated joint B) c. Immediate pain and swelling C) b. An unstable joint D) d. Vascular compromise

B) c. Immediate pain and swelling

One of the most common causes of vascular abdominal injuries is: A) b. Blast injuries B) c. Improper use of seat belts C) d. Knife wounds D) a. Bone fracture fragments

B) c. Improper use of seat belts

Following a traumatic pancreatic injury, the major concern becomes: A) b. Hyposecretion of insulin B) c. Leakage of digestive enzymes into the peritoneal space C) a. Hypersecretion of insulin D) d. Massive hemorrhage

B) c. Leakage of digestive enzymes into the peritoneal space

You and your partner have splinted a possible midshaft radial-ulna fracture. After applying the splint, PMS is reevaluated, noting that the pulse is absent. Your next action would be to: A) b. Contact medical control B) c. Loosen the splint C) a. Apply ice D) d. Realign the injury

B) c. Loosen the splint

For which of the following incidents should crush injury be suspected? A) b. Entrapment under a tractor with extrication in 15 minutes of the accident B) c. Overturned tractor under which the victim was trapped for 2 hours--- C) d. Rollover tractor in which the patient sustained a 4-inch scalp laceration D) a. Entrapment in a conventional silo in which grain was stored

B) c. Overturned tractor under which the victim was trapped for 2 hours

You are evaluating an extremity fracture of the lower arm. You find a distal pulse; however, your patient states there is numbness below the sight of the injury. Using the 6 P's of assessment, you state this is: A) b. Paralysis B) c. Paresthesia C) a. Pallor D) d. Pressure

B) c. Paresthesia

When responding to a farm for a report of an overturned tractor, the paramedic must consider several possible challenges including: A) a. Air bag deployment pinning the tractor operator B) c. That the patient has been trapped for several hours C) d. Vehicle fluids being drained away from the scene D) b. Electrical shock from a hybrid tractor engine

B) c. That the patient has been trapped for several hours

Which statement best describes training needed for wilderness EMS? A) a. Traditional providers are better trained in clinical skills and can therefore be inserted with minimal training. B) c. Traditional providers cannot be inserted without additional training and extensive logistical support. C) b. Traditional providers can be inserted without additional training and extensive logistical support. D) d. Traditional providers need some training but can accomplish the same tasks without the additional logistical support.

B) c. Traditional providers cannot be inserted without additional training and extensive logistical support.

Which of the following best describes what the most probable injury would be from a wrap point? A) b. Injection of hydraulic fluid under the skin B) d. Amputation of an arm or leg C) c. Toxic inhalation of organophosphates D) a. Blunt trauma to the head, neck, or torso

B) d. Amputation of an arm or leg

The most common route of pesticide exposure on a farm is: A) a. By inhalation B) d. By dermal exposure C) c. By injection D) b. By ingestion

B) d. By dermal exposure

A person has drowned whenever he or she: A) b. Breathes water into the lungs B) d. Experiences respiratory impairment as a result of being in or under a liquid C) a. Experiences a blackout while swimming D) c. Experiences death from submersion

B) d. Experiences respiratory impairment as a result of being in or under a liquid

As a paramedic, you recognize the greatest potential of blood loss is from a fracture of the: A) c. Rib B) d. Pelvis C) b. Humerus D) a. Femur

B) d. Pelvis

The patient is a 28-year-old male cleaning a manure pit. The paramedic is called because the man is complaining of difficulty breathing accompanied by a runny nose and cough. Lung sounds indicate pulmonary edema in the lung bases. The patient states he cannot smell anything and wonders whether that is unusual. Treatment for the patient includes: A) c. Prompt evacuation from the area, high-flow oxygen, and IV atropine B) d. Removal from the area, oxygen and airway support, and treatment for pulmonary edema C) b. Having the patient sniff more manure to ensure the sense of smell is intact D) a. Extrication from the environment, oxygenation, and airway support if needed

B) d. Removal from the area, oxygen and airway support, and treatment for pulmonary edema

Regarding tractors and safety equipment, the term ROPS best describes which of the following? A) c. Rollover positioning service B) d. Rollover protective structure C) a. Rollout positioning system D) b. Rollout protective system

B) d. Rollover protective structure

B) d. Ruptured a blood vessel

Your crew is called to a local park for a 34-year-old male who injured his shoulder while playing softball. There is swelling at the left shoulder where the clavicle meets the proximal humerus. If this is the patient's only injury, what device should you use for immobilization? A) c. Short backboard B) d. Sling and swathe C) b. Rigid splint D) a. Long backboard

B) d. Sling and swathe

Other than hemorrhage, the major cause of mortality following a traumatic duodenal rupture is: A) b. Ileus B) d. Spillage of intraluminal contents into the peritoneum C) a. Bowel infarction from ischemia D) c. Inability to digest food/malnutrition

B) d. Spillage of intraluminal contents into the peritoneum

A patient is being brought to shore after becoming unresponsive while scuba diving. Which of the following treatments is least likely to benefit the patient? A) b. Cardiac monitoring B) d. Spinal immobilization C) c. Hyperbaric chamber therapy D) a. 100% oxygen

B) d. Spinal immobilization

Your patient has been standing outside for 25 minutes after a motor vehicle crash and has fingers that are pale, cool, soft, and painful. The patient has: A) b. Full-thickness frostbite B) d. Superficial frostbite C) a. Deep frostbite D) c. Mild frostbite

B) d. Superficial frostbite

You are receiving a 26-year-old male patient with altered mental status on an incoming airplane from Florida. When you receive the patient, his friends tell you that he began having a headache and joint pain midflight, and his condition progressively worsened. The patient looks extremely uncomfortable, is constantly wincing, and responds only to painful stimuli. He is diaphoretic, breathing rapidly, and has no obvious signs of injury. All his friends can tell you is that he went scuba diving several times during their trip. You suspect that this patient may have: A) a. A myocardial infarction B) d. The bends C) c. A septic infection from a saltwater drowning D) b. A neurotoxin exposure from a snake

B) d. The bends

An easy way to remember the various components of musculoskeletal injury assessment is to recall: A) a. The four M's of musculoskeletal assessment B) d. The six P's of musculoskeletal assessment C) c. The mnemonic TIC D) b. The mnemonic ARM-LEGS

B) d. The six P's of musculoskeletal assessment

Crush injury syndrome is caused by: A) c. The inability to breathe because of extreme weight on the chest B) d. Toxins that accumulate from damaged or dead cells C) a. Bone fragments entering the circulation D) b. Fat emboli caused by damaged subcutaneous tissues

B) d. Toxins that accumulate from damaged or dead cells

Most farm-related deaths are the result of: A) b. Silage B) d. Tractor C) c. Silo D) a. Auger

B) d. Tractor

How is traditional 'street' EMS different from wilderness EMS? A) b. Injuries seen in 'street' EMS tend to be more severe. B) d. Wilderness EMS presupposes much longer periods of EMS care and does not assume all patients will be transported to definitive care. C) c. Wilderness EMS focuses on natural and herbal remedies for conditions that arise in the woods. D) a. All injuries and illness need to be managed in the exact same manner; the setting is simply different.

B) d. Wilderness EMS presupposes much longer periods of EMS care and does not assume all patients will be transported to definitive care

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare to extricate the patient, you advise everyone on scene that you are going to immobilize the patient: A) a. In a traditional manner B) d. With padding underneath her right hip and pelvis only to elevate the right side of her pelvis C) b. On her left side on the backboard with padding in the spaces D) c. With padding under her feet and legs supine on the backboard

B) d. With padding underneath her right hip and pelvis only to elevate the right side of her pelvis

C. critical.

Based on total body surface area and burn depth, you have determined that an 88-year-old female has a moderate burn. Considering the age of the patient, you should consider this burn:

A. Epidural bleeding is more likely arterial than venous.

Based on your knowledge of anatomy of the head, which of the following statements is true?

. Your crew is called to the scene of a sports injury at a local park. A 43-year-old female injured her ankle while sliding into home base. There is gross deformity at the joint that appears consistent with a severe dislocation. She is in a tremendous amount of pain and has extreme difficulty when trying to wiggle her toes. Her distal pulse is absent. Proper intervention would include analgesics and: A) d. Splinting the injury in the position found, using a pillow or blanket B) c. Attempted reduction by taking the ankle through its full range of motion C) a. Attempted reduction by pulling on the talus D) b. Attempted reduction by pulling on the toes

A 23-year-old male has been stabbed in the right chest wall. You can hear air entering the chest cavity. He has a trachea that is slightly deviated to the left, and he has perioral cyanosis. Which of the following is the most appropriate initial intervention? A) b. Perform needle decompression. B) d. Provide rapid transport. C) c. Apply an occlusive dressing. D) a. Administer bag-mask supplemented oxygen.

A 60-year-old male patient presents with occipital head pain, neck pain, and sharp shooting pains traveling down his arms. You perform your examination and notice no step-offs or pain on palpation, but he has considerable tenderness on flexion and extension. Which of the following is the most likely cause of his pain? A) a. Degenerative disk disease B) b. Musculoskeletal injury C) c. Spondylosis D) d. Trauma

A Colles fracture refers to what area of the body? A) c. Proximal tibia B) b. Mandible C) a. Distal radius D) d. Ribs

A PASG can be used in place of which other type of splint? A) a. Flexible B) b. Ridged C) d. Air splint D) c. Sling and swath

A blood glucose level in an infant of 38 mg/dL indicates: A) b. Elevated blood glucose B) a. Dangerously high glucose C) c. Low blood glucose D) d. Normal blood glucose

A breech birth is one in which the: A) b. Infant's head is face up instead of face down B) a. Cord precedes the head in the vaginal opening C) d. Head is delivered last D) c. Shoulders have become lodged in the vaginal opening

A condition where the abdominal wall is damaged and underlying abdominal structures are protruding through the abdominal wall is known as: A) c. Abdominal inversion B) d. Abdominal protrusion C) b. Abdominal evisceration D) a. Abdominal contusion

A fracture or dislocation should be realigned when: A) c. The patient reports extreme pain B) b. The lower leg is involved C) a. Circulation is impaired D) d. The site is bleeding

A male patient has sustained an injury to the right facial/head area. During the assessment, the paramedic asks the patient to wrinkle his forehead on the right side. The patient is unable to wrinkle the right side of his forehead. The paramedic suspects damage to the: A) A. Buccal branch of the facial nerve B) B. Mandibular nerve C) C. Temporal branch of the facial nerve D) D. Zygomatic branch of the facial nerve

A mnemonic for remembering signs and symptoms of musculoskeletal injury is: A) a. AVPU B) d. SAMPLE C) b. DCAP-BTLS D) c. OPQRST

A newborn is not breathing shortly after delivery. Which should be your first action? A) a. Check for a pulse. B) b. Provide supplemental oxygen. C) c. Stimulate the infant by rubbing the infant's back. D) d. Use a bag-mask device.

A newborn presents with a pulse rate of 40 beats/min after 30 seconds of positive-pressure ventilation with a bag-mask device. What is the next most appropriate intervention? A) d. Begin ventilations with a bag-mask device. B) a. Administer atropine. C) c. Begin chest compressions. D) b. Administer epinephrine.

A newborn presents with acrocyanosis, a vigorous cry, some flexion of the extremities, and a pulse rate of 104 beats/min. What would be the Apgar score for this infant? A) a. 6 B) d. 9 C) c. 8 D) b. 7

A newborn with a temperature of 99.5° F (rectal) would be considered: A) b. Abnormal B) c. Hyperthermic C) a. Normal D) d. Hypothermic

A patient has driven his car into a tree. There is a branch that is crushing his neck. He is pulseless and apneic upon your arrival. He is restrained and has no other injuries. Which of the following might best explain the reason for his physical findings? A) a. Crush injury to the alveoli B) c. Crush injury to the spleen C) d. Crush injury to the trachea D) b. Crush injury to the ribs

A patient presents with weakness. During your examination, the patient demonstrates a positive Babinski sign. Which of the following, pathophysiologically, is responsible for this finding? A) c. Lower motor neuron injury B) a. Cord contusion C) d. Upper spinal column injury D) b. Cord transection

A patient presents with what is identified as a tracheoesophageal fistula. Your primary actions should be to suction secretions and place the patient in which position? A) c. Supine position B) b. Sitting position C) d. Upright position D) a. Prone position

A patient was in a severe motor vehicle crash and is complaining of lower extremity numbness and weakness. The patient's skin is warm and flushed. The vital signs indicate hypotension and bradycardia. You suspect spinal shock. Which of the following best explains the pathophysiology that is occurring in this clinical situation? A) c. Increased peripheral muscle tone B) a. Increased communication of spinal nerves C) b. Increased distal vascular vasodilation D) d. Increased vasoconstriction

A predisposing factor for ectopic pregnancy is: A) b. Oral contraceptive use B) d. Previous cesarean delivery C) c. PID D) a. Hypertension

A severe diffuse axonal injury was formerly called a: A) c. Contrecoup injury B) d. Temporal lobe injury C) a. Brainstem injury D) b. Cerebellar injury

After consulting with medical direction, a decision has been made to attempt realignment of a badly angulated tibia-fibula fracture. While attempting to realign the bone fragments, you observe obvious anatomic resistance to your effort. You should: A) a. Administer a muscle relaxant, and reattempt realignment B) d. Pull harder C) b. Cease your efforts to realign, and transport D) c. Gently rotate the limb, reapply traction, and then splint

After securing the airway of a pediatric seizure patient, which of the following would be the most appropriate intervention? A) b. Administer midazolam. B) d. Obtain an ECG reading. C) c. Treat hypoglycemia if present. D) a. Administer fosphenytoin.

An abnormal placement of the placenta that causes it to partly or completely cover the cervical opening, typically presenting in bright red vaginal bleeding with little or no contractions or pain, is known as: A) A. Ectopic pregnancy B) B. Placenta abruption C) C. Placenta previa D) D. Uterine prolapse

An intrapartum risk factor that may affect the need for neonatal resuscitation is: A) b. Postterm gestation B) d. Single gestation C) c. Prolapsed cord D) a. Inadequate prenatal care

Approximately 40% to 60% of the fetal blood bypasses the liver through the ductus venosus and then enters which structure? A) b. Left atrium B) d. Superior vena cava C) a. Inferior vena cava D) c. Right atrium

As the volume in a patient's cranial vault continues to swell as a result of trauma, herniation of the brain compresses cranial nerve III, which results in: A) a. Constricted pupils B) d. Vertical and horizontal gaze nystagmus C) c. Dilated pupils D) b. Dilated pupils and hypersensitivity to light

At approximately how many weeks gestation does the production of surfactant occur? A) d. 36 to 40 B) a. 18 to 22 C) c. 28 to 32 D) b. 22 to 28

At the scene of a head-on motor vehicle crash, you notice a patient ejected from a vehicle. As you and your partner approach the patient, which of the following is an important immediate action for this patient? A) b. Provide pain medication. B) a. Check for signs of shock. C) d. Stabilize the cervical spine. D) c. Splint all fractures in the position that they were found.

At what point after birth is an Apgar score is obtained? A) b. 2 and 10 minutes B) c. 3 and 5 minutes C) a. 1 and 5 minutes D) d. 5 and 10 minutes

At what rate per minute should chest compressions be performed in a neonate? A) b. 80 B) a. 60 C) d. 120 D) c. 100

Body surface area is calculated by the square root of which of the following equations? A) b. Height (cm) × weight (kg)/2600 B) d. Height (cm) × weight (kg)/4600 C) c. Height (cm) × weight (kg)/3600 D) a. Height (cm) × weight (kg)/2000

Care of the patient with epistaxis from blunt trauma to the nose includes: A) a. Packing both nostrils with sterile gauze B) c. Placing the patient in a prone position C) b. Applying direct external pressure to the anterior nares to control bleeding D) d. Providing positive-pressure ventilation

Clinical signs of irreversible shock include: A) b. Decreased muscle tone B) a. Confusion C) d. Hypoxemia D) c. Hot, dry skin

Determining whether additional resources are necessary, including law enforcement, special rescue services, additional medical personnel, or special transport services, is part of which of the following? A) d. Secondary survey B) b. Primary survey C) c. Scene size-up D) a. Patient assessment

During compensated shock, what happens to ventilations? A) A. They decrease in rate and increase in depth. B) B. They increase in rate and decrease in depth. C) C. They increase in rate and depth. D) D. They stay the same.

During the crushing phase of injury, blood flow to the extremity is obstructed, which results in hypoxia at the cellular level. This, in turn, results in a decrease of: A) d. Myoglobin B) b. Creatinine C) a. Adenosine triphosphate D) c. Creatine kinase

During the crushing phase of injury, flow to the extremity is obstructed, resulting in: A) c. Tissue asphyxia B) a. Lipid peroxidation C) d. Tissue ischemia D) b. Oxygen superoxide

How much blood can be contained in one hemothorax? A) b. 500 to 750 mL B) c. 500 to 1000 mL C) d. 2500 to 3000 mL D) a. 200 to 500 mL

How often should an IO site be reassessed? A) c. Every 10 to 15 minutes B) d. Every 15 to 20 minutes C) b. Every 5 to 10 minutes D) a. Every 2 to 5 minutes

If an expectant mother improperly wears a seat belt too high and is involved in a motor vehicle crash, she could experience what condition? A) b. Placenta previa B) a. Fetal decapitation C) d. Placental abruption D) c. Preterm labor

If intracranial pressure continues to increase, the result may be herniation in which brain tissue: A) c. Extrudes through the nares B) a. Collapses within the cranial vault C) d. Is displaced laterally or downward D) b. Extrudes through the ear canals

Immobilization of an injured femur requires: A) a. A four-person crew B) d. Only one rescuer C) c. At least two rescuers D) b. At least three rescuers

In a pedestrian versus motor vehicle crash, in what region of the body would the pediatric patient sustain the majority of his or her injuries? A) d. Posterior B) c. Cephalic C) a. Anterior D) b. Caudal

In addition to the administration of sodium bicarbonate, the treatment of a myoglobin-induced kidney injury includes which of the following? A) a. Magnesium B) d. Potassium C) c. Polyethylene glycol D) b. Mannitol

In children, at what age do subdural hematomas most commonly occur? A) b. Older than 5 years old B) d. Younger than 5 years old C) c. Younger than 2 years old D) a. Older than 2 years old

In the older adult, most facial injuries are caused by: A) c. Motor vehicle crashes B) b. Firearms C) a. Accidental falls D) d. Physical assault

In what year did the U.S. Congress enact the legislation authorizing federal funds for Emergency Medical Services for Children? A) d. 1995 B) b. 1987 C) a. 1984 D) c. 1990

In which of the following situations is an analgesic more appropriate than a sedative? A) c. Head injury B) a. Abdominal injury C) d. Long bone fracture D) b. Cardioversion

In which of the following situations would cervical spinal immobilization be contraindicated and manual stabilization used instead? A) d. Tracheal deviation B) c. Massive cervical swelling C) a. Cervical tenderness D) b. Jugular vein distention

In writing a maternal history, how would you record the patient telling you she has had five pregnancies, three live births, and two abortuses? A) A. A0P3G5 B) B. G3P2A5 C) C. G5P3A2 D) D. P5G3A2

Integrating emergency care for children, developing pediatric equipment, and providing injury/illness prevention for children are the goals of which organization? A) b. EMSP B) d. NREMT C) a. EMSC D) c. NAEMT

Maintaining a patent airway in a patient with severe facial lacerations may include: A) d. Suctioning, intubation, and placing the patient in a prone position B) a. Placing the patient in head-down position and suctioning C) c. Suctioning, intubation, and positioning D) b. Rolling the patient onto the right side followed by intubation

Mortality secondary to solid abdominal organ injury is primarily caused by: A) c. Infection B) d. Organ death C) a. Hemorrhagic shock D) b. Ileus

Name the four elements to the CUPS assessment. A) A. C-spine, unstable, pulses, stable B) B. Circulation, unstable, potentially unstable, stable C) C. Critical, unstable, potentially unstable, stable D) D. Critical, unstable, pulses, stable

Not padding under the torso of a child who is being immobilized would result in which position of the neck? A) d. Flexed B) b. Adducted C) c. Extended D) a. Abducted

Once the head has delivered and there are no signs of the umbilical cord around the baby's neck, your next step is to: A) A. Administer oxygen to the baby via nonrebreather blow by. B) B. Deliver the rest of the baby. C) C. Use a bulb syringe and suction the baby's mouth first then the nose. D) D. Use a bulb syringe and suction the baby's nose first then the mouth.

Paramedics are treating a construction worker who has amputated his left arm with a circular saw. After wrapping the amputated part in a sterile dressing, what is the next most appropriate step? A) a. Place the amputated part directly on ice. B) c. Seal the amputated part in a bag, and place it on ice. C) b. Seal the amputated part in a bag, and place it in cool water. D) d. Submerse the amputated part in cold sterile water.

Paramedics have been dispatched to a construction site where a worker has fallen and been impaled by a piece of rebar. Of which type of trauma should the paramedics be most suspicious? A) c. Crush B) a. Blast C) d. Open D) b. Closed

Persistent central cyanosis despite oxygen administration in a newborn requires which intervention? A) a. Chest compressions B) b. Medication administration C) d. Positive-pressure ventilation D) c. Suctioning

Placenta previa is: A) A. Also referred to as placenta abruption B) B. Painful and causes dark red vaginal bleeding C) C. The abnormal placement of the placenta such that it partly or completely covers the cervical opening D) D. Usually detected during the first trimester

Possible complications of an IO infusion include which of the following? A) d. Inability to aspirate blood B) c. Inability to administer fluids by gravity C) b. Penetration of the posterior cortex D) a. Penetration of the bone marrow

Seizures that present in the newborn involving eye deviation, pedaling movements of the legs, blinking, and sucking are called: A) b. Multifocal B) c. Myoclonic C) d. Subtle D) a. Focal clonic

Severe (or major) partial-thickness burns are those involving more than what percentage of the TBSA? A) b. 50% B) c. 60% C) a. 25% D) d. 75%

Severe burns caused by which substance can be associated with delayed signs and symptoms? A) a. Acetic acid B) d. Tannic acid C) b. Hydrofluoric acid D) c. Sulfuric acid

Shock might best be defined as: A) c. Internal or external blood loss B) a. Hypoxemia C) b. Inadequate tissue perfusion D) d. Low blood pressure

Sperm normally fertilize a mature ovum in the: A) c. Ovary B) b. Ovarian follicle C) a. Fallopian tube D) d. Uterus

Stage II labor ends when the: A) c. Placenta is delivered B) b. Cervix is fully dilated C) a. Baby is delivered D) d. Baby enters the birth canal

Studies have shown that methylprednisolone works: A) d. With about the same success rate as placebo in spinal cord injury B) b. Immediately on administration; results are seen at once C) a. If administered within 8 hours after injury D) c. Only if administered within 1 hour after injury

Substances that tend to seek out and bind to fatty substances are called: A) a. Cytokines B) b. Keratinized C) c. Lipophilic D) d. Roentgen

The assessment of breathing in a pediatric patient should take no longer than which of the following? A) b. 20 seconds B) c. 30 seconds C) a. 10 seconds D) d. 60 seconds

The correct placement for a needle thoracostomy (or needle decompression) would be: A) c. The third intercostal space, over the third rib, midaxillary line B) d. The fifth intercostal space, over the sixth rib, midclavicular line C) a. The second intercostal space, over the third rib, midclavicular line D) b. The second intercostal space, under the third rib, midclavicular line

The dermis primarily consists of: A) c. Deep fascia B) d. Ligaments C) b. Collagen D) a. Cartilage

The destruction of the muscle tissues that results in a release of cellular material and acidosis and can lead to acute renal failure is called: A) A. Compartment syndrome B) B. Peritonitis C) C. Rhabdomyolysis (Crush syndrome) D) D. Traumatic asphyxia

The female patient fell onto a hard surface and presents with malocclusion of the teeth, CSF rhinorrhea, and an elongated face. The paramedic suspects a LeFort ____ fracture. A) A. I B) B. II C) C. III D) D. V

The heart rate of the newly born should be assessed by palpating A) the carotid pulse. B) the femoral pulse. c) the umbilical pulse. D) the brachial pulse.

The most common bones to receive stress fractures are: A) a. Bones of the arm B) c. Ribs C) d. Weight-bearing bones D) b. Long bones

The most common cause of vaginal bleeding during pregnancy is: A) d. Uterine rupture B) c. Placenta previa C) a. Abortion D) b. Abruptio placentae

The most commonly fractured bone of the face is the: A) a. Cheek B) b. Eye orbit C) d. Nose D) c. Jaw

The patient is a 22-year-old male who was involved in a motor vehicle crash while en route to work. He was unrestrained and, as a result of the collision, struck the windshield of the car as he was ejected from the vehicle. He sustained severe scalp and facial lacerations along with an open, comminuted fracture of the skull. Brain matter is visible in the wound and CSF is evident from the ears. Care of the patient's injury includes: A) d. Applying pressure dressing over the wound to control bleeding B) b. Covering the exposed brain tissue with a dry dressing C) a. Applying a moist saline sterile dressing to the exposed tissue D) c. Packing the ear to reduce the loss of CSF

The patient is a 30-year-old male who was involved in a fight in which he sustained facial injuries. There is significant discoloration and swelling around his left eye. As you assess the patient, he tells you that he is 'seeing double' and the area around the eye, cheek, and upper lip seems numb. Based on this information, you suspect: A) d. Significant injury to the eye globe B) b. Injury to the trochlear nerve C) c. Orbital blow-out fracture D) a. Damage to the ocular nerve

The patient is an 18-year-old woman who sustained facial injuries during a motor vehicle crash. Her facial injuries include abrasions and lacerations. In conducting an assessment, you ask the woman to use her eyes to follow the penlight, and you notice that the woman cannot look downward. This finding indicates potential injury to the: A) a. Hypoglossal nerve B) d. Vagus nerve C) c. Trochlear nerve D) b. Oculomotor nerve

The patient is presenting with pupil dilation on the side of the injury, severe headache, decreased LOC, and a stiff neck. The patient is most likely suffering from a(n) __________________ hematoma. A) A. Epidural B) B. Intracerebral C) C. Subarachnoid D) D. Subdural

The placenta has not delivered within 5 minutes of the infant's birth. What should you do? A) b. Gently pull on the placenta to speed delivery. B) d. Wait on scene until the placenta delivers. C) c. Transport the patient and be prepared for placental delivery. D) a. Administer Pitocin to speed delivery of the placenta.

The preferred site for IO infusion on a pediatric patient is the: A) A. Anterior lateral surface of the distal tibia B) B. Anterior lateral surface of the proximal tibia C) C. Anterior medial surface of the proximal tibia D) D. Posterior medial surface of the proximal tibia

The preferred technique for neonatal CPR is: A) c. Two-handed chest compression B) b. Two fingers with hands encircling the chest C) d. Two thumbs with fingers encircling the chest D) a. One-handed chest compression

The primary danger to the fetus of a rapid, uncontrolled delivery of the fetal head is: A) a. Apnea B) b. Fetal asphyxiation C) d. Tearing of the perineum D) c. Shoulder dystocia

The term gravida refers to the number of: A) a. Live births B) c. Weeks of gestation C) b. Pregnancies D) d. Weeks until delivery

To achieve neutral alignment when immobilizing children: A) a. Immobilize children over the age of 6 to a short spine board instead of a long spine board B) d. Turn the board upside down to minimize spaces C) c. Pad under the child's torso D) b. Pad under the child's head to bring the body into alignment

To open the airway in an infant or small child and maintain the head and cervical spine in a neutral position, you should: A) A. Hyperflex the patient's neck B) B. Insert an endotracheal tube immediately C) C. Place padding under the patient's torso D) D. Place the patient in the supine position on a flat surface

Traction splints are designed specifically to be used for what type of injuries? A) d. Tibia fractures B) b. Knee dislocations C) a. Femur fractures D) c. Pelvic fractures

Use of the PASG would be indicated for: A) A. Congestive heart failure B) B. Penetrating thoracic injury C) C. Suspected intraperitoneal hemorrhage with hypotension D) D. Traumatic cardiopulmonary arrest

What are the correct dose and most appropriate choice of fluids for treating hypovolemia in a neonate? A) d. 20 mL/kg, NS B) a. 10 mL/kg, D10W C) b. 10 mL/kg, NS D) c. 20 mL/kg, D10W

What can result when widespread tissue hypoxia and cellular damage causes leakage of contents from damaged muscle cells? A) c. Traumatic asphyxia B) a. Lipid peroxidation C) b. Rhabdomyolysis D) d. Thromboplastin

What disease is described as a bacterial infection of the subglottic area, complicated with copious thick, pus-filled secretions? A) a. Asthma B) c. Croup C) b. Bacterial tracheitis D) d. Epiglottitis

What does a decrease by 2 points on the Glasgow Coma Scale suggest in a child with a head injury? A) a. Mild deterioration B) b. Moderate deterioration C) d. Significant deterioration D) c. No deterioration

What is an appropriate endotracheal tube depth for a newborn weighing 1000 to 2000 g? A) b. 7.5 to 8.5 cm B) d. 9.5 to 10.5 cm C) a. 7.0 to 8.0 cm D) c. 9 to 10 cm

What is it called when measures are applied in advance to reduce the likelihood that an injury will occur? A) c. Primary prevention B) d. Secondary prevention C) b. Injury prevention D) a. Illness prevention

What is it called when necrosis is not visible, but is already present? A) d. Zone of stasis B) c. Zone of ischemia C) a. Zone of coagulation D) b. Zone of hyperemia

What is the appropriate dose for the initial fluid bolus of a 4-day-old trauma patient who weighs 8 pounds? A) c. 80 mL B) d. 160 mL C) b. 72 mL D) a. 36 mL

What is the compression-to-ventilation ratio in a newborn? A) d. 15:2 B) c. 10:2 C) a. 3:1 D) b. 5:1

What is the correct management for avulsions? A) A. Apply direct pressure. If hemorrhage not controlled, apply more dressing. If hemorrhage continues, apply a tourniquet. B) B. Apply splints to immobilize the bones above and below the affected joint. Periodically reassess the injury to ensure that there has been no nerve or vascular compromise. C) C. Place the tissue in its normal position. Then dress and bandage the injury. Do not remove avulsed tissue. D) D. Place the tissue in the position found. Then dress and bandage the injury. Remove avulsed tissue.

What is the leading cause of low birth weight in the United States? A) d. Trauma B) a. Drug misuse C) c. Preterm birth D) b. Multiple gestations

What is the most appropriate intervention when caring for a newborn with a meningomyelocele? A) b. Cover with a nonporous dressing. B) a. Cover with a dry sterile dressing. C) d. Cover with a wet sterile dressing. D) c. Cover with a petroleum-infused dressing.

What is the most correct location for the application of direct pressure? A) a. Between the wound and the heart B) d. One inch superior to the wound C) b. Directly over the wound D) c. One inch distal from the wound

What is the name of the valve, in the fetal circulation, that prevents blood flow from the left atrium to the right atrium? A) c. Foramen ovale B) d. Septum primum C) a. Ductus arteriosus D) b. Ductus venosus

What is the normal respiratory rate for an infant (1 to 12 months old)? A) c. 24 to 40 breaths/min B) a. 18 to 30 breaths/min C) d. 30 to 60 breaths/min D) b. 22 to 34 breaths/min

What measurement should you use to adjust the Hare traction splint before applying it to a femur fracture? A) A. Estimate the patient's height divided by 2 and add 6 to 8 inches past the end of the extremity. B) B. Measure it against the injured leg from the ischium and add 6 to 8 inches past the end of the extremity. C) C. Measure it against the uninjured leg from the ischium and add 6 to 8 inches past the end of the extremity. D) D. Start with the traction splint fully extended and apply, tightening until the patient voices relief of pain.

What metal is highly reactive and is capable of violent exothermic reactions in water? A) a. Hydrogen fluoride B) b. Lewisite C) c. Lithium D) d. Sulfur

What sexually transmitted bacterial infection causes a patient to have lower abdominal pain, possible fever, vaginal discharge, dyspareunia, and to double over when walking, and has an onset typically within 1 week of the patient's menstrual period? A) A. Bladder infection B) B. Endometriosis C) C. Pelvic inflammatory disease (PID) D) D. Ruptured ovarian cyst

What term is used to describe the measurement of ionizing radiation effective doses? A) b. Rem B) c. Roentgen C) d. Sievert D) a. Hertz

What type of distributive shock results in a loss of sympathetic vascular tone? A) A. Anaphylactic B) B. Cardiogenic C) C. Neurogenic D) D. Septic

What usually causes primary bradycardia in newborns? A) c. Hypothyroidism B) a. Decreased vagal tone C) d. Structural heart disease D) b. Hypothermia

What would be the correct fluid bolus amount for a neonate weighing 2.5 kg? A) a. 20 mL B) c. 55 mL C) b. 25 mL D) d. 110 mL

When a caregiver of an ill child responds in an angry and fearful manner, what should you as the paramedic do? A) d. Respond in a condescending manner. B) b. Ignore the caregiver's concerns. C) a. Accept the caregiver's feelings as normal. D) c. Remove the child from the home.

When an expectant mother experiences significant abdominal trauma, the placenta can separate from the uterine wall. This condition is known as: A) d. Uterine rupture B) c. Placenta previa C) b. Abruptio placentae D) a. Abruptio placental previa

When assessing musculoskeletal injuries, paramedics should: A) a. Make every attempt to diagnose the injury correctly B) b. Manage patients as though they have a sprain C) d. Not be concerned with differentiating among sprains, strains, and fractures D) c. Manage patients as though they have a strain

When handling a patient who is in shock, what is the concern if they are taking an ACE inhibitor? A) A. ACE inhibitors block channels in the heart, limiting performance. B) B. ACE inhibitors inhibit ADH from being released from the pituitary gland. C) C. ACE inhibitors inhibit the conversion of angiotension I to angiotension II. D) D. ACE inhibitors prevent blood clotting, thus causing excess hemorrhage.

When is it considered appropriate to use the scalp vein as a means of peripheral venous access in an infant? A) b. For medication administration only B) c. Only as a last effort C) a. For both fluid and medication administration after patient stabilization D) d. Only during resuscitation

When the diaphragm ruptures: A) b. Chest cavity organs can fall into the abdominal cavity B) d. The chest wall cannot expand normally C) a. Herniation of the abdominal contents upward into the chest cavity occurs D) c. Partially digested food does not flow from the stomach into the duodenum

Where is the most appropriate place to assess the skin color of children with darker skin tones? A) a. Conjunctiva B) d. Mucosa C) c. Lips D) b. Fingernails

Which condition is characterized by a loss of peripheral vascular tone and results in widespread vasodilation? A) d. Septic shock B) b. Hypovolemic shock C) c. Neurogenic shock D) a. Anaphylactic shock

Which of the following areas is composed of large, dense collagen fibers and provides much of the skin's elasticity? A) d. Superficial fascia B) b. Papillary dermis C) c. Reticular dermis D) a. Deep fascia

Which of the following assessment findings would be consistent with traumatic asphyxia? A) d. Stable vital signs B) b. Normal pulse oximetry C) a. Cyanosis to the face and upper neck D) c. Paradoxical motion of the chest wall

Which of the following best describes the pathophysiology of a hemopneumothorax? A) a. Air in the pleural space B) c. Blunt cardiac injury C) b. Blood in the pleural space D) d. Penetrating trauma to the chest wall

Which of the following best describes the pathophysiology of flail chest? A) d. Two or more ribs are fractured in three or more locations. B) b. One rib is fractured in three locations. C) c. Two or more ribs are fractured in two or more locations. D) a. More than one rib is fractured in one location.

Which of the following conditions is characterized by a deep purple color of the skin of the head and neck, bilateral subconjunctival hemorrhage, petechiae, and facial edema? A) c. Tension pneumothorax B) a. Pulmonary contusion C) d. Traumatic asphyxia D) b. Sternal fracture

Which of the following dressings allows the wound to drain exudate but does not incorporate the dressing into the scab or clot? A) d. Occlusive B) a. Adherent C) b. Nonadherent D) c. Nonocclusive

Which of the following dressings is typically used when infection is a concern or for direct application to an open wound? A) a. Adherent B) d. Wet C) c. Sterile D) b. Occlusive

Which of the following dysrhythmias is rare in children and could indicate a myocardial heart disease? A) b. Pulseless electrical activity B) a. Bradycardia C) d. Ventricular tachycardia D) c. Supraventricular tachycardia

Which of the following is a cause of dissociative shock? A) a. Anemia B) b. Excessive vomiting C) d. Pulmonary embolism D) c. Pericarditis

Which of the following is a common cause of nontraumatic low back pain? A) b. Meningitis B) d. Tumor C) c. Musculoskeletal injury D) a. Cauda equina syndrome

Which of the following is a true statement regarding spondylosis? A) c. The thoracic spine is the site where the most pain occurs. B) a. Severe pain can occur in older patients. C) d. Treatment is often surgery. D) b. The cervical spine is typically asymptomatic.

Which of the following is an accumulation of bacteria in a wound? A) b. Coagulation B) d. Eschar C) a. Bioburden D) c. Cosmesis

Which of the following is associated with the pathophysiology of a traumatic aortic rupture? A) c. Hypotension B) a. Absent brachial pulses C) b. Absent femoral pulses D) d. Pain radiating to the abdomen

Which of the following is characterized by chronic inflammation, hyperreactive airways, and episodes of bronchospasm? A) b. Bronchiolitis B) a. Asthma C) d. Pneumonia D) c. Croup

Which of the following is considered to be a strong acid? A) b. Salicylic B) d. Tannic C) c. Sulfuric D) a. Acetic

Which of the following is considered to be an open soft tissue injury? A) d. Traumatic asphyxia B) a. Contusion C) c. Avulsion D) b. Hematoma

Which of the following is correct regarding the use of traction splints? A) d. Traction splints are used to reduce open, midshaft long-bone fractures. B) a. Traction splints are used for dislocations of the knee with associated femur fracture. C) b. Traction splints are used for isolated midshaft femur fractures. D) c. Traction splints are used for proximal femur fractures or hip dislocations.

Which of the following is the best personal protective equipment for an obstetric delivery? A) a. Gloves B) b. Gloves, gown C) c. Gown, gloves, mask D) d. Mask, booties

Which of the following is the most common type of shock in children? A) c. Neurogenic B) a. Anaphylactic C) b. Hypovolemic D) d. Septic

Which of the following is the most important management decision in the field when dealing with a tracheobronchial injury? A) b. Intubation B) a. Analgesia C) c. Rapid transport D) d. Repair/bandage wound

Which of the following is true regarding spinal shock? A) d. The patient experiencing spinal shock will not have motor movement but will perceive sensation. B) c. Spinal shock occurs primarily in complete spinal transections. C) a. It is temporary and the symptoms usually correct themselves in 24 hours. D) b. Spinal shock is usually a permanent condition.

Which of the following may indicate a cerebrospinal fluid shunt malfunction? A) d. Tachycardia B) a. Calmness C) c. Irritability D) b. Hypotension

Which of the following pathophysiologic findings is associated with myocardial rupture? A) b. Fluid surrounding the heart B) c. Pneumothorax C) d. Traumatic perforation of atria or ventricles D) a. Bruising to the myocardium

Which of the following patients would be more susceptible to sudden infant death syndrome? A) b. Asian male B) d. Native American female C) a. African American male D) c. Caucasian female

Which of the following signs are the most important when determining if additional resuscitative efforts are needed in the newly born? A) Heart rate, muscle tone, and color B) Absence of meconium, muscle tone, and color c) Heart rate and ventilatory effort D) Ventilatory effort and absence of meconium

Which of the following stages of labor corresponds to the paramedic delivering the baby? A) a. Stage I B) d. Stage IV C) b. Stage II D) c. Stage III

Which of the following statements most accurately describes the pressure within an artery? A) c. It is moderate pressure. B) b. It is low pressure. C) a. It is high pressure. D) d. There is no pressure.

Which seizure is recognized by eye deviation, blinking, sucking, swimming movements of the arms, pedaling movements of the legs, and apnea? A) b. Simple B) a. Clonic C) c. Subtle D) d. Tonic

Which thick, dense layer of fibrous connective tissue provides the final layer of the skin's defense? A) d. Superficial fascia B) c. Reticular dermis C) a. Deep fascia D) b. Papillary dermis

Whiplash injuries involve what motion? A) d. Rotation B) a. Axial loading C) c. Hyperflexion/hyperextension D) b. Distraction

With a few exceptions, burn wounds should be treated with what kind of dressing? A) c. Occlusive B) d. Wet C) b. Dry D) a. Adherent

You are called to a young woman who is complaining of back pain. She states that it is severe. She also states that she has pain with urination, but denies vaginal discharge. She states that she has also had a fever and chills. Which of the following conditions is most likely? A) b. Mittelschmerz B) a. Cystitis C) d. Pyelonephritis D) c. Ovarian torsion

You are called to the home of a 48-year-old male who is complaining of chronic lower back pain in the lumbar region. The pain has become more intense over the past 24 hours and has begun to radiate down the right thigh. The patient denies trauma and states that the pain is from an old 'lifting' injury. Treatment of this patient would include: A) c. Placing the patient in Fowler's position with slight neck traction B) a. Administering 10 mg of morphine sulfate IM and transporting the patient in the Trendelenburg position C) d. Transporting the patient in the position that affords the most comfort and supportive care D) b. Full spinal immobilization and transport to a level 1 trauma center

You are delivering a baby. The head is crowning. Which of the following is an appropriate method of assisting delivery? A) d. Pull on the head. B) a. Place both hands on the head. C) c. Place one hand on the head and one hand on the perineum. D) b. Place one hand on each side of the perineum.

You are delivering the head of a baby. You notice mucus in the nose and mouth. Which piece of equipment is the most critical at this time? A) c. Gauze sponges B) b. Clean towel C) a. Bulb syringe D) d. Sanitary napkins

You are evaluating a 14-year-old female patient who fell off a top bunk and onto a binder. You expose her abdomen and can see a line of demarcation from the edge of the binder across both lower quadrants. When you palpate the abdomen, it is soft and nontender in all quadrants, and she rates her pain at 3 out of 10. Her heart rate is 86 beats/min, her respiratory rate is 20 breaths/min, her blood pressure is 114/60 mm Hg, and her skin is normal. You suspect that your patient: A) d. Will likely have liver swelling B) c. May have perforated her stomach C) a. Appears to only have superficial injuries but should still be evaluated by a physician D) b. Likely has massive internal bleeding

You are evaluating a 33-year-old female patient who was ejected from a motorcycle when her husband lost control on a corner. After exposing her body, you observe abrasions across her right flank and abdomen and note that bruising is developing along the posterior aspect of her right flank. Based on this information, you suspect that your patient: A) a. Has fatal injuries B) c. Likely has superficial abdominal injuries only C) d. May have internal abdominal injuries D) b. Is in decompensated hemorrhagic shock

You are evaluating a newborn with mild respiratory distress. Assessment of the patient shows decreased breath sounds, displaced heart sounds, and bowel sounds in the chest. Based on this presentation, from what might the patient be suffering? A) a. Choanal atresia B) d. Tracheoesophageal fistula C) b. Diaphragmatic hernia D) c. Omphalocele

You are on scene with a 25-year-old male who has complaints of lower back pain that started following mowing the lawn. He states he has no numbness, tingling, or weakness. On examination you determine that he can flex and extend at the ankles. Which of the following is the most important management of this patient? A) a. Cervical spine immobilization B) b. High-dose steroids C) d. Supportive D) c. Rapid transport

You are on scene with a 35-year-old female who is 40 weeks' pregnant. She states she has to push. Which of the following is the best position for this patient in preparation for delivery? A) b. Left lateral decubitus B) a. Kneeling or squatting C) d. Supine with knees flexed D) c. Prone

You are on scene with a patient who fell off of a construction beam. He has multiple fractures and bleeding. You are monitoring vital signs. Blood pressure is 50 mm Hg by palpation. Heart rate is 60 beats/min. Which of the following best describes this patient's condition? A) d. Washout phase B) a. Early (compensated) shock C) b. Irreversible shock D) c. Late (compensated) shock

You are on scene with a patient who has contractions. She is 30 weeks' pregnant. She has no evidence of contractions. What is the most appropriate therapy? A) d. Apply uterine massage. B) c. Apply tocolytic therapy. C) a. Prepare for delivery. D) b. Reassure the patient.

You are on scene with a patient who was in a snowmobiling accident. He hit a tree at a high rate of speed. He is cyanotic around the head and neck. He has a pulse of 130 beats/min that is thready. His oxygen saturation is 74%. He has a blood pressure of 100/80 mm Hg. Which of the following is an important management consideration for this patient? A) c. High-volume fluids B) a. Analgesic medications C) d. Supplemental oxygen D) b. Chest compressions

You are responding to a call to assist a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP, 174/104 mm Hg; P, 84 beats/min; and R, 20 breaths/min. The cause of this condition is: A) a. Excessive sodium intake B) b. Fetal pressure on the vena cavae C) d. Unknown D) c. Genetic abnormality

You are responding to a call to assist a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP, 174/104 mm Hg; P, 84 beats/min; and R, 20 breaths/min. The patients most likely to experience this condition are: A) b. Younger patients B) d. Women with previous histories of hypotension C) a. First-time mothers D) c. Patients taking steroids

You are treating a 14-year-old girl on scene at a motor vehicle crash. She is conscious but disoriented and has a rapid carotid pulse and no palpable radial pulse. She should be removed from the car: A) c. Using a short spine board such as a KED B) d. With one rescuer supporting her torso and neck C) b. By rapid extrication techniques D) a. By any rapid means possible

You are treating a 2-year-old, 24-lb patient. Upon assessment, the patient is unconscious, with the following vital signs: BP, 64/42 mm Hg; R, 26 breaths/min; P, 48 beats/min. Once the patient's airway is secured, what is the most appropriate pharmacologic intervention? A) b. Atropine 0.48 mg B) a. Atropine 0.22 mg C) c. Epinephrine 0.11 mg D) d. Epinephrine 0.24 mg

You are treating a 40-year-old female patient who was stabbed in the right upper quadrant with a steak knife. Oxygen has been administered, and the entry wound has been covered with a sterile dressing. Appropriate care for this patient includes: A) c. Transport to the closest emergency department for a blood transfusion B) a. Administration of IV epinephrine to help the patient compensate C) d. Transport to the closest trauma center D) b. IV fluids infusing at a KVO rate

You are working with a newly born infant who experienced an explosive delivery and is now vomiting. Which of the following should you most likely suspect? A) Gastric ulcer B) Gastrointestinal Infection C) Increased intracranial pressure D) Obstructed upper gastrointestinal tract

You arrive on scene to find a father administering rescue breaths to his 3-year-old child. He tells you that she was chewing on a piece of candy and began to choke. He tried but could not clear her throat, and she collapsed several minutes ago. The child appears ashen. You cannot ventilate the child's lungs; your partner completes an assessment while you perform laryngoscopy and remove the candy with Magill forceps. As you remove the candy, your partner tells you there is no pulse. You should immediately: A) b. Declare the patient dead B) c. Intubate the patient because the laryngoscope is already in the mouth C) a. Begin resuscitation D) d. Perform 30 seconds of bag-mask ventilations

You arrive on scene to treat a patient who has a fever and is complaining of lower abdominal pain. She states it has been getting worse over the past 2 weeks. Which of the following gynecologic emergencies would demonstrate these symptoms? A) a. Endometriosis B) d. Vaginitis C) b. Pelvic inflammatory disease D) c. Pregnancy

You arrive on scene to treat a woman who just delivered a baby. Your partner attends to the baby. Which of the following is a complication of delivery for the mother that needs to be addressed immediately? A) a. Hypotension B) b. Pain C) d. Vaginal bleeding D) c. Seizure

You arrive on scene where a building is on fire and a pregnant patient has been pulled from the smoke. She is unconscious. What should be your first action? A) d. Assess the baby for fetal heart tones. B) b. Assess for vaginal bleeding. C) c. Assess the airway. D) a. Assess for burns.

You begin preparing a patient for transport following a motor vehicle crash. During your assessment and development of a field impression, you determine that spinal immobilization is necessary. Which of the following is a true statement regarding spinal immobilization? A) a. Multiple rescuers may immobilize the spine. B) b. One rescuer should operate the bag mask while immobilizing the cervical spine. C) c. The cervical spine should be held until the patient is secured to the long board. D) d. The cervical spine should be immobilized until the cervical collar is placed.

You have been called to evaluate a 19-month-old boy in respiratory distress. His parents tell you that he seems to be having trouble breathing and appears subdued. On examination, you observe thick mucus in the nose and back of the mouth and hear rhonchi throughout his lungs. His temperature is 101° F. As you administer oxygen, you suspect this patient likely has: A) d. Respiratory syncytial virus B) b. New-onset asthma C) a. Bronchitis D) c. Pneumonia

You suspect that a 28-year-old female patient might be developing a pericardial tamponade after striking her chest against the steering wheel in a motor vehicle crash. She is currently awake and oriented. The most appropriate intervention is: A) b. Prehospital pericardiocentesis B) a. Bilateral needle chest decompression C) d. Rapid transport to the nearest trauma center D) c. Preparing the patient to have CPR performed while transporting her to a community hospital

Your patient is complaining of muscle spasms in the lower leg. Your choice of treatment would be to: A) d. Administer compression B) c. Apply ice C) b. Apply heat D) a. Administer medication

Your pediatric patient is 3 years old and has an elevated temperature of less than 102.2, loud stridor that is 'seal like,' cough, and nasal flaring. These are typically signs and symptoms of: A) A. Anaphylaxis B) B. Bronchiolitis C) C. Croup D) D. Epiglottitis

The minimum hydraulic pressure needed to break the skin and cause injury is: A) d. 2000 psi B) b. 500 psi C) a. 100 psi D) c. 1000 psi

C) a. 100 psi

Wilderness EMS teams should expect to interact with a variety of different groups and that can best be described as: A) b. Law enforcement, federal officials, and state officials B) d. Travel agents, clergy, and federal officials C) a. Aeromedical, military, and professional trip leaders/guides D) c. State officials, military police, and wilderness firefighters

C) a. Aeromedical, military, and professional trip leaders/guides

Which symptom is the most serious sign of a life-threatening environmental emergency? A) d. Tachypnea B) b. Hypotension C) a. Altered mental status D) c. Tachycardia

C) a. Altered mental status

You are evaluating a 14-year-old female patient who fell off a top bunk and onto a binder. You expose her abdomen and can see a line of demarcation from the edge of the binder across both lower quadrants. When you palpate the abdomen, it is soft and nontender in all quadrants, and she rates her pain at 3 out of 10. Her heart rate is 86 beats/min, her respiratory rate is 20 breaths/min, her blood pressure is 114/60 mm Hg, and her skin is normal. You suspect that your patient: A) c. May have perforated her stomach B) b. Likely has massive internal bleeding C) a. Appears to only have superficial injuries but should still be evaluated by a physician D) d. Will likely have liver swelling

C) a. Appears to only have superficial injuries but should still be evaluated by a physician

Following recognition of a pelvic fracture, your next intervention should be to: A) d. Provide pharmacologic pain management B) b. Apply a traction splint C) a. Apply a pelvic binder D) c. Inflate the abdominal compartment only of a pneumatic antishock garment

C) a. Apply a pelvic binder

In addressing wilderness EMS, which of the following best represents aspects of the 10 essentials for rescuer safety? A) b. Navigation aids and IV fluids B) d. Weather awareness, signaling and helicopter training, and Combitubes C) a. Attitude, clothing, and weather awareness D) c. Shelter, IV fluids, and ET kit

C) a. Attitude, clothing, and weather awareness

The best indicator of bladder or internal genitalia injury in the male patient is: A) d. Scrotal swelling and bruising B) c. Prehospital Foley catheter placement to look for blood in the urine C) a. Blood at the urethral meatus D) b. Swelling of the penis

C) a. Blood at the urethral meatus

A fracture or dislocation should be realigned when: A) b. The lower leg is involved B) d. The site is bleeding C) a. Circulation is impaired D) c. The patient reports extreme pain

C) a. Circulation is impaired

Which is the best statement regarding stabilizing an overturned tractor? A) c. Most overturned tractors do not need cribbing because of the unique shape of the tractor. B) d. Standard cribbing is usually sufficient to stabilize a tractor and attachment. C) a. Cribbing resources may be limited, which could hinder vehicle stabilization. D) b. It is important to standardize stabilization techniques to protect patients

C) a. Cribbing resources may be limited, which could hinder vehicle stabilization.

Traction splints are designed specifically to be used for what type of injuries? A) d. Tibia fractures B) c. Pelvic fractures C) a. Femur fractures D) b. Knee dislocations

C) a. Femur fractures

A patient injured his hand while punching someone with a closed fist. You anticipate his injury to be to the: A) c. Second phalange B) d. Thumb C) a. Fifth metacarpal D) b. First carpal

C) a. Fifth metacarpal

Following blunt abdominal trauma, the primary problem that develops for the patient is: A) c. Pain B) b. Ileus C) a. Hemorrhage D) d. Swellin

C) a. Hemorrhage

You are waiting for a mountain climber to be brought down from an altitude of 10,000 feet after he had an acute decline in his level of consciousness. A report from a wilderness first responder tells you that the patient had been experiencing worsening shortness of breath, had been coughing heavily, and said that he felt like he had no energy. According to the wilderness first responder, the patient's respiratory rate declined from 36 to 10 breaths/min when the patient's level of consciousness decreased from awake to responsive to painful stimuli. The first responder is treating the patient for high-altitude pulmonary edema. You suspect that this condition has resulted in: A) c. Respiratory failure B) b. Respiratory arrest C) a. High-altitude cerebral edema D) d. Severe respiratory distress

C) a. High-altitude cerebral edema

Wilderness EMS requires familiarity with fire and rescue equipment such as: A) d. Technical ropes, swift water transfer, and principles of hydraulics B) c. Technical ropes, swift water rescue, and hiking equipment C) a. Litter wheels, rescue sleds, and stokes baskets D) b. Swift water rescue and transfer, basics of height hydraulics, and hiking equipment

C) a. Litter wheels, rescue sleds, and stokes baskets

Which is the correct statement regarding IV access and fluid replacement for a patient who has been trapped under heavy equipment for over 1 hour? A) d. Start two or more large-bore IVs and run at KVO rates while extricating. B) c. Start one large-bore IV and monitor for fluid overload after extrication. C) a. Start at least one large-bore IV as soon as the patient is safely accessible. D) b. Start one IV after the patient has been extricated

C) a. Start at least one large-bore IV as soon as the patient is safely accessible.

Which of the following best describes a significant challenge to wilderness EMS in the United States? A) b. The dependence of paid personnel to provide rescue operations B) d. The undue intervention of federal government agencies such as FEMA C) a. The absence of a coordinating or certifying body D) c. The intransigence of the states in regard to reimbursement

C) a. The absence of a coordinating or certifying body

A condition where the abdominal wall is damaged and underlying abdominal structures are protruding through the abdominal wall is known as: A) a. Abdominal contusion B) c. Abdominal inversion C) b. Abdominal evisceration D) d. Abdominal protrusion

C) b. Abdominal evisceration

When an expectant mother experiences significant abdominal trauma, the placenta can separate from the uterine wall. This condition is known as: A) a. Abruptio placental previa B) c. Placenta previa C) b. Abruptio placentae D) d. Uterine rupture

C) b. Abruptio placentae

Toxic gasses that may be present in stored manure include: A) d. Methane, nitrous dioxide B) a. Ammonia, carbon monoxide C) b. Ammonia, hydrogen sulfide D) c. Carbon monoxide, methane

C) b. Ammonia, hydrogen sulfide

Before manipulating any injured extremity, you must: A) a. Administer intravenous analgesic per medical direction B) c. Place the patient on high-flow oxygen C) b. Assess distal pulses, sensation, and motor function D) d. Position the patient on a long backboard

C) b. Assess distal pulses, sensation, and motor function

C) b. Cease your efforts to realign, and transport

The most effective and definitive treatment for any illness related to high altitude is: A) a. Ascent B) c. Fluids C) b. Descent D) d. Rest

C) b. Descent

How does fever differ from heat stroke? A) a. Fever is caused by exercising the body too hard, whereas heat stroke is caused by the introduction of heat from the environment. B) d. Heat stroke resets the hypothalamus; fever does not. C) b. Fever is caused by pyrogens attempting to create an inhospitable environment in the body for some infection source, whereas heat stroke is caused by the introduction of heat from the environment. D) c. Heat stroke is the result of a failure of the circulatory system.

C) b. Fever is caused by pyrogens attempting to create an inhospitable environment in the body for some infection source, whereas heat stroke is caused by the introduction of heat from the environment.

Which is the best statement regarding farm injuries and written treatment protocols? A) a. Protocols can be ignored because they do not pertain to farm accidents. B) d. Protocols should always be exceeded when treating a patient in a farm accident. C) b. Protocols may be too limiting for farm accident victims who may need more care. D) c. Protocols must always be followed strictly to provide optimum care for the patient.

C) b. Protocols may be too limiting for farm accident victims who may need more care.

Which of the following best represents the symptom of a stinging sensation followed by pain and swelling 1 to 3 hours later, while working on farm machinery? A) b. Crush injury B) a. Allergic reaction to a bee sting C) c. Hydraulic fluid injection D) d. Silo filler's disease

C) c. Hydraulic fluid injection

Your crew is called to a local nightclub for a 23-year-old male with a hand injury. The patient tells you that he hit a brick wall when he missed his intended target. The patient's knuckles and the entire back of his hand are edematous and painful. His hand has limited movement of the distal phalanges. His hand is open and his fingers are bent. To immobilize this injury, you should: A) d. Straighten the fingers and then immobilize the hand B) b. Close the hand into a fist and then immobilize the hand C) c. Immobilize the hand in a position of function D) a. 'Buddy splint' the fingers together

C) c. Immobilize the hand in a position of function

Wilderness EMS is best defined as a system that is: A) d. Intertwined with more deliberate and dedicated EMS systems but with a separate medical skills set and objectives B) b. Integrated into a particular region or activity, which is distinct and separate from a traditional EMS system C) c. Integrated into or part of the standard EMS system, to provide wilderness care to a particular region D) a. Distinctively different from other EMS systems and operates with the structure and hindrances of traditional EMS

C) c. Integrated into or part of the standard EMS system, to provide wilderness care to a particular region

Many organizations are involved in wilderness EMS, and one contribution of the U.S. Department of Defense is: A) d. Providing physician support of all operations B) b. Integration of out-of-state resources C) c. Integration of former military members into wilderness teams D) a. As the sole provider of aircraft for rescue operations

C) c. Integration of former military members into wilderness teams

Pit vipers have what form of venom? A) d. Tissue toxins B) a. Local toxins C) c. Local and systemic toxins D) b. Neurotoxins

C) c. Local and systemic toxins

Which is the best explanation for the following set of symptoms: dizziness, drooling, eyes are watering, incontinent of urine, pupils are pinpoint in room light and nonreactive, and vital signs indicate hypotension and bradycardia? A) b. Heat stroke B) d. Silo filler's disease C) c. Pesticide poisoning D) a. Heat exhaustion

C) c. Pesticide poisoning

Paramedics play a vital role in early abdominal trauma management by: A) d. Triaging with patients who may or may not have suffered internal injuries following abdominal trauma B) a. Controlling internal bleeding C) c. Providing rapid response and rapid transport to a trauma center D) b. Identifying for the surgeons which organ is bleeding

C) c. Providing rapid response and rapid transport to a trauma center

The most accurate temperature is measured from which site? A) a. Axillary B) d. Tympanic C) c. Rectal D) b. Oral

C) c. Rectal

One of the most recognized wilderness systems is: A) a. The divers alarm network B) d. Search and recovery resulting from the high number of drownings C) c. Search and rescue D) b. The national wilderness medicine foundation

C) c. Search and rescue

_____________muscles are involved in movement. A) a. Cardiac B) b. Involuntary C) c. Skeletal D) d. Smooth

C) c. Skeletal

How does the management for classic heat stroke and exertional heat stroke differ? A) b. After rapid cooling, classic heat stroke also requires aggressive fluid resuscitation. B) a. Classic heat stroke requires rapid cooling, whereas exertional heat stroke requires aggressive fluid. C) d. After rapid cooling, there is no difference in care. D) c. After rapid cooling, exertional heat stroke requires aggressive fluid resuscitation

C) d. After rapid cooling, there is no difference in care.

A PASG can be used in place of which other type of splint? A) b. Ridged B) a. Flexible C) d. Air splint D) c. Sling and swath

C) d. Air splint

Prehospital management of internal genitalia or bladder injury includes: A) c. Foley catheter placement B) b. Flushing saline into the genitalia with a plastic catheter C) d. Attention to the ABCs and treating hemorrhagic shock if present D) a. Applying a compression bandage to the genitalia

C) d. Attention to the ABCs and treating hemorrhagic shock if present

While standing by at the scene of a fire, you are called over to treat a firefighter being dragged out of the fire. His turnout gear is intact and his face mask is on. However, he is responding to verbal stimuli with only incomprehensible verbal mumbling. After moving him into the ambulance, his colleagues assist you in removing his turnout gear and you find his skin hot and flushed with excessive sweating. He is breathing 40 breaths/min, and his exhaled air is noticeably hot. There is no evidence of trauma. You suspect he has: A) b. Hypoglycemia B) c. Evidence of a seizure C) d. Exertional heat stroke D) a. Classic heat stroke

C) d. Exertional heat stroke

Your ambulance is providing first-response coverage at a high school track meet. You are summoned to a 17-year-old female patient lying down by a bench. Her coach is concerned because she keeps vomiting the water she is trying to 'chug' down. You immediately notice she seems pale for such a hot day and she is sweating, and when you take her pulse it feels weak and rapid, approximately 120 beats/min. Your patient also complains she feels nauseated, is lightheaded, and has no energy. However, she can answer all questions appropriately. You suspect that this patient has: A) a. Classic heat stroke B) b. Exertional heat stroke C) d. Heat exhaustion D) c. Heat cramps

C) d. Heat exhaustion

A patient who is complaining of burning and irritation of the eyes and upper airways after working around manure has most likely been exposed to: A) c. Carbon monoxide inhalation B) b. Hydrogen sulfide inhalation C) d. Methane gas D) a. Ammonia

C) d. Methane gas

Farm machinery is powered by any one of three mechanisms including: A) c. Power take off, hydraulics, manual power B) a. Cascading electronics, hydraulics, motor C) d. Power take off, motor, hydraulics D) b. Power assist, motor, hydraulics

C) d. Power take off, motor, hydraulics

The acronym SLUDGE-BBM represents signs and symptoms including: A) c. Miosis, urination, mitosis, bronchospasm, emesis, lacrimation B) a. Bradycardia, urination, miosis, bronchospasm, enuresis, lacrimation C) d. Salivation, urination, miosis, bronchoconstriction, emesis, lacrimation D) b. Diarrhea, urination, miosis, bronchospasm, emesis, lacrimation

C) d. Salivation, urination, miosis, bronchoconstriction, emesis, lacrimation

The most serious concern of a bladder rupture is: A) a. Loss of the body's ability to eliminate urine B) b. Massive hemorrhage C) d. Shock and/or peritonitis D) c. Urine and blood leakage

C) d. Shock and/or peritonitis

Which of the following solid organs can be injured with trauma to the upper left abdominal quadrant? A) c. Pancreas B) a. Appendix C) d. Spleen D) b. Kidney

C) d. Spleen

In consideration of wilderness EMS, providers need to have knowledge not only of EMS but also of: A) b. The techniques of remote wilderness clinical or field medicine B) a. The techniques of practicing in solitude because of the solitary nature of wilderness EMS C) d. The techniques to care for themselves and their team D) c. The techniques of specialized skills such as field amputation and chest tubes

C) d. The techniques to care for themselves and their team

How does prehospital management of solid organ injury differ from management of hollow organ injury? A) b. Solid organ injuries require less fluid resuscitation. B) c. Solid organ injuries require treatment at a trauma center, unlike hollow organ injuries. C) d. There is no difference in prehospital management. D) a. Hollow organ injuries require less fluid resuscitation.

C) d. There is no difference in prehospital management.

When approaching an incident involving a patient trapped in a silo, the paramedic must consider: A) b. Collapsing walls of the silo that may interfere with rescue efforts B) a. Animal manure around the silo that may pose bacterial contamination C) d. Toxic gasses in the silo as a result of the fermentation of stored materials D) c. Higher than normal concentration of oxygen that may be flammable

C) d. Toxic gasses in the silo as a result of the fermentation of stored materials

Which of the following is considered a minor injury from a lightning strike? A) b. Mental status changes B) a. Cardiac dysrhythmia C) d. Tympanic membrane rupture D) c. Partial-thickness burns

C) d. Tympanic membrane rupture

Problems associated with an accidental injection of hydraulic fluid would include: A) a. Bacterial meningitis and respiratory compromise if sufficient fluid was injected B) c. Subcutaneous emphysema and pulmonary edema secondary to histamine release C) d. Vascular compression and ischemic necrosis to the point of amputation D) b. Severe generalized anaphylaxis and neurogenic hypoperfusion

C) d. Vascular compression and ischemic necrosis to the point of amputation

The best way to prevent frostbite is to: A) a. Avoid high mountain passes B) b. Place a lubricant on any exposed skin in a cold climate C) d. Wear proper clothing to protect the skin D) c. Stay well hydrate

C) d. Wear proper clothing to protect the skin

Which of the following statements about carbon monoxide poisoning is TRUE?

CO binds to iron-containing enzymes inside the cell, contributing to cellular acidosis.

C. Cheyne-Stokes respirations

Central herniation syndrome typically results in which of the following?

Which of the following is NOT an intrinsic (naturally occuring) risk factor associated with respiratory disease?

Cigarette smoking

C. Venous return to the right atrium is facilitated during inspiration.

Considering the mechanics of ventilation, which of the following is true?

A. The first 1 to 2 minutes

Cool-water immersion of a burned part effectively reduces burning only when done within which of the following time frames?

A 61-year-old male with a 24-pack-a-year history of smoking presents with pursed-lipped breathing and shortness of breath. You note that he is thin and has florid skin and a barrel chest. Auscultation of his lungs reveals diffuse expiratory wheezing to all fields. Based on this clinical condition, what additional complication is he most likely to develop?

Cor Pulmonale (or pulmonary heart disease is enlargement of the right ventricle of the heart as a response to increased resistance or high blood pressure in the lungs)

To which of the following medications does the late phase of an asthma attack best respond?

Corticosteroids

'Buddy splinting' refers to a technique in which a broken: A) d. Leg is secured by holding the injury in place against a long backboard B) b. Arm is secured to a rigid splint C) a. Arm is secured to a long backboard D) c. Finger or toe is taped to an adjacent but uninjured finger or toe

A 17-year-old male was body surfing at the beach when a particularly strong wave tossed him into the sea and he struck his head against the sand. Although he felt dizzy, he did not seek medical attention. A few hours later, he noticed a clear discharge from his right ear accompanied by a headache that did not respond to an over-the-counter pain reliever. He decided to call 9-1-1. When you arrive, you find no evidence of external injury and no indication of ear canal injury. Care for this patient and his draining ear would include: A) b. Aspirating any fluid from the ear, and then packing the ear canal with gauze B) a. Advising the patient to seek medical help if the draining does not stop over night C) c. Spinal immobilization and packing the ear canal with sterile gauze D) d. Spinal precautions and covering the affected ear with a loose dressing

A 21-year-old female has suffered a gunshot wound to the neck. On physical assessment you note that there is decreased air entry bilaterally; she has a crunching sound on auscultation of her heart tones and also crunching that is palpable on chest wall palpation. Which of the following is the best immediate intervention? A) d. Supplemental oxygen with a bag-mask device B) b. Chest compression C) a. Blind endotracheal intubation D) c. Immediate transport

A 24-year-old female patient was rear ended in a motor vehicle crash. She was stopped at a traffic light and was struck at approximately 45 mph. Which type of spinal injury would you suspect in this patient? A) d. Rotational B) b. Distraction C) a. Axial loading D) c. Flexion/extension

A 41-year-old man complains of lower back pain. He states that he was lifting a cabinet when he felt a sudden sharp pain that started in his low back and wraps around his torso. He states that his pain is worse with movement, coughing, and sneezing. On physical examination you notice reproducible point tenderness in the lumbar spine area. Based on your assessment, which of the following would be the most likely field impression for this patient? A) d. Tumor B) a. Degenerative disk C) c. Spondylosis D) b. Herniated disk

A 56-year-old male was struck in the center of his chest with a baseball bat during an altercation. He is complaining of chest pain. On physical assessment, there is bruising. He has equal breath sounds bilaterally. His heart rate is 108 beats/min, his blood pressure is 110/88 mm Hg, and he has respirations of 20 breaths/min. Which of the following would be indicated in the management of this patient? A) d. Solu-Medrol B) a. Dexamethasone C) b. Dopamine D) c. Morphine

A break that involves several breaks in the bone, causing bone fragment damage, is called a(n): A) c. Open fracture B) d. Spiral fracture C) b. Greenstick fracture D) a. Comminuted fracture

A critical assessment finding during your evaluation of a patient who experienced abdominal trauma is: A) d. Pain B) b. Bruising C) a. Anxiety D) c. Hypovolemic shock

A fracture of the femur can result in blood loss of up to: A) c. 1000 mL B) a. 250 mL C) b. 500 mL D) d. 2000 mL

A healthy adult will usually tolerate a blood loss of what percentage? A) d. 25% to 30% B) b. 15% to 20% C) c. 20% to 25% D) a. 10% to 15%

A neonate's heart rate is 50 beats/min after 30 seconds of positive-pressure ventilation and effective chest compressions. What is the next most appropriate pharmacologic choice for this patient? A) d. Naloxone B) a. Atropine C) c. Glucagon D) b. Epinephrine

A newborn has just been delivered. Which of the following is your first action? A) c. Wipe moisture off of the baby. B) b. Discuss findings with the mother. C) d. Wrap the infant in a blanket. D) a. Assess the airway; repeat suction if necessary.

A newly born infant stops breathing and when stimulated does not return to spontaneous respirations. What does this assessment describe? A) a. Newborn asphyxia B) b. Primary apnea C) c. Primary asphyxia D) d. Secondary apnea

A patient has a gunshot wound to the chest. He has dyspnea and loss of breath sounds on the side of the chest wound. Which of the following is most likely to occur? A) d. Traumatic asphyxia B) b. Simple pneumothorax C) c. Sternal fracture D) a. Hemothorax

A patient has been hit in the chest with a metal tire iron. You notice that he has a flail segment. Which of the following, based on the physiology of this injury, would be the most appropriate initial management? A) b. Perform chest compressions. B) c. Initiate an IV saline bag to the unaffected side. C) a. Provide bag-mask supplemental oxygenation. D) d. Administer high-flow oxygen.

A patient has been in a boating accident while water-skiing. She states that she cannot feel her legs. She is floating in the water by means of a life jacket. On physical examination, her legs are flaccid and she exhibits no muscle tone. Which of the following is an appropriate action for patient management and extricating the patient from the water? A) c. Pull the patient from the water with a life preserver. B) b. Pull the patient from the water immediately. C) a. Keep the patient in the water and pull to shore. D) d. Provide spinal stabilization and place the patient on a long board if possible.

A patient has been involved in a barroom altercation and is complaining of pain in the jaw. Examination of the patient reveals poor alignment of the teeth, step-off deformity, and trismus. Treatment of this patient includes: A) a. Applying heat to reduce swelling, immobilizing the cervical spine, and suctioning B) c. Removing loose teeth, applying heat, and using a cervical collar to splint the jaw C) b. Opening the mouth widely to examine for bleeding, then suctioning as needed D) d. Suctioning the airway as needed, cervical and spinal immobilization, and airway maintenance

A patient has been stabbed in his back just to the right of the midline of the upper thoracic spine. You are doing your clinical rotations in the hospital. The neurosurgeon informs you that the patient has Brown-Séquard syndrome. Which of the following physical examination findings would you expect to find in this patient? A) b. Right-sided loss of pain sensation B) a. Right-sided increased motor control C) d. Right-sided loss of temperature sensation D) c. Right-sided loss of proprioception

A patient has bleeding from a laceration on the right forearm. What is the most often used and most effective method to control this bleeding? A) d. Volume infusion B) b. Elevation of the extremity C) c. Pressure point D) a. Direct pressure

A patient has jumped from the fifth story of a building. Upon preparing this patient for transport, what is an important consideration? A) c. Transport in the Trendelenburg position. B) b. Transport in a position of comfort. C) a. Transport in semi-Fowler's position. D) d. Transport with cervical collar and long board application.

A patient has suffered severe blunt trauma to the abdomen. He denies any trauma to his back. He later complains of loss of function in his legs and bladder. Which of the following most likely explains this finding? A) a. Primary spinal cord injury B) c. Subjective findings only C) d. Tertiary spinal cord injury D) b. Secondary spinal cord injury

A patient is complaining of back pain. He states that he was playing paint ball and took a paint ball shot to his upper right back. He feels short of breath and has pain at the sight. On physical assessment, you observe that the patient has respirations of 24 breaths/min and shallow, a pulse oximetry of 91% on room air, and rales appreciated on auscultation in the right upper lung field posteriorly. Which of the following conditions is most likely causing his assessment findings? A) a. Pneumothorax B) c. Sternal fracture C) d. Subcutaneous emphysema D) b. Pulmonary contusion

A patient presents with a cleft palate. What would the primary concern be for this patient? A) d. Increased intracranial pressure B) a. Altered mental status C) b. Bradycardia D) c. Aspiration and airway obstruction

A patient presents with the following indications of a skull fracture: CNS drainage from the ears, loss of hearing, and Battle's sign. Based on this information, the location of the skull fracture is most likely the: A) c. Lateral fossa B) a. Anterior fossa C) b. Middle fossa D) d. Posterior fossa

A patient states he has a history of conus medullaris. Describe the pathophysiology of this injury pattern. A) c. Thoracic spinal cord compression B) d. Unilateral compression of nerve roots C) a. Cervical spine compression D) b. Injury to the nerve roots that continue down the spinal column

A patient who presents for 2 to 3 days with loud stridor, nasal flaring, retractions, and a temperature of 99° F is most likely suffering from which disease? A) b. Bacterial tracheitis B) d. Epiglottitis C) a. Asthma D) c. Croup

A patient with noted hypotension, bradycardia, and jugular venous distention would lead you to suspect what type of shock? A) b. Hypovolemic shock B) c. Neurogenic shock C) d. Septic shock D) a. Cardiogenic shock

A severe allergic reaction caused by histamine release from exposure to an antigen is called: A) c. Psychogenic shock B) b. Antihistamine shock C) d. Septic shock D) a. Anaphylactic shock

A woman states that she is pregnant and is having abdominal pain. You have asked her about previous pregnancies. She states that she has had two previous pregnancies, both of which resulted in live births. Which of the following represents this statement? A) d. G3P3 B) a. G2P0 C) b. G2P3 D) c. G3P2

A) A. An early sign of peritoneal irritation B) B. A late finding of peritoneal irritation C) C. A rupture or tear in the diaphragm D) D. Consistent with the hemorrhage associated with damage to a solid organ

After a crushing injury, restoration of blood flow brings oxygen in contact with the cells, but it also brings an oxygen free radical known as: A) c. Lipid peroxidase B) b. Lactic acid C) a. Creatine kinase D) d. Oxygen superoxide

After controlling the airway and any severe external bleeding in a patient with traumatic abdominal injuries, the most important treatment is to: A) b. Provide aggressive pain management B) d. Stabilize any musculoskeletal injuries C) a. Establish two large-bore IVs D) c. Provide early rapid transport to a trauma center

After delivery, you notice the following about the newborn: the heart rate has dropped abruptly, the skin has become blue and blotchy, and the newborn has stopped breathing. After you dry the infant, spontaneous respirations occur. What does this assessment describe? A) c. Primary asphyxia B) d. Secondary apnea C) a. Newborn asphyxia D) b. Primary apnea

Among children 5 to 9 years of age, which of the following is the most common cause of death from trauma? A) c. Motor vehicle crash B) a. Bicycle injuries C) b. Drowning D) d. Pedestrian crash

An Apgar score is based on which numeric values for each category? A) d. 1 to 4 B) c. 1 to 2 C) b. 0 to 4 D) a. 0 to 2

An elderly man complains of severe pain in his upper thigh and hip after a fall. The leg on the affected side is shortened and internally rotated. Which action would be appropriate? A) a. Apply a traction splint. B) b. Apply PASG and inflate leg segments. C) c. Attempt to reduce the dislocation. D) d. Pad behind the knee for comfort.

Anterior cord syndrome is characterized by: A) d. Weakness of the extremities on one side B) b. Paralysis of the arms C) c. Paralysis of the legs D) a. Decreased pain and temperature sensation

Appropriate care for abdominal organs protruding through the abdominal wall includes: A) d. Having the patient lie supine and providing aggressive pain management B) c. Inserting the organs back into the body C) b. Covering the organs with a dry dressing D) a. Covering the organs with moist dressing

As a paramedic, you realize that your ability to quickly recognize and treat a musculoskeletal injury helps to limit: A) a. Disease B) c. Morbidity C) d. Mortality D) b. Loss of use

As a paramedic, you recognize the greatest potential of blood loss is from a fracture of the: A) c. Rib B) a. Femur C) b. Humerus D) d. Pelvis

Assessing for the presence of the Babinski sign would have no clinical relevance in which of the following patients? A) b. An 18-year-old male B) c. A 34-year-old female C) d. A 69-year-old male D) a. A 1-year-old female

At which point should the blood pressure be obtained during the assessment of a pediatric patient? A) d. During the airway assessment B) c. During the breathing assessment C) a. After the breathing assessment D) b. After the rest of the circulatory assessment

Based on your knowledge of anatomy, you would suspect a patient with a stab wound in the upper right quadrant to be at risk for: A) d. A perforated stomach, causing infection B) c. A perforated bladder, causing infection C) b. A lacerated spleen, causing internal hemorrhage D) a. A lacerated liver, causing internal hemorrhage

Because of the relatively high resistance of the skin, lightning may travel across it, causing a pattern in the skin known as: A) b. Eschar B) d. Third spacing C) a. Cosmesis D) c. Ferning

Beck's triad is associated with which of the following conditions? A) b. Myocardial contusion B) a. Aortic dissection C) d. Pulmonary contusion D) c. Pericardial tamponade

Before manipulating any injured extremity, you must: A) d. Position the patient on a long backboard B) a. Administer intravenous analgesic per medical direction C) c. Place the patient on high-flow oxygen D) b. Assess distal pulses, sensation, and motor function

Blood from an artery is generally what color? A) c. Pink B) a. Black C) b. Blue D) d. Red

Braxton-Hicks contractions: A) d. Subside with rest B) b. Occur after 35 weeks' gestation C) c. Signal the beginning of labor D) a. Are mild, irregular contractions not associated with cervical dilation

Burns from ______ often have a garlic odor to them. A) b. Phenol B) d. Rubidium C) a. Lime D) c. Phosphorus

During irreversible shock, arterial hypotension and opening of AV shunts cause: A) b. Increased blood flow through the arterioles B) d. Systemic hypertension C) a. Decreased blood flow in the capillaries D) c. Stagnation of blood flow in the capillaries

Early shock is compensated by: A) b. Cellular/vascular shunting B) a. Capillary leakage C) c. Increased preload pressure D) d. Vasoconstriction

Ecchymosis around the umbilicus (Cullen's sign) is indicative of hemorrhage in which of the following organs? A) A. Spleen B) B. Liver C) C. Stomach D) D. Pancreas

Endometriosis is _________________________. A) A. The growth of endometrial tissue around the kidneys. B) B. The growth of endometrial tissue on the bladder. C) C. The growth of endometrial tissue on the diaphragm. D) D. The growth of endometrial tissue outside the uterus, usually on the pelvic structures around the uterus.

Following a traumatic pancreatic injury, the major concern becomes: A) a. Hypersecretion of insulin B) d. Massive hemorrhage C) b. Hyposecretion of insulin D) c. Leakage of digestive enzymes into the peritoneal space

Following blunt abdominal trauma, the primary problem that develops for the patient is: A) b. Ileus B) c. Pain C) d. Swelling D) a. Hemorrhage

Fractures of the zygoma: A) b. Are usually isolated injuries B) a. Are rare because of its heavy construction C) d. Rarely require any long-term care because they heal well on their own D) c. Commonly occur after motor vehicle crashes

Hollow organ rupture is most frequently caused by which of the following mechanisms? A) a. Contact sport collisions B) b. Restrained drivers in motor vehicle crashes C) c. Skiing accidents D) d. Unrestrained drivers in motor vehicle crashes

Hypothermia has the following effect on a newborn: A) a. Alkalosis B) c. Hypercarbia C) d. Hyperglycemia D) b. Bradycardia

If no trauma is suspected, which position would be appropriate for assessing the anterior and posterior fontanelles of an infant? A) b. Prone B) a. Lying on side C) d. Supine D) c. Sitting up

In assessment tool TICLS, what does the 'L' stand for? A) A. Lacrimation B) B. Lethargic C) C. Lividity D) D. Look or gaze

In children, what is usually the cause of cardiac arrest? A) d. Trauma B) c. Seizures C) a. Congenital heart disease D) b. Respiratory failure

In gunshot wounds, the _______ of the projectile is the most important factor in determining the amount of kinetic energy transferred to the body and therefore the amount of damage sustained by the patient. A) A. Mass B) B. Shape C) C. Tumble D) D. Velocity

In terms of burn zone injury, this area is in the greatest danger of becoming necrotic if perfusion (fluid resuscitation) is not restored in a timely manner. A) A. Keratinized cells B) B. Zone of coagulation C) C. Zone of hyperemia D) D. Zone of stasis

In terms of radioactive particles, these particles are most dangerous. A) A. Alpha particles B) B. Beta particles C) C. Delta particles D) D. Gamma radiation

It is recommended that patients with penetrating trauma receive a tetanus vaccine if they have not had one in _____ years. A) a. 3 B) c. 10 C) d. 15 D) b. 5

Most retroperitoneal hemorrhages occur as a result of: A) A. Kidney laceration B) B. Pancreas injury C) C. Tear of the duodenum D) D. Pelvic fractures

Muscle death precedes increased pressures in what soft tissue injury? A) a. Compartment injury B) c. Crush injury C) d. Crush syndrome D) b. Compartment syndrome

Neurogenic shock resulting from head injury creates: A) b. Hyperventilation syndrome B) a. Decreased cardiac output C) c. Peripheral vascular constriction D) d. Peripheral vascular dilation

On-scene care for the head-injured patient should be kept short and not exceed: A) d. 20 minutes B) c. 15 minutes C) a. 5 minutes D) b. 10 minutes

Once ignited, which of the following chemicals is difficult to extinguish and can burn in carbon dioxide and nitrogen environments? A) b. Mustard gas B) c. Phenol C) d. Phosphorus D) a. Magnesium

Once the decision has been made to realign a fracture site, you should: A) a. Continue realignment attempts until distal pulses are present B) b. Continue realignment attempts until the gross deformity has been reduced C) d. Wait to perform the procedure and realign only if the patient loses distal circulation D) c. Make only one attempt at realignment

Painless vaginal bleeding during pregnancy is most likely related to: A) c. Ruptured ectopic pregnancy B) a. Abruptio placentae C) d. Uterine rupture D) b. Placenta previa

Paramedics are on the scene of an industrial accident where a 34-year-old male has been entrapped between two pieces of sheet metal for more than 5 hours. Before calling medical direction, what can the paramedics anticipate will be ordered? A) d. NS with magnesium and furosemide B) b. D50 with potassium and mannitol C) c. LR with sodium bicarbonate and furosemide D) a. D5 1/2NS with sodium bicarbonate and mannitol

Paramedics are treating a patient who is experiencing pain and swelling to the lower extremity after a fall. After assessing the need for spinal immobilization, what is the next most appropriate treatment for this patient? A) a. Apply a cold pack. B) b. Apply manual traction. C) d. Splint above and below the injury. D) c. Check for pulse, motor, and sensory responses.

Paramedics play a vital role in early abdominal trauma management by: A) b. Identifying for the surgeons which organ is bleeding B) a. Controlling internal bleeding C) d. Triaging with patients who may or may not have suffered internal injuries following abdominal trauma D) c. Providing rapid response and rapid transport to a trauma center

Peritonitis and cellulitis might produce what type of shock? A) b. Hemorrhagic shock B) c. Hypovolemic shock C) a. Cardiogenic shock D) d. Septic shock

Prehospital management of internal genitalia or bladder injury includes: A) a. Applying a compression bandage to the genitalia B) c. Foley catheter placement C) b. Flushing saline into the genitalia with a plastic catheter D) d. Attention to the ABCs and treating hemorrhagic shock if present

Symptoms that are associated with hypoglycemia in the newborn include: A) a. Eye rolling and hyperactivity B) b. Lethargy and hyperpnea C) c. Limpness and sweating D) d. Twitching and a high-pitched cry

Synovial joints are composed of the bones' ends, which are held together by: A) d. Tendons B) a. Cartilage C) c. Synovial fluid D) b. Ligaments

The best indicator of bladder or internal genitalia injury in the male patient is: A) b. Swelling of the penis B) d. Scrotal swelling and bruising C) c. Prehospital Foley catheter placement to look for blood in the urine D) a. Blood at the urethral meatus

The concern for an infant with a prolapsed cord is that the cord will: A) c. Become contaminated by the outside environment B) b. Be too short for an appropriate delivery C) d. Obstruct the vaginal opening and interfere with delivery D) a. Be compressed and cut off blood supply and oxygen to the infant

The damage of frontal lobe brain tissue by an impact to the occipital lobe is referred to as: A) d. Transmural organic brain trauma (TOBT) B) b. A coup injury C) c. Rebound tenderness D) a. A contrecoup injury

The death rate for patients with cardiogenic shock is: A) d. Typically low with adequate fluid replacement B) c. Lower than 20% with antibiotic therapy C) b. High unless bronchodilators are administered immediately D) a. High

The development of the ligamentum arteriosum originates from the closure of which structure? A) b. Ductus venosus B) c. Foramen ovale C) d. Septum primum D) a. Ductus arteriosus

The greatest factor in the amount of energy causing trauma to a patient is: A) b. The angle at which an object strikes the body B) d. The insulting object's weight C) a. Patient weight D) c. The insulting object's velocity

The inability of a newborn to begin and continue breathing at birth is called: A) c. Primary asphyxia B) d. Secondary apnea C) b. Primary apnea D) a. Newborn asphyxia

The leading cause of maternal injury is: A) b. Interpersonal violence B) d. Penetrating objects C) a. Falls D) c. Motor vehicle crashes

The most common cause of herniated intervertebral disks is: A) d. Motor vehicle crashes B) b. Degenerative disk disease C) a. Arthritis D) c. Improper lifting

The most common type of skull fracture is the _____ fracture. A) a. Basilar B) b. Depressed C) d. Open D) c. Linear

The part of the vertebrae that supports most of the weight of the vertebral column is the: A) d. Transverse process B) c. Disk C) a. Arch D) b. Body

The patient is a 38-year-old woman who suddenly became unconscious moments before her husband called 9-1-1. Upon arriving at the scene, you find the unresponsive patient with increasing blood pressure, bradycardia, and irregular breathing. Her left pupil is dilated. When you inquire about the patient's medical history, you learn that the couple was on vacation 1 month ago and took a horseback tour. While on the tour, the woman fell off the horse. She seemed to be fine at the time, and the staff in the ED said she was okay. Based on this information, you suspect: A) c. Subarachnoid bleeding B) d. Subdural hematoma C) a. Epidural hematoma D) b. Herniated brainstem

The patient shows bleeding that presents in a steady, slow flow that is dark and red. This type of hemorrhage is called a(n): A) A. Arterial bleed B) B. Capillary bleed C) C. Coagulation D) D. Venous bleed

The signs of external bleeding are dependent on which of the following? A) a. The patient's age B) c. The size of the patient C) b. The patient's temperature D) d. The source of the bleeding

The structure of the outer ear is mostly comprised of: A) a. Blood vessels B) b. Bone C) d. Muscle D) c. Cartilage

To reduce pain and swelling in the first 24 hours after a sprain, apply: A) a. Heat and ice, alternating every 3 to 4 hours B) d. Warm soaks C) b. Heat first, and then ice, once the muscles are warmed D) c. Immobilization and ice

Upon examining your patient, you suspect she may be developing a compartment syndrome of the lower leg. What is your best course of action when treating this patient in the field? A) A. Apply a PASG to decrease swelling and control internal bleeding. B) B. Administer RICE. C) C. Splint it with a padded splint in the position found. D) D. Transport the patient to the closest, most appropriate facility

Use of the PASG is indicated for what type of injury? A) A. Abdominal hemorrhage B) B. Dislocated ankle C) C. Humoral fracture D) D. Pelvic fracture

What chemical is used primarily in the manufacturing of munitions and fireworks? A) b. Phenol B) d. Rubidium C) a. Lime D) c. Phosphorus

What is described as renal failure after crush injuries? A) a. Compartment injury B) b. Compartment syndrome C) c. Crush injury D) d. Crush syndrome

What is described as the protrusion of abdominal organs into the umbilical cord? A) d. Spina bifida occulta B) b. Meningocele C) a. Hydrocephalus D) c. Omphalocele

What is the correct dose of epinephrine during the cardiac arrest of a newborn? A) b. 0.1 mg/kg B) c. 0.015 mL/kg C) d. 0.15 mL/kg D) a. 0.01 mg/kg

What is the most appropriate action to take if hemorrhage control has not been achieved with direct pressure? A) a. Apply a bulky dressing. B) c. Apply pressure to a pressure point. C) b. Apply a tourniquet. D) d. Use elevation of the limb.

What is the most appropriate treatment plan for the patient with a cerebrospinal fluid shunt malfunction? A) b. Hyperventilate. B) a. Administer oxygen. C) c. Intubate. D) d. Tap the shunt reservoir.

What is the most common result of blunt trauma to the head? A) d. Hematoma B) b. Contusion C) c. Diffuse axonal injury D) a. Concussion

What is the pathophysiology associated with SCIWORA? A) d. No spinal cord injury B) a. Fractured cervical vertebrae C) b. Fractured spinous process D) c. No evidence of injury on x-ray

What is the transplantation of the skin of one patient from its original location to that of a wound on the same patient? A) a. Allograft B) c. Homologous grafting C) d. Xenograft D) b. Autologous grafting

What is the typical goal for the administration of IV fluids for the patient with signs and symptoms of shock? A) c. A systolic pressure between 70 and 80 mm Hg B) a. A systolic pressure between 50 and 60 mm Hg C) b. A systolic pressure between 60 and 70 mm Hg D) d. A systolic pressure between 80 and 90 mm Hg

What occurs when the supply of narcotics is cut off from a newborn who has an addicted mother? A) b. Infant withdrawal syndrome B) d. Neonatal withdrawal syndrome C) a. Infant abstinence disorder D) c. Neonatal abstinence syndrome

What pathophysiology is associated with a pulmonary contusion? A) c. The presence of air in the soft tissue B) d. Three or more fractured ribs, causing a moving segment of chest wall C) b. Increased pressure in the head, neck, and chest cavity D) a. Direct bruising to the lung tissue

What possible condition should be considered when a patient reports a 'ripping' or 'tearing' pain in the back or abdomen? A) c. Pancreatic cancer B) d. Pelvic inflammatory disease C) b. Liver disease D) a. Aortic aneurysm

What should be done to decrease the flexion of the cervical region of a pediatric patient? A) b. Place a towel under the head. B) a. Place a towel under the chest. C) c. Place a towel under the shoulders. D) d. Place padding under the shoulders to the hips.

What should you do when the amniotic fluid in your infant patient is stained with meconium and the infant is not vigorous? A) a. Apply cricoid pressure to prevent aspiration. B) d. Position the infant's head down to facilitate drainage. C) b. Initiate cardiopulmonary resuscitation. D) c. Suction the trachea.

What size bag-mask device is most appropriate for a 3-day-old infant? A) b. 350 to 400 mL B) d. 500 to 1000 mL C) a. 250 to 300 mL D) c. 450 to 500 mL

What syndrome is caused by administered fluids accumulating in the peritoneal cavity and the bowel walls, resulting in increased pressure of the abdomen? A) d. Abdominal mesenteric syndrome B) a. Abdominal ascites syndrome C) c. Abdominal effusion syndrome D) b. Abdominal compartment syndrome

What term denotes ionizing radiation passing through the air? A) b. Rem B) a. Hertz C) d. Sievert D) c. Roentgen

What type of tissue is also known as dense connective tissue and is composed of an abundant amount of collagenous fibers where one end is joined to muscle? A) A. Bursa B) B. Cartilage C) C. Ligaments D) D. Tendons

What would be the minimum systolic blood pressure for a 5-year-old? A) b. 70 mm Hg B) d. 90 mm Hg C) a. 60 mm Hg D) c. 80 mm Hg

When delivering positive-pressure ventilations with a bag-mask device to a newborn, the assisted ventilation rate should be ____ breaths/min and _____ breaths/min when chest compressions are being delivered. A) 10 to 20; 30 B) 20 to 40; 20 C) 30 to 40; 40 D) 40 to 60; 30

When paramedics are called to assist with a public education event to inform children about the importance of wearing bicycle helmets, which form of prevention would they be teaching? A) b. Primary B) c. Secondary C) d. Trauma D) a. Injury

When treating a patient who is a victim of a dry chemical burn, after ensuring the airway is secure and the clothing is removed, what is the next step? A) b. Cover the area. B) c. Irrigate the area with water. C) d. Neutralize the chemical. D) a. Brush off the chemical.

Which of the following are considered normal vital signs for a newborn? A) a. Respirations, 28 breaths/min; heart rate, 98 beats/min B) d. Respirations, 60 breaths/min; heart rate, 96 beats/min C) b. Respirations, 30 breaths/min; heart rate, 190 beats/min D) c. Respirations, 40 breaths/min, heart rate, 170 beats/min

Which of the following assessment findings is consistent with subcutaneous emphysema? A) d. Rales B) b. Large chest wall hematomas C) c. Localized tenderness D) a. Crunching sensation on palpation

Which of the following assessment findings would be consistent with a tracheobronchial injury? A) b. Hypertension B) d. Increased lung sounds C) c. Increased heart tones D) a. Crunching of heart tones

Which of the following can occur secondary to rib fractures? A) a. COPD B) b. Decreased atelectasis C) d. Hyperventilation D) c. Decreased ventilatory function

Which of the following causes obstructive shock? A) c. Stenosis B) a. Deep vein thrombosis C) b. Peripheral vascular constriction D) d. Tension pneumothorax

Which of the following conditions is considered to be an upper airway disease? A) d. Pneumonia B) a. Asthma C) b. Bronchiolitis D) c. Epiglottitis

Which of the following dressings enhances healing by creating a wound environment that is supportive of the movement of cells across the membranes? A) b. Occlusive B) a. Dry C) c. Sterile D) d. Wet

Which of the following dressings is commonly used after wound closure to allow for drainage away from the wound? A) c. Nonocclusive B) d. Nonsterile C) a. Nonabsorbent D) b. Nonadherent

Which of the following is a cause of distributive shock? A) c. Laceration B) a. Broken femur C) b. Heart attack D) d. Spinal cord injury

Which of the following is a common vesicant chemical? A) d. Sodium bicarbonate B) a. Hydrochloric acid C) c. Paint lacquer D) b. Lewisite

Which of the following is a possible cause of bleeding from the nose, ears, or mouth? A) c. Liver laceration B) b. Kidney contusion C) a. Femur fracture D) d. Skull fracture

Which of the following is an uncommon dysrhythmia in children? A) a. Sinus bradycardia B) b. Sinus tachycardia C) c. Ventricular fibrillation D) d. Ventricular tachycardia

Which of the following is considered a form of closed soft tissue trauma? A) d. Traumatic asphyxia B) c. Pneumothorax C) a. Avulsion D) b. Hematoma

Which of the following is considered a type of soft tissue trauma that lies somewhere between the two broad categories of open and closed? A) d. Penetrating B) a. Blast C) c. Crush D) b. Blunt

Which of the following is true regarding the incidence of thoracic injuries in the trauma patient? A) a. The incidence of sternal fracture is higher in those who are unrestrained. B) b. Patients with COPD can easily compensate minor chest trauma. C) c. Rib fractures occur more commonly in children. D) d. The most common cause is motor vehicle crashes.

Which of the following most accurately defines croup? A) A. Bacterial infection, affects the lower airway, affects patients younger than 6 months old B) B. Bacterial infection, affects the upper airway, affects patients 6 months to 6 years old C) C. Viral infection, affects the lower airway, affects patients older than 6 years of age D) D. Viral infection, affects the upper airway, affects patients 6 months to 6 years old

Which of the following most appropriately define 'newly born'? A) the first week of life B) The first month of life C) From 1 month to 1 year of life D) From the first minutes to hours of life

Which of the following plays a significant role in allergic reactions and the inflammatory response to injury? A) a. Fibroblasts B) d. Neutrophils C) b. Macrophages D) c. Mast cells

Which of the following radiation exposure levels is the highest that will yield no significant acute symptoms? A) a. 50 rem B) b. 70 rem C) d. 500 rem D) c. 100 rem

Which of the following statements most accurately describes the presentation of signs and symptoms of internal bleeding? A) c. Signs and symptoms of internal bleeding may mimic a heart attack. B) b. Signs and symptoms of internal bleeding may be masked by an illness. C) a. Signs and symptoms of internal bleeding are readily apparent in all cases. D) d. Signs and symptoms of internal bleeding may not develop for a significant period of time.

Which of the following would be considered part of the appearance assessment in the pediatric assessment triangle? A) a. Body position B) d. Work of breathing C) c. Skin color D) b. Mental status

Which of the following would be considered part of the circulation assessment in the patient assessment triangle? A) a. Body position B) b. Mental status C) c. Muscle tone D) d. Skin color

Which of the following would have a greater risk for severe complications after a lower extremity injury? A) a. A 25-year-old female with a spinal cord injury B) c. A 45-year-old female with hypertension C) b. A 35-year-old male with a head injury D) d. A 55-year-old male with diabetes

Which open soft tissue wound is described as flaps of skin or other tissue that are pulled partially or completely off of the patient? A) c. Evisceration B) a. Amputation C) d. Laceration D) b. Avulsion

Which part of the spinal cord accounts for the highest incidence of spinal cord injury? A) b. Lumbar B) c. Sacral C) d. Thoracic D) a. Cervical

Which penetrating object is least likely to have a straight trajectory through the body? A) c. Glass shard B) d. Knife C) a. Arrow D) b. Bullet

Which radioactive particles are large and only travel short distances? A) d. Roentgens B) b. Beta C) c. Gamma D) a. Alpha

Which seizures are characterized by sudden but short contractions of either single muscles or a muscle group? A) b. Multifocal B) d. Subtle C) a. Focal motor D) c. Myoclonic

Which soft tissue injury occurs when large veins or arteries are ruptured beneath intact skin? A) d. Tamponade B) b. Ecchymosis C) a. Contusion D) c. Hematoma

Which statement is correct regarding the bones of the cranium? A) a. Because the layers are thick in everyone, the risk of fracture is less. B) d. They consist of two layers—one solid bone and one spongy bone. C) b. They are protected by padding from layers of cranial muscle. D) c. They consist of three layers—a spongy layer between two solid layers.

Why are fractures in the area of the epiphyseal plate of pediatric patients considered serious? A) A. Because of their location, epiphyseal plate fractures are inherently difficult to immobilize properly. B) B. The epiphyseal plate is a very vascular area. A fracture here may result in a great deal of blood loss, especially dangerous in the pediatric population because of their smaller amount of circulating blood volume. C) C. The epiphyseal plate is located near a joint and therefore may involve nerve and vascular structures. These plates must be handled carefully to avoid permanent damage to the extremity. D) D. The epiphyseal plate is the area of the bone responsible for the growth of the bone. A fracture here may prevent proper growth of the bone and cause unusual deformity to joints or an unnatural bending.

Why is the use of alcohol, Betadine, and hydrogen peroxide contraindicated in the cleansing of wounds? A) d. Suppresses the immune system B) c. Inhibits the action of neutrophils C) b. Increases inflammation D) a. Destroys healing cells

Within how many days of injury do fibroblasts begin to divide and produce collagen? A) b. 6 to 9 B) c. 8 to 12 C) d. 10 to 15 D) a. 3 to 5

Wounds that involve the large arteries of the neck or those that open into the chest cavity require which type of dressing? A) c. Nonocclusive B) b. Nonadherent C) a. Adherent D) d. Occlusive

You are assessing a 2-year-old patient who is irritable and restless, has audible wheezes with retractions, and has see-saw respirations. What do these signs and symptoms indicate? A) a. Congestive heart failure B) c. Respiratory failure C) b. Pulmonary edema D) d. Respiratory distress

You are assessing an infant who has spontaneous eye opening, cries only to pain, and withdraws from touch. Which rating on the pediatric Glasgow scale would this patient receive? A) a. 10 B) c. 13 C) d. 15 D) b. 12

You are called to a high school metal shop to treat a 14-year-old female who has metal shavings in her left eye. The instructor informs you that while operating a lathe, the patient was not wearing her safety goggles; metal shavings flew into her face. The patient is complaining of pain at the left lateral aspect of the globe in the sclera region. When you examine the eye, you observe the presence of small, free-floating metal particulates. Proper management of this presentation should include attempting to: A) c. Remove the particulates by gently massaging the patient's closed eyelid B) b. Pull out the particulates using sterile tweezers C) d. Remove the particulates using a cotton-tipped applicator D) a. Flush out the particulates by means of gentle irrigation

You are called to a long-term care rehabilitation facility for a 24-year-old male patient with elevated blood pressure. The patient is a quadriplegic who was just transferred to the facility from the hospital after a complete transection of the cord at the level of T1. Assessment shows blood pressure 240/126 mm Hg, respirations 24 breaths/min, and a distended abdomen. The patient is also complaining of a headache and blurred vision. The cause of this patient's signs and symptoms is: A) a. Healing of the spinal nerves B) b. Parasympathetic nervous system stimulation C) c. Sympathetic nervous system blockade D) d. Sympathetic nervous system stimulation

You are called to a rehabilitation center for patients who have spinal cord injury. A patient was working with weights when he suddenly had a seizure. The staff noticed that his blood pressure was 220/120 mm Hg. On your physical examination and assessment you determine that the patient has piloerection, diaphoresis, and skin pallor. What is the pathophysiology behind this syndrome? A) a. Lack of sympathetic reflexes B) b. Massive vasodilation above the site of spinal cord injury C) c. Parasympathetic dysreflexia D) d. Sympathetic overstimulation

You are dispatched to treat a 22-year-old male patient who has reportedly been struck with a ball bat at the midshaft right femur. The area is contused, swollen, and angulated. The patient is conscious, alert, and normotensive, but tachycardic. He is in what stage of shock? A) c. Irreversible shock B) b. Decompensated shock C) d. Postcapillary shock D) a. Compensated shock

You are evaluating a 24-year-old female patient who was the driver of a sedan involved in a head-on highway-speed motor vehicle crash. After she has been extricated from being pinned against the steering wheel, you begin your evaluation. She is awake but very anxious and confused. You do not note any head trauma, JVD is present, her chest wall appears intact, but her lung sounds are decreased bilaterally, though clear. Her heart tones sound distant. There is a large abrasion from the seatbelt developing across her chest and bruising in the shape of the steering wheel. Her abdomen is tender in the upper quadrants with bruising developing in the right upper quadrant. Her vital signs are heart rate, 128 beats/min; blood pressure, 88/74 mm Hg; and respiratory rate, 26 breaths/min and shallow. Immediate care for this patient includes: A) a. IV fluids, blood ideally, for hypovolemia B) c. Needle chest decompression for a tension pneumothorax C) b. PASG and rapid sequence intubation D) d. Pericardiocentesis for cardiac tamponade

You are on scene of a patient who fell playing basketball, landing on his head and causing it to hyperextend. He is complaining of a burning sensation in his upper arms and has lost control of his bladder. On physical examination and assessment, he has weakness in his upper arms, loss of proprioception, and sensation of temperature. Which of the following is the best pathophysiologic description for this injury? A) a. Anterior cord syndrome B) d. Cord contusion C) b. Brown-Séquard syndrome D) c. Central cord syndrome

You are on scene with a 24-year-old female who is pregnant with twins. She feels the contractions starting. Which of the following is the most appropriate management? A) c. Prepare for delivery. B) b. Contact the obstetrician. C) d. Transport immediately. D) a. Contact the hospital for special instructions.

You are on scene with a 92-year-old female who lives alone. The heat index is above 100° F. She denies trauma but smells of incontinence of watery stool. You arrive on scene and measure a heart rate of 120 beats/min and a blood pressure of 72 mm Hg systolic by palpation. You notice no injury. Which of the following is the probable cause of her hypovolemic shock? A) d. Internal bleeding B) c. External bleeding C) a. Congestive heart failure D) b. Dehydration

You are on scene with a patient who had open-heart surgery 2 weeks ago. He is complaining of chest pain, shortness of breath, and weakness. On physical examination, you notice jugular venous distention, clear lung sounds, and muffled heart tones. Which of the following types of shock is this patient demonstrating? A) b. Dissociative B) a. Cardiogenic C) c. Hypovolemic D) d. Obstructive

You are on scene with a patient who is 22 years old. She is crying and will not provide any history. Which of the following would indicate a possible gynecologic emergency in which there is significant bleeding? A) d. Temperature B) c. Syncope C) a. Hypertension D) b. Respiratory distress

You are on scene with a patient who is 39 weeks' pregnant. She has been having contractions. Which of the following is evidence of imminent delivery? A) a. Contractions that are 2 minutes apart B) d. Vaginal bleeding C) b. Her water breaking D) c. Observation of the presenting part

You are on scene with a woman who is about to deliver a baby. The infant is presenting with a hand. Which of the following is the most appropriate action? A) c. Provide a tocolytic. B) a. Contact the obstetrician. C) b. Prepare for delivery. D) d. Provide rapid transport.

You are responding to the scene of the possible drowning of a 2-year-old. Which of the following is considered a normal respiratory rate for this patient? A) a. 12 to 20 breaths/min B) b. 18 to 30 breaths/min C) c. 22 to 34 breaths/min D) d. 24 to 40 breaths/min

You are treating a patient in decompensated shock. On physical exam, you note that the patient has hypotension, tachycardia, tachypnea, and crackles. What type of shock do you suspect? A) d. Septic B) a. Anaphylactic C) c. Hypovolemic D) b. Cardiogenic

You are treating a patient with a rapid onset of stridor, drooling, and a high fever. What is the most appropriate intervention for this patient? A) d. Intubate immediately. B) c. Examine the oropharynx. C) b. Assist ventilations. D) a. Administer oxygen.

You are treating a pregnant patient in her 35th week of gestation with her first child. She called 9-1-1 for sudden-onset abdominal pain, vaginal bleeding, and contractions. You suspect this patient has: A) d. Uterine rupture B) b. Placenta previa C) c. Ruptured ectopic pregnancy D) a. Abruptio placentae

You arrive on scene to assist a 78-year-old female who is complaining of pain in her neck. She states it travels down her arms and has a sharp, burning quality. She denies any trauma, but has a history of mild dementia. On physical examination you note that she has pain with palpation of her cervical spine. Which of the following is important in the management of this patient? A) a. Allow the patient to follow up with her primary care doctor. B) d. Transport the patient in a position of comfort. C) b. Provide warm compresses to the neck. D) c. Stabilize the neck with a cervical collar and long board.

You arrive on scene to treat an 'unresponsive infant.' Two very anxious parents direct you to a bedroom where a baby is lying face down in the crib and is not moving. You lift the infant to assess the airway, and the infant's extremities stay fixed in position. The infant feels cold to the touch, and its face and chest are purple; there is no breathing and no pulse. The infant's mother tells you she put him down for a nap 2.5 hours ago and thought he was just sleeping until she went to check on him. What should you do? A) d. Immediately begin CPR. B) b. Attempt intubation, and if the airway cannot be established declare the patient dead. C) a. Accuse the parents of neglecting the baby. D) c. Complete your assessment, and declare this patient dead following established protocols.

You have arrived on scene to treat a patient who states that she is having contractions. She says that they are mild. She is 34 weeks' pregnant and denies any vaginal bleeding. Which of the following is a possible cause of this patient's contractions? A) d. Stage II labor B) b. Cystitis C) c. Premature rupture of membranes D) a. Braxton Hicks

You have just assisted in the delivery of a baby. The placenta has not delivered yet. Which of the following is appropriate when delivering the placenta? A) b. Discard the placenta. B) c. Manually remove the placenta from the uterine wall. C) d. Pull on the umbilical cord. D) a. Allow the placenta to deliver on its own.

You have just delivered a newborn at 38 weeks' gestation. Upon assessment, you discover a scaphoid abdomen and hear unusual sounds in the left lower chest. The neonate is exhibiting mild respiratory distress. Based on this presentation, what should you suspect? A) c. Tension pneumothorax B) d. Tracheoesophageal fistula C) a. Choanal atresia D) b. Diaphragmatic hernia

You respond to a car versus bicycle accident involving a 10-year-old boy who is wearing a helmet. Which of the following would indicate the need to remove the helmet? A) a. The patient is complaining of neck pain. B) b. The patient has adequate respirations. C) d. Because helmets should never be removed, you must work around it. D) c. The helmet has an improper fit.

Your ambulance crew is called to a scene where a 42-year-old female fell from a second-story balcony and landed on her outstretched right arm. There is gross deformity at the shoulder. The patient is unconscious. You should address immobilization of the deformed right shoulder by: A) c. Applying a traction splint B) a. Applying a sling C) b. Applying a sling and swathe D) d. Immobilizing the patient to a long backboard

Your crew is called to a local skating rink to treat a 42-year-old female who fell. She is complaining of severe elbow pain and is supporting the affected limb against her body. To manage this situation effectively, you should: A) b. Rotate the arm to 90 degrees and secure it with a sling and swathe B) a. Rotate the arm to 90 degrees and secure it with a rigid splint C) d. Splint the arm in the position found, using a traction splint D) c. Splint the arm in the position found, using a pillow or blanket

Your patient has a blood pressure of 60/40 mm Hg and a heart rate of 110 beats/min, and you suspect internal bleeding. Which of the following is an appropriate initial treatment for this patient? A) b. Contact medical control. B) a. Consider cardioversion. C) c. Start dopamine. D) d. Start two large peripheral IV lines.

Your unit is dispatched to a possible suicide attempt by hanging. Which specific type of injury should be suspected? A) c. Extension B) a. Axial loading C) d. Rotational D) b. Distraction

_____________muscles are involved in movement. A) a. Cardiac B) d. Smooth C) b. Involuntary D) c. Skeletal

Based on your knowledge of anatomy, you would suspect a patient with a stab wound in the upper right quadrant to be at risk for: A) c. A perforated bladder, causing infection B) d. A perforated stomach, causing infection C) b. A lacerated spleen, causing internal hemorrhage D) a. A lacerated liver, causing internal hemorrhage

D) a. A lacerated liver, causing internal hemorrhage

A major risk for both an expectant mother and her fetus following a serious traumatic event is: A) d. Preecclampsia B) c. Placenta previa C) b. HELLP syndrome D) a. Abruptio placentae

D) a. Abruptio placentae

The most robust wilderness EMS systems attain preparation by: A) b. Atypical basic skills with little flexibility built in B) d. Fully designed protocols with little variance to ensure clinical standards C) c. Flexible protocols but with rigid online medical direction D) a. Atypical and advanced skills with some flexibility built in

D) a. Atypical and advanced skills with some flexibility built in

Appropriate care for abdominal organs protruding through the abdominal wall includes: A) b. Covering the organs with a dry dressing B) c. Inserting the organs back into the body C) d. Having the patient lie supine and providing aggressive pain management D) a. Covering the organs with moist dressing

D) a. Covering the organs with moist dressing

In planning for a wilderness EMS system, it is necessary to define mechanisms and missions because of: A) c. Differences in medicolegal protocols and outcome consequences B) d. Differences in protocols and clinical objectives C) b. Differences in medicolegal consequences and protocols D) a. Differences in mechanism of injury and clinical consequences

D) a. Differences in mechanism of injury and clinical consequences

A Colles fracture refers to what area of the body? A) b. Mandible B) d. Ribs C) c. Proximal tibia D) a. Distal radius

D) a. Distal radius

When the diaphragm ruptures: A) d. The chest wall cannot expand normally B) c. Partially digested food does not flow from the stomach into the duodenum C) b. Chest cavity organs can fall into the abdominal cavity D) a. Herniation of the abdominal contents upward into the chest cavity occurs

D) a. Herniation of the abdominal contents upward into the chest cavity occurs

Your patient is complaining of muscle spasms in the lower leg. Your choice of treatment would be to: A) d. Administer compression B) a. Administer medication C) c. Apply ice D) b. Apply heat

D) b. Apply heat

You are managing a 25-year-old male patient who was involved in a gang-related fight; police have secured the scene. During your assessment, you find several stab wounds along the patient's right flank and lower back. The patient is awake and anxious, in obvious pain. While your partner obtains vital signs, appropriate management for the stab wounds includes: A) a. Applying wet sterile dressings over each wound and then an occlusive dressing B) c. Only covering them with an occlusive dressing C) d. Packing each wound with gauze to control internal bleeding D) b. Covering the wounds with gauze or trauma dressings

D) b. Covering the wounds with gauze or trauma dressings

Which of the following organs is in the retroperitoneal space? A) a. Bladder B) d. Spleen C) c. Liver D) b. Kidney

D) b. Kidney

It is late fall and you are assisting with the rescue of two men missing in northern Minnesota. They had gone out for an afternoon hunting trip and never returned. After 4 days, they have been located in a swamp, awake, with their clothes soaking wet. The two were huddled together beneath a tree in the snow shivering uncontrollably; they were confused and looked exhausted. During an examination of the 52-year-old male, you note that his core body temperature is 92° F but his other vital signs are within normal limits. What type of hypothermia does this patient have? A) d. Submersion B) c. Immersion C) a. Acute D) b. Moderate

D) b. Moderate

Patients suffering from heat exhaustion may need more than ___ of fluid to return their body to a normal hydration level. A) b. 5 L B) d. 10 L C) a. 2 L D) c. 7 L

D) c. 7 L

Before performing a reduction of a dislocated joint, which class of medication should be administered to help with muscle relaxation? A) d. Narcotics B) b. Anesthetics C) a. Analgesics D) c. Benzodiazepines

D) c. Benzodiazepines

A hyperbaric chamber: A) d. Can create an artificially low pressure to improve healing B) a. Can be used to practice breathing at extremely high altitudes C) b. Can be used to practice scuba diving D) c. Can create an artificially high pressure to improve healing and dissolve nitrogen bubbles in the body back into the bloodstream

D) c. Can create an artificially high pressure to improve healing and dissolve nitrogen bubbles in the body back into the bloodstream

You and your partner have been running back-to-back calls since you walked in at 7 AM. By 2 PM you have already completed six emergency calls and a scheduled transport. The day is flying by, and to make matters worse, it is one of the hottest days of the year. Your partner has begun to complain of spasms and cramps in his legs and that he also feels nauseated. When you ask him what he had to drink today, he tells you, 'A couple of cans of Diet Coke.' You suspect that he may be experiencing: A) b. Exertional heat stroke B) d. Heat exhaustion C) a. Classic heat stroke D) c. Heat cramps

D) c. Heat cramps

As scuba divers proceed to increasing depths, the amount of oxygen and nitrogen that becomes dissolved in the blood increases. When they begin to surface, they must do so slowly because the dissolved nitrogen will return into its gaseous form. This principle refers to: A) d. Newton's law B) b. Dalton's law C) a. Boyle's law D) c. Henry's law

D) c. Henry's law

D) c. Immobilization and ice

You are evaluating a 16-year-old male patient who was playing hockey with his friends at an outdoor skating rink when he slammed against his hockey stick, driving the handle deep into his epigastric region. He believes he fell on top of the stick and it caught under his ribs. He is also in obvious respiratory distress, and his abdomen appears slightly sunken; he seems unable to take a full breath. Which of the following interventions is contraindicated in this patient? A) d. Performing rapid sequence intubation B) a. Performing bag-mask ventilations without an ETT in place C) b. Having the patient lie supine D) c. Inflating a pneumatic antishock garment

D) c. Inflating a pneumatic antishock garment

Which of the following injuries can be caused by a shearing mechanism following abdominal trauma? A) d. Liver injury B) a. Bladder perforation C) b. Intestinal tearing along the aorta D) c. Kidney tearing at the ligamentum teres Points Earned: 0.0/1.0

D) c. Kidney tearing at the ligamentum teres

What is shallow water blackout? A) a. Drowning that occurs in less than 1 foot of water B) b. Loss of consciousness from diving into a shallow body of water and striking one's head on the bottom C) d. Loss of consciousness that occurs from trying to swim too far underwater and ignoring the need to take a breath D) c. Loss of consciousness that occurs after hyperventilating before swimming (to hold one's breath longer)

D) c. Loss of consciousness that occurs after hyperventilating before swimming (to hold one's breath longer)

Once the decision has been made to realign a fracture site, you should: A) d. Wait to perform the procedure and realign only if the patient loses distal circulation B) b. Continue realignment attempts until the gross deformity has been reduced C) a. Continue realignment attempts until distal pulses are present D) c. Make only one attempt at realignment

D) c. Make only one attempt at realignment

Which set of gasses poses the most significant hazards on a farm? A) b. Methane, carbon tetrachloride, nitrogen dioxide B) d. Nitrogen dioxide, ethane, carbon tetrachloride C) a. Carbon monoxide, methane, ethane, nitric oxide D) c. Nitric oxide, carbon monoxide, nitrogen dioxide

D) c. Nitric oxide, carbon monoxide, nitrogen dioxide

You are called to the ski patrol headquarters of a ski resort because there has been a skiing accident. When you arrive, you find a 23-year-old male patient immobilized and in obvious pain. He reportedly lost control on the mogul run and tumbled down the side, eventually striking a tree. During your assessment, his abdomen is slightly rigid with rebound tenderness. There is no abdominal bruising; it just appears slightly red. His pulse rate is 82 beats/min, his respiratory rate is 18 breaths/min, his blood pressure is 136/72 mm Hg, his skin is normal, and he rates his pain as a 10 out of 10. Based on these findings, you suspect: A) d. Spleen rupture B) b. Pelvis fracture C) a. Massive internal hemorrhage D) c. Potential intestinal rupture

D) c. Potential intestinal rupture

After controlling the airway and any severe external bleeding in a patient with traumatic abdominal injuries, the most important treatment is to: A) d. Stabilize any musculoskeletal injuries B) a. Establish two large-bore IVs C) b. Provide aggressive pain management D) c. Provide early rapid transport to a trauma center

D) c. Provide early rapid transport to a trauma center

The greatest factor in the amount of energy causing trauma to a patient is: A) b. The angle at which an object strikes the body B) a. Patient weight C) d. The insulting object's weight D) c. The insulting object's velocity

D) c. The insulting object's velocity

What are the most correct reasons why paramedics should expect a serious situation if they are called to a farm machinery incident? A) b. The machinery is usually in remote areas where there is little support. B) a. The equipment is large, and maintenance crews may have to be called to assist. C) d. The rural community has multiple weapons, and they may not know the EMS crew. D) c. The mechanism of injury has probably been severe

D) c. The mechanism of injury has probably been severe

Which of the following describes the best method of extricating a victim from a silo? A) a. Chute of the silo, bottom of the silo, or side of the silo B) d. Top of the silo, ventilation duct of the silo, or chute of the silo C) b. Top of the silo, bottom of the silo, or side of the silo D) c. Top of the silo, chute of the silo, or side of the silo

D) c. Top of the silo, chute of the silo, or side of the silo

A fracture of a child's bone at the epiphyseal plate commonly leads to: A) b. Infection B) d. Torn ligaments and tendons C) a. Frequent breakage of bones in the future D) c. Unusual deformity of the joint or an unnatural bending

D) c. Unusual deformity of the joint or an unnatural bending

A fracture of the femur can result in blood loss of up to: A) c. 1000 mL B) a. 250 mL C) b. 500 mL D) d. 2000 mL

D) d. 2000 mL

A 28-year-old patient was being evacuated for acute mountain sickness. When he is brought to your ambulance at the 5500-foot (altitude) trail head, he tells you that he feels fine now and wishes to return to his group and continue his ascent to the 11,000-foot peak. What do you advise him? A) a. Advise him that he can continue on his trip at the same pace he maintained before. B) c. Advise him that he needs to be seen in the emergency department. C) b. Advise him that he can continue on his trip if he follows behind the group by 1000 feet. D) d. Advise him that his symptoms could easily return if he returned to that altitude.

D) d. Advise him that his symptoms could easily return if he returned to that altitude.

Your ambulance crew is called to a scene where a 42-year-old female fell from a second-story balcony and landed on her outstretched right arm. There is gross deformity at the shoulder. The patient is unconscious. You should address immobilization of the deformed right shoulder by: A) c. Applying a traction splint B) b. Applying a sling and swathe C) a. Applying a sling D) d. Immobilizing the patient to a long backboard

D) d. Immobilizing the patient to a long backboard

D) d. Placental abruption

When the ambient temperature surpasses 98.6° F, what mechanism can no longer be used for heat loss but rather becomes a source of heat gain? A) a. Conduction B) c. Evaporation C) b. Convection D) d. Radiation

D) d. Radiation

You have immobilized a patient who was ejected from a car in a motor vehicle crash and landed in the river running beside the road. You can help prevent hypothermia in this patient by: A) c. Placing the patient in a well-heated ambulance B) b. Infusing IV fluids warmed to 104° F C) a. Covering the patient with several wool blankets D) d. Removing all of the patient's wet clothing and covering the patient with blankets

D) d. Removing all of the patient's wet clothing and covering the patient with blankets

Which of the following is a solid abdominal organ? A) c. Stomach B) b. Intestines C) a. Gallbladder D) d. Spleen

D) d. Spleen

Hollow organ rupture is most frequently caused by which of the following mechanisms? A) c. Skiing accidents B) a. Contact sport collisions C) b. Restrained drivers in motor vehicle crashes D) d. Unrestrained drivers in motor vehicle crashes

D) d. Unrestrained drivers in motor vehicle crashes

Which of the following best describes what the paramedic needs to know when rescuing someone from a silo? A) a. Enter the silo wearing a level-A hazardous materials suit to avoid contamination. B) b. Enter the silo from the bottom to avoid toxic gasses. C) c. Use nonsparking tools to cut into the silo near the worker. D) d. Use breathing protection

D) d. Use breathing protection

The most common bones to receive stress fractures are: A) a. Bones of the arm B) c. Ribs C) b. Long bones D) d. Weight-bearing bones

D) d. Weight-bearing bones

You are the paramedic on a search and rescue team that is preparing to carry a 21-year-old male patient who fell 18 feet from his tree stand, injuring his back and sustaining obvious bilateral lower leg fractures. Which of the following environmental conditions could most easily affect the patient's condition during the half-mile litter carry to the closest helicopter landing zone? A) c. Uneven rocky terrain on the trail to the landing zone B) a. Approximately 1 foot of snow covering the ground C) b. Snow falling at 2 inches per hour D) d. Winds of 30 mph with a wind chill of -10° F

D) d. Winds of 30 mph with a wind chill of -10° F

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Which of the following patients is at risk for the most common cause of upper airway obstruction?

21-year-old female unconscious and supine on the floor

27. Your pregnant patient's baby is crowning. Her contractions are 1 minute apart. She is gravida 3, para 2. You should: A) c. Stay and prepare to assist delivery B) b. Reassure the mother that she will not deliver for approximately 60 minutes C) a. Prepare for delivery, while traveling with lights and sirens D) d. Transport immediately

A 26-year-old woman was hit in the left chest wall by a softball. She felt a 'pop' and thinks some of her ribs were broken. She has a heart rate of 100 beats/min, blood pressure of 90/60 mm Hg, and distended neck veins. She is working hard to breathe, and you note cyanosis around her lips. Lung sounds are decreased on the left chest wall. Based on signs and symptoms, you suspect the woman has sustained a(n): A) b. Flail chest B) d. Tension pneumothorax C) a. Cardiac tamponade D) c. Open pneumothorax

A 32-year-old male presents approximately 1 hour after falling off of a horse. He states he has loss of bladder control and numbness in his scrotum and penis. He also states he has numbness, tingling, and weakness in his right leg. Which of the following is a condition that would fit these symptoms and mechanism? A) b. Cauda equina syndrome B) a. Anterior cord syndrome C) c. Conus medullaris syndrome D) d. Paraplegia

A 42-year-old patient was an unrestrained male passenger involved in a motor vehicle crash in which he struck his head on the windshield but was retained inside the vehicle. Bystanders state the man was unconscious when they arrived but regained consciousness before your arrival. The patient is complaining of a severe headache. While you are assessing the patient, he lapses into unconsciousness and begins having a seizure. You suspect: A) a. Epidural hematoma B) c. Subarachnoid bleeding C) b. Status epilepticus D) d. Subdural hematoma

A contrecoup injury is a brain injury that occurs: A) b. On the opposite side of the impact B) d. Posterior to the original injury C) c. On the same side as the original injury D) a. Anterior to the original injury

A cyanotic/bradycardic newborn is assisted with a bag-mask device (attached to oxygen). What would be an indication that the intervention is effective? A) d. An increased heart rate B) c. An increased blood pressure C) b. A decreased heart rate D) a. A decreased blood pressure

A dermatome can be described as: A) b. An area of the skin innervated by a specific spinal nerve B) c. Limited range of spinal motion following injury C) d. Overall paresthesia of an injured extremity D) a. A type of reflex

A fracture of a child's bone at the epiphyseal plate commonly leads to: A) c. Unusual deformity of the joint or an unnatural bending B) d. Torn ligaments and tendons C) b. Infection D) a. Frequent breakage of bones in the future

A male patient complains of numbness and tingling in his lower extremities after diving off of a dock into shallow water. Cervical spinal precautions have been taken. The patient is being log-rolled onto his side. As you palpate his spine, which anatomic part of the spinal column do you palpate through the skin? A) c. Spinous process B) d. Transverse process C) b. Spinal cord D) a. Body

A newly born infant has a respiratory rate of 6 breaths/min. Which of the following is the most appropriate action? A) a. Assist ventilations with a bag-mask device. B) b. Check for a pulse. C) d. Supply supplemental oxygen. D) c. Start CPR.

A patient complains of back and rib pain. He states that he has been having this pain for the past 3 days. He says it is a deep, aching pain with no radiation. His past medical history is significant for prostate cancer, diabetes, and hypertension. He states that he has numbness and weakness in his legs and has lost control of his bladder. Which of the following, according to the field assessment, would be the most appropriate cause for this pain? A) d. Tumor B) a. Degenerative disk C) b. Herniated disk D) c. Spondylosis

A patient has an impaled object through the cheek that is obstructing the airway. What is the correct treatment for this injury? A) A. Apply a tourniquet to control bleeding. B) B. Carefully remove the object. C) C. Do not remove the object. D) D. Stabilize the object by placing bulky dressing around it to prevent lateral movement.

A patient has been stabbed in the right side of the chest. You can hear air moving in and out through this chest wall wound. Which of the following is the most appropriate management for this patient? A) a. Apply an occlusive dressing. B) c. Apply needle decompression. C) d. Pack the wound with sterile gauze. D) b. Administer chest compressions.

A patient has fallen from a window after a fight. He has no movement in his arms or legs. Which of the following terms best describes his present condition? A) d. Tetraplegia B) b. Hemiplegia C) a. Contusion D) c. Paraplegia

A patient injured his hand while punching someone with a closed fist. You anticipate his injury to be to the: A) a. Fifth metacarpal B) b. First carpal C) c. Second phalange D) d. Thumb

A patient presents with lower back pain. She denies any acute trauma but states that it hurts when she moves and feels better when she stretches. Which of the following medications is indicated in the management of this patient? A) a. Analgesics B) c. Morphine C) b. Dexamethasone D) d. Solu-Medrol

A patient with a rapid onset of difficulty swallowing, drooling, stridor, and a high fever is most likely suffering from which disease? A) d. Epiglottitis B) a. Asthma C) b. Bacterial tracheitis D) c. Croup

A pediatric epidural hematoma may occasionally be the result of which type of bleeding? A) d. Venous B) b. Capillary C) c. Meningeal D) a. Arterial

A rash with reddish-purple, nonblanchable discolorations greater than 0.5 cm in diameter is called: A) b. Petechiae B) c. Purpura C) a. Macular D) d. Vesicular

A subcutaneous infection of the pulp space of the finger pad that is characterized by throbbing pain and a red, tense finger pad is called: A) A. Felon B) B. Flexor tenosynovitis C) C. Folliculitits D) D. Paronchia

A woman sustains a laceration to the external genitalia during a sexual assault. Which of the following anatomic structures is most likely injured? A) a. Labia minora B) c. Uterus C) b. Ovaries D) d. Vagina

A young mother has just delivered her first baby. She is bleeding, and you estimate her blood loss is greater than 1000 mL. Which of the following is the appropriate treatment for this patient? A) b. Massage the uterus. B) d. Withhold breast-feeding. C) c. Pack the vagina with sterile dressings. D) a. Apply direct pressure to the external genitalia.

Abruptio placentae is often associated with: A) a. Hypertension, advanced maternal age B) b. Preterm labor, hypertension C) d. Trauma, preterm labor D) c. Teen pregnancy, trauma

After an electrical burn injury, in addition to myoglobinuria, the damaged muscle cells release large quantities of: A) c. Potassium B) b. Magnesium C) a. Calcium D) d. Sodium

After assisting with delivery, you dry, suction, and stimulate the newborn. He has gasping respirations. What is your next appropriate step? A) c. Begin positive-pressure ventilation. B) b. Administer epinephrine and atropine. C) a. Administer chest compressions. D) d. Give blow-by oxygen.

After direct pressure has failed to control the bleeding of a large neck laceration, the medical direction physician may instruct you to: A) d. Apply direct pressure to the involved vessel B) c. Clamp the hemorrhaging vessel with a hemostat C) a. Apply a pressure dressing around the neck D) b. Apply indirect pressure bilaterally to the carotid arteries

An easy way to remember the various components of musculoskeletal injury assessment is to recall: A) d. The six P's of musculoskeletal assessment B) b. The mnemonic ARM-LEGS C) a. The four M's of musculoskeletal assessment D) c. The mnemonic TIC

An unrestrained driver has bruising over the sternum secondary to striking the steering column. He complains of chest pain but appears to be stable. You suspect: A) a. Myocardial contusion B) b. Myocardial embolism C) c. Myocardial infarction D) d. Myocardial ischemia

Any damage to tissue will alter the normal anatomy, which causes the release of tissue factors. This is the beginning of which process? A) a. Coagulation B) d. Neovascularization C) c. Histamine release D) b. Hemostasis

At what point is the patient assessment triangle performed? A) c. Before approaching the patient B) b. After the initial assessment C) d. During the initial assessment D) a. After approaching the patient

At which weight is an infant considered to have an extremely low birth weight? A) a. Less than 1000 g B) b. Less than 1200 g C) c. Less than 1500 g D) d. Less than 2500 g

Beck's triad relates to the symptoms of what trauma-induced condition? A) d. Pericardial tamponade B) b. Diaphragmatic rupture C) c. Myocardial contusion D) a. Aortic rupture

Before performing a reduction of a dislocated joint, which class of medication should be administered to help with muscle relaxation? A) c. Benzodiazepines B) b. Anesthetics C) d. Narcotics D) a. Analgesics

Causes of an injury to the head or brain can be primary, secondary, or tertiary. An example of a tertiary cause of head injury includes: A) a. Apnea B) d. Skull fracture C) b. Concussion D) c. Hypertension

Death due to abdominal trauma is usually a result of: A) A. Continuing hemorrhage and delayed surgical repair B) B. Unpreventable infection C) C. Exsanguination occurring within 30 minutes of the injury D) D. Rupture of hollow organs and resulting nutritional deficiencies

Define Braxton-Hicks contractions. A) A. Also called false labor, they are a normal occurrence during the second half of the pregnancy. B) B. These contractions occur during the first trimester. C) C. In the field, these contractions are easily distinguished from early labor. D) D. These are usually regular contractions that increase in duration over time.

During the delivery of a baby, you notice that the cord is wrapped around the baby's neck. Which of the following should be your first action? A) a. Attempt to slip the cord over the head. B) d. Pinch the cord. C) c. Cut the cord. D) b. Clamp the cord in two locations.

During which phase of menstruation is the endometrium stimulated by estrogen? A) c. Proliferative B) b. Ovulation C) d. Secretory D) a. Menopause

Following recognition of a pelvic fracture, your next intervention should be to: A) a. Apply a pelvic binder B) c. Inflate the abdominal compartment only of a pneumatic antishock garment C) d. Provide pharmacologic pain management D) b. Apply a traction splint

For a patient to be considered acidic, the pH would be: A) A. Less than 7.0 B) B. Greater than 7.0 C) C. Between 7.35 and 7.45 D) D. Humans do not get acidic.

For purposes of evaluation, the neck has been divided into three zones. Zone 1 represents the: A) c. Area between the cricoid cartilage and clavicle/sternum B) d. Left and right lateral neck surfaces C) a. Area above the angle of the mandible D) b. Area between the angle of the mandible and the cricoid cartilage

Gastric distention is a complication caused by which of the following? A) c. Positive-pressure ventilation B) d. Vomiting C) b. Cardiac compressions D) a. Aspiration

How does prehospital management of solid organ injury differ from management of hollow organ injury? A) d. There is no difference in prehospital management. B) c. Solid organ injuries require treatment at a trauma center, unlike hollow organ injuries. C) b. Solid organ injuries require less fluid resuscitation. D) a. Hollow organ injuries require less fluid resuscitation.

How long does a complicated febrile seizure last? A) d. Longer than 15 minutes B) c. 7 to 10 minutes C) a. Less than 3 minutes D) b. 4 to 6 minutes

Hypovolemic shock resulting from any cause is first treated with: A) b. Crystalloid fluid volume replacement B) a. Colloid plasma expander agents C) d. Vasopressor agents to aid in peripheral vascular resistance D) c. Vasodilatory agents to aid preload

If a pregnant woman loses 30% of her blood volume, you would expect the mother: A) c. To show minimal changes, but the fetus will be distressed B) d. To show signs of extreme hypoperfusion but the fetus to tolerate the loss well C) b. And fetus to tolerate this blood loss well D) a. And fetus to be gravely hypoxic

If your patient's uterus inverts immediately after delivery of the infant, it is important to: A) a. Attempt to reinsert it once, without removing the placenta B) d. Wrap the uterus and placenta in dry towels C) b. Quickly pull on the placenta to reduce bleeding D) c. Soak the placenta in a saline bath to keep it from drying

In dividing the neck into three zones, the most common zone for injuries is: A) b. Zone II B) c. Zone III C) d. Zones II and III D) a. Zone I

In the mechanism of autoregulation, the diameter of the cerebral blood vessels changes automatically to meet the needs of the brain's tissues. Increased intracranial pressure affects perfusion to the brain by: A) d. Reducing cerebral perfusion pressure and dilating the vessels B) b. Causing the blood vessels to override autoregulation C) c. Increasing cerebral perfusion pressure and constricting the vessels D) a. Causing the blood vessels to automatically constrict

In which congenital anomaly will the infant have cyanosis that disappears when the infant cries and returns with rest? A) a. Choanal atresia B) d. Tracheoesophageal fistula C) b. Diaphragmatic hernia D) c. Omphalocele

In which of the following situations is a sedative more appropriate than an analgesic? A) b. Cardioversion B) c. Degloving injury C) a. Burns D) d. Long bone fracture

Initial management for most patients in hypovolemic shock is: A) c. Fluid boluses B) b. Chest compressions C) a. Antibiotics D) d. Vasopressors

Injury mechanisms such as hangings typically cause a(n) _____ type spinal cord injury. A) b. Distraction B) c. Herniation C) a. Axial loading D) d. Subluxation

Intubation is recommended for patients with a Glasgow Coma Scale score of: A) a. 8 or less B) c. 11 or 12 C) d. 13 to 15 D) b. 9 or 10

Intubation is required before ventilating a neonate with a diaphragmatic hernia because these infants are at high risk for which of the following? A) c. Pneumothorax B) a. Airway obstruction C) b. Aspiration D) d. Rupture of hernia

Irreversible shock is noted by: A) c. Multiple organ failure B) b. Hypotension at 70 to 80 mm Hg systolic pressure C) a. Hyperactive hepatic perfusion D) d. Refractory capillary occlusions

Newborn would be the appropriate term for a child who is: A) a. 2 hours old B) d. 2 months old C) c. 2 weeks old D) b. 2 days old

On inspection of the head of a patient who was just assaulted, you note multiple serious injuries. One injury in particular has resulted in the hair and scalp being pushed through a break in the skull and coming in contact with brain tissue. This type of wound is referred to as a(n): A) b. Depressed fracture B) c. Linear fracture C) d. Open-vault fracture D) a. Basilar fracture

One of the main goals of fluid resuscitation in burns is preservation of the: A) d. Zone of stasis B) a. Zone of coagulation C) b. Zone of hyperemia D) c. Zone of shock

One of the most common causes of vascular abdominal injuries is: A) c. Improper use of seat belts B) b. Blast injuries C) a. Bone fracture fragments D) d. Knife wounds

Other than hemorrhage, the major cause of mortality following a traumatic duodenal rupture is: A) d. Spillage of intraluminal contents into the peritoneum B) a. Bowel infarction from ischemia C) c. Inability to digest food/malnutrition D) b. Ileus

Paramedics are treating a patient whose arm has been entrapped in a compressor for more than 6 hours. What can the paramedics anticipate will be ordered by medical control? A) d. 1500-mL bolus of NS B) b. 500-mL bolus of LR C) c. 1500-mL bolus of D5 0.25% NS D) a. 500-mL bolus of D5 0.9% NS

Paramedics are treating a patient with an obvious deformity to the right elbow. After assessing the need for spinal immobilization and obtaining a neurovascular assessment, which of the following is the next most appropriate step? A) d. Splint the bone above and below the joint. B) b. Apply manual traction. C) c. Begin transport to a trauma center. D) a. Apply a cold pack.

Paramedics have been dispatched to a residence where the homeowner has fallen off of the roof. Of which type of trauma should the paramedics be most suspicious? A) b. Closed B) d. Open C) a. Blast D) c. Crush

Paramedics have just delivered a child in the field. At this point the infant is classified as a(n): A) d. Newborn B) a. Adolescent C) b. Child D) c. Neonate

Preeclampsia is: A) A. Also known as pregnancy-induced hypertension, is potentially life-threatening, and occurs in approximately 5% to 7% of pregnancies B) B. Also known as pregnancy-induced hypotension C) C. Seizures as a result of being pregnant D) D. Usually seen in patients who are in the first 20 weeks of gestation

Signs and symptoms of a skull fracture may include: A) d. Raccoon's eyes, epistaxis, and visual disturbances B) b. Incontinence, hyphema, and focal motor seizures C) c. Loss of consciousness, priapism, and drainage from the ears D) a. Depression of the skull, loss of consciousness, and priapism

The average circulating blood volume in an adult is: A) A. 55 to 75 ml/kg B) B. 75 ml/kg C) C. 85 ml/kg D) D. 90 to 105 ml/kg

The classic presentations of preeclampsia are hypertension, excessive weight gain, and: A) c. Proteinuria B) a. Hypoglycemia C) b. Increased intracranial pressure D) d. Seizures

The most commonly fractured ribs include ribs: A) b. 4 through 9 B) a. 1 and 2 C) c. 10 through 12 D) d. 11 and 12

The most serious concern of a bladder rupture is: A) d. Shock and/or peritonitis B) c. Urine and blood leakage C) b. Massive hemorrhage D) a. Loss of the body's ability to eliminate urine

The most significant indicator of severe abdominal trauma is the presence of: A) A. Unexplained shock B) B. Bowel sounds in the chest cavity C) C. Referred pain in one or both shoulder blades D) D. Abdominal distention

The patient is a 12-year-old girl who is upset after a motor vehicle crash in which she was a restrained passenger in the rear seat. The girl is crying and sobbing. In assessing the girl, you notice tears rolling down her cheeks. Knowing that the lacrimal glands transport water, tears, and other secretions from the eyes to the nose, you suspect that the tears on the patient's cheek are: A) a. A normal finding and not the result of injury B) b. Caused by a blocked lacrimal gland C) d. The result of damage to the lacrimal duct D) c. Caused by injury to the lacrimal gland or duct

The patient is a 16-year-old boy who fell from a ladder while helping his father perform household repairs. The father states that the boy landed on his face. On assessing the teenager, you find considerable edema around the nose, epistaxis, and ecchymosis. When you look at the patient from the side, you note that his face has a spoonlike appearance. Based on these findings, you should suspect a: A) c. Le Fort III fracture B) a. Le Fort I fracture C) d. Le Fort IV fracture D) b. Le Fort II fracture

The patient is a 17-year-old male who was inadvertently struck in the neck by a karate kick. He is complaining of pain in the anterior neck and is speaking with a raspy, hoarse voice. There is noticeable bruising and subcutaneous emphysema in the area. Based on this information, which of the following injuries has the patient most likely sustained? A) d. Tracheal fracture B) a. Carotid compression C) b. Hyoid bone fracture D) c. Jugular vein laceration

The patient is presenting with signs/symptoms of hypovolemic shock. Proper treatment for this patient should include: A) A. Maintaining a supine position for the patient B) B. Supplying oxygen at 2 to3 liters per minute C) C. Providing fluids via oral and IV routes D) D. Raising the patient's body temperature by using blankets and heat packs

The patient was in a fight and sustained a laceration to his forearm. A bystander placed a tourniquet to the patient's forearm before the paramedic unit arrived. The patient does not have a pulse distal of the tourniquet. The best treatment for this patient is to: A) A. Leave the tourniquet in place. B) B. Loosen the tourniquet until a pulse is felt. C) C. Remove the tourniquet. D) D. Remove the tourniquet and then replace the tourniquet on a different area of the arm.

The pediatric assessment triangle consists of _________, ________, and _________. A) A. Appearance, breathing, circulation B) B. Appearance, breathing, color C) C. Appearance, breathing, mental statusc D) D. Body position, breathing, circulation

The release of which of the following substances starts the inflammatory phase of healing by dilating the capillaries? A) c. Histamine B) a. Fibrin C) d. Hydroxylysine D) b. Fibroblasts

The role of the middle ear is to: A) d. Transmit vibrations of the tympanic membrane to the inner ear B) b. Modulate the sound to enhance the actual tones C) c. Muffle extremely loud noise to protect the auditory nerve D) a. Echo sound waves as they pass through the ear canal

The urinary bladder is more likely to rupture: A) A. When it is full B) B. When it is empty C) C. In women D) D. In men

To administer blow-by oxygen to the newborn, the maximum flow rate should be no more than how many liters per minute? A) c. 10 L/min B) a. 2 L/min C) b. 5 L/min D) d. 15 L/min

To administer blow-by oxygen to the newborn, the minimum flow rate should be no less than how many liters per minute? A) b. 5 L/min B) c. 10 L/min C) d. 15 L/min D) a. 2 L/min

To minimize the possibility of sound transmission from one side of the chest to the other, which of the following is the best location to assess the breath sounds of an infant? A) b. Axillary region B) c. Midclavicular region C) d. Posterior region D) a. Anterior region

Treatment for myocardial contusion following significant blunt force trauma may include: A) c. High-flow oxygen B) b. Epinephrine for hypotension C) a. Atropine for dysrhythmias D) d. Nitroglycerin for chest pain

Unless proven otherwise, any unexplained signs of shock are assumed to be _____ in nature. A) b. Hypovolemic B) a. Cardiogenic C) c. Neurogenic D) d. Septic

Using the '20-10-20' rule as a guide in determining a positive test result for orthostatic vital signs, what does each number represent? A) A. Decrease in systolic blood pressure up to 20 mm Hg, an increase in the diastolic blood pressure of 10 mm Hg, an increase of the heart rate by 20 beats/min B) B. Decrease in systolic blood pressure up to 20 mm Hg, an increase the heart rate by 10 beats/min, an increase in the diastolic blood pressure of 20 mg Hg C) C. Increase in systolic blood pressure up to 20 mm Hg, an increase in the diastolic blood pressure by 10 mm Hg, and an increase in the heart rate by 20 beats/min D) D. No changes in orthostatic vitals when the patient stands up

What burns result when a metal object contacts electrically charged fuses or other similar electrical objects? A) d. Flash B) a. Arc C) b. Arch D) c. Burst

What disease is characterized by thick mucus and inflammation and swelling of the smaller air passages? A) b. Bronchiolitis B) d. Pneumonia C) c. Croup D) a. Asthma

What is the average duration for primary apnea? A) c. 30 to 60 seconds B) d. 45 to 60 seconds C) b. 3 to 4 minutes D) a. 1 to 2 minutes

What is the initial fluid bolus for a 6-year-old trauma patient who weighs 42 pounds? A) b. 380 mL B) c. 420 mL C) a. 190 mL D) d. 840 mL

What is the largest and most complex organ of the human body? A) b. Skin B) d. Stomach C) a. Liver D) c. Spleen

What is the most appropriate way to determine the proper size of a nasal airway? A) d. From the tip of the nose to the tip of the ear B) c. From the tip of the jaw to the tip of the ear C) b. From the corner of the mouth to the tip of the ear D) a. From the corner of the mouth to the angle of the jaw

What is the term for an abnormal buildup of CSF in the brain? A) a. Hydrocephalus B) d. Spina bifida occulta C) b. Meningomyelocele D) c. Omphalocele

What is the umbilical cord responsible for? A) A. The fetus receives nutrition and oxygen and eliminates waste through the umbilical cord. B) B. The placenta receives nutrition and oxygen and eliminates waste through the umbilical cord. C) C. It provides oxygen and a method of elimination for the fetus. D) D. It provides oxygen and nutrition to the placenta.

What medications are generally used to treat status epilepticus in a newborn? A) b. Benzodiazepines B) a. Barbiturates C) d. Paralytics D) c. Neuroleptics

What percentage of diaphragmatic hernias will be found on the left side? A) c. 85% to 90% B) a. 60% to 70% C) d. 90% to 100% D) b. 80% to 100%

What will occur as a result of ocular pressure that is caused by the ventilation of a newborn with a mask that is too large? A) a. Bradycardia B) c. Hypoxia C) b. Cardiac arrest D) d. Respiratory failure

What would be the correct fluid bolus amount for a neonate weighing 5.5 lb? A) b. 55 mL B) c. 65 mL C) a. 25 mL D) d. 110 mL

What would be the correct fluid bolus amount for a neonate weighing 6.6 lb? A) c. 66 mL B) a. 30 mL C) b. 60 mL D) d. 132 mL

When a patient has a flail chest, there is paradoxical chest wall movement. What is the effect of this on the lungs during inspiration? A) a. The lung on the injured side cannot expand as effectively. B) d. The lung on the uninjured side expands more effectively, and the affected lung is collapsed. C) c. The lung on the uninjured side cannot expand as effectively. D) b. The lung on the injured side expands more effectively.

When assessing the eyes of a pediatric patient, you find blood in the anterior chamber of the eye. What term is used for this condition? A) b. Hyphema B) c. Periorbital ecchymosis C) d. Raccoon eyes D) a. Battle's sign

When assessing/treating the stable pediatric patient, what is the most appropriate location/action for the caregiver? A) a. Involved with the patient and the patient's care B) c. Separated from the child C) b. Out of the child's sight D) d. With the patient, uninvolved with the patient's care

When is it appropriate to use the child's safety seat as a means of spinal immobilization? A) c. When the child is stable B) b. At all times C) d. Never D) a. When the airway is compromised

When obtaining a blood pressure, how much of the upper arm should the width of the cuff cover? A) b. one-half to two-thirds B) c. one-fourth to three-fourths C) d. one-fourth to two-thirds D) a. one-half to three-fourths

When should you get an Apgar score on a newborn? A) A. 1 and 5 minutes after delivery B) B. 3 and 5 minutes after delivery C) C. Only after the first minute D) D. Every 5 minutes

When the spinal cord develops a saclike cyst that contains the meninges and CSF, and it protrudes from the opening of the spine, this is called: A) b. Meningocele B) a. Hydrocephalus C) c. Omphalocele D) d. Spina bifida occulta

Where are the constantly developing cells of the epidermis formed? A) a. Germinativum B) c. Sebaceous gland C) d. Stratum corneum D) b. Papillary dermis

Where is the best location to assess the skin turgor of an infant? A) c. The abdomen B) b. Side of the cheek C) d. The thigh D) a. Back of the hand

Where is the most appropriate location to perform a needle decompression on a neonate? A) c. Midclavicular, at the second intercostal space B) b. Midaxillary, at the third intercostal space C) a. Midaxillary, at the fifth intercostal space D) d. Midclavicular, at the fourth intercostal space

Which area is most commonly affected in a patient who has croup? A) a. Below the glottis B) c. Supraglottic C) d. Tracheal D) b. Below the trachea

Which closed soft tissue injury involves the stretching of the ligaments that form the joint? A) c. Sprain B) b. Fracture C) d. Strain D) a. Contusion

Which factor plays the greatest role in regulating the vascular diameter and systemic resistance in the brain? A) b. Carbon dioxide pressure B) c. Neurohumoral control C) d. Oxygen pressure D) a. Autonomic control

Which hollow organ is most commonly injured as a result of blunt force trauma? A) c. Stomach B) d. Uterus C) a. Small intestine D) b. Spleen

Which of the following answers most accurately defines hyperpnea? A) A. Increased depth of breathing B) B. Increased heart rate C) C. Increased respiratory rate D) D. Increased tidal volume

Which of the following best describes the pathophysiologic cause of traumatic asphyxia? A) d. Increased compressive forces to the chest wall B) a. Decreased blood flow in head and neck C) b. Decreased pressure in the chest cavity D) c. Forward rush of blood through the right heart

Which of the following directly affects perfusion as it relates to shock? A) c. Fluid volume B) a. Baseline muscle mass C) d. Heart size D) b. Body weight

Which of the following etiologies accounts for the majority of all burn injuries? A) c. Flame B) d. Radiation C) a. Chemical D) b. Electrical

Which of the following first-impression findings is associated with an altered mental status? A) a. Abnormal work of breathing B) d. Hypotension C) b. Bradycardia D) c. Fever

Which of the following is a criterion for transport or transfer to a verified burn center? A) b. Partial-thickness burns >10% B) c. Superficial burns >5% C) d. Superficial burns >10% D) a. Partial-thickness burns >5%

Which of the following is a life-threatening injury in which the thorax is severely crushed, preventing ventilation? A) d. Traumatic asphyxia B) a. Hemopneumothorax C) c. Tension pneumothorax D) b. Pericardial tamponade

Which of the following is a normal compensatory response to the need for increased cardiac output or oxygen delivery? A) d. Tachycardia B) a. Atrial fibrillation C) b. Atrial flutter D) c. Bradycardia

Which of the following is a solid abdominal organ? A) d. Spleen B) b. Intestines C) c. Stomach D) a. Gallbladder

Which of the following is a true statement regarding the anatomic term dermatome? A) a. A dermatome is a specific region of the skin innervated by one spinal nerve. B) c. Spinal cord injury rarely follows dermatomes. C) b. Each dermatome innervates one muscle group. D) d. There are 39 pairs in the human body.

Which of the following is an antepartum risk factor that may affect the need for neonatal resuscitation? A) a. Maternal anemia B) c. Premature labor C) b. Meconium staining D) d. Prolapsed cord

Which of the following is associated with a tension pneumothorax? A) a. Cyanosis B) b. Hypertension C) c. Increased heart tones D) d. Normal lung sounds

Which of the following is considered a thoracic injury? A) c. Pulmonary contusion B) b. Liver laceration C) d. Splenic rupture D) a. Duodenal perforation

Which of the following is considered normal after the delivery of a newborn? A) a. Acrocyanosis B) c. Methocyanosis C) d. Peripheral cyanosis D) b. Central cyanosis

Which of the following is considered tertiary prevention? A) d. Rehabilitation B) b. Public education C) c. Quality assurance D) a. A prehospital report

Which of the following is considered the most appropriate way to transport a stable 2-year-old child to the hospital? A) a. In a child safety seat B) c. On the stretcher with the attached belts C) b. On a backboard D) d. Sitting in his or her parent's lap

Which of the following is considered to be an intrapartum risk factor? A) a. Fetal bradycardia B) c. Maternal anemia C) d. No prenatal care D) b. Fetal malformation

Which of the following is crucial in the treatment of the patient with a significant head injury? A) d. Repeat assessments B) b. Hyperventilation C) c. Intubation D) a. Administration of valium

Which of the following is one of the biggest concerns for the paramedic while caring for a victim with soft tissue injury? A) d. Exposure to bloodborne pathogens B) c. Disfigurement C) b. Debilitation from the injury D) a. Blood loss

Which of the following is the leading cause of death in children after infancy? A) d. Trauma B) b. Dysrhythmias C) a. Drowning D) c. Seizures

Which of the following is the least common type of trauma in the pediatric population? A) c. Penetration B) a. Blunt force trauma C) b. Cavitation D) d. Suffocation

Which of the following is true regarding the use of nasal airways in an infant or small pediatric patient? A) a. It does not allow adequate airflow. B) c. It is the preferred airway adjunct. C) b. It is placed in the left nares. D) d. It provides adequate airflow.

Which of the following methods of obtaining a temperature is considered the most accurate reflection of the patient's core body temperature? A) c. Rectal B) d. Tympanic C) a. Axillary D) b. Oral

Which of the following mnemonics is most useful in determining the possible causes of an altered mental status? A) d. TICLS B) a. AEIOU-TIPPS C) b. DCAP-BTLS D) c. SAMPLE

Which of the following organs is in the retroperitoneal space? A) b. Kidney B) d. Spleen C) c. Liver D) a. Bladder

Which of the following organs is responsible for releasing the egg each month in the female reproductive system? A) c. Ovaries B) d. Uterus C) a. Endometrium D) b. Fallopian tube

Which of the following processes is occurring when cells from the basal layer of the epidermis migrate across the damaged area of tissue, resulting in the regeneration of the epidermis? A) b. Epithelialization B) c. Hemostasis C) a. Coagulation D) d. Neovascularization

Which of the following would be considered part of the breathing assessment in the patient assessment triangle? A) a. Body position B) d. Skin color C) c. Muscle tone D) b. Mental status

Which of these events would be the best determinant of whether you stay on the scene and prepare to deliver or transport? A) b. Presence of crowning B) c. Ruptured membranes C) a. History of previous quick delivery D) d. Strong uterine contractions

Which organ can have an 'organ fracture,' causing massive internal hemorrhage? A) d. Liver B) a. Appendix C) c. Intestine D) b. Bladder

Which type of fracture is more common in children because of the softness and flexibility of their bones? A) A. Greenstick fracture B) B. Oblique fracture C) C. Spiral fracture D) D. Stress fracture

While assisting in the delivery of twins, you note an arm protruding from the vagina. This is the only visible part of the infant. You should: A) d. Transport immediately B) b. Deliver the anterior shoulder C) a. Attempt to turn the infant D) c. Position the mother on her side to promote stronger contractions

While suctioning the secretions of a neonate, you should watch for: A) a. Bradycardia B) c. Reflex tachycardia C) b. Hypothermia D) d. Ventricular dysrhythmias

Why is an occlusive dressing used for lacerations/wounds of the neck? A) c. Risk of developing an air embolus B) d. Risk of suffocation C) b. Risk of contamination D) a. Risk for an increase in infection

Why is the administration of D25/50 contraindicated in a newborn? A) b. It causes cerebral hemorrhage. B) a. It causes bradycardia. C) d. It causes respiratory failure. D) c. It increases ICP.

Within 3 days of injury, new blood vessels have begun to form through which of the following processes? A) d. Neovascularization B) b. Epithelialization C) a. Coagulation D) c. Hemostasis

You and your partner have splinted a possible midshaft radial-ulna fracture. After applying the splint, PMS is reevaluated, noting that the pulse is absent. Your next action would be to: A) b. Contact medical control B) a. Apply ice C) c. Loosen the splint D) d. Realign the injury

You are assessing a 4-year-old patient who has been in a motor vehicle crash. Which of the following is considered a normal rate of breathing for this patient? A) c. 22 to 34 breaths/min B) a. 12 to 30 breaths/min C) d. 24 to 40 breaths/min D) b. 18 to 30 breaths/min

You are assessing an 11-month-old infant. Which of the following is considered a normal heart rate for this patient? A) d. 100 to 160 beats/min B) b. 80 to 140 beats/min C) c. 90 to 150 beats/min D) a. 70 to 120 beats/min

You are assisting a mother who is 39 weeks' pregnant. She states that she needs to push. Describe the appropriate coaching for this patient. A) c. Have the patient push for 10 seconds and then rest for 10 seconds. B) d. Have the patient push for as long as possible. C) a. Have the patient develop her own rhythm. D) b. Have the patient push for 2 minutes and then rest for 2 minutes.

You are called to a long-term care rehabilitation facility for a 24-year-old male patient with elevated blood pressure. The patient is a quadriplegic who was just transferred to the facility from the hospital after a complete transection of the cord at the level of T1. Assessment reveals blood pressure 240/126 mm Hg, respirations 24 breaths/min, and a distended abdomen. The patient is also complaining of a headache and blurred vision. You suspected that the patient is suffering from: A) a. Autonomic dysreflexia syndrome B) c. Parasympathetic override discharge C) d. Sympathetic hyperinsufficiency cascade D) b. Parasympathetic insufficiency syndrome

You are examining a woman in her eighth month of pregnancy and discover that her blood pressure is 100/70 mm Hg, her heart rate is 90 beats/min, and her respirations are 20 breaths/min. These vital signs indicate: A) b. Normal changes during pregnancy B) d. The patient is hypoxic C) a. Moderate hypovolemia at this stage of pregnancy D) c. Severe dehydration

You are managing a 25-year-old male patient who was involved in a gang-related fight; police have secured the scene. During your assessment, you find several stab wounds along the patient's right flank and lower back. The patient is awake and anxious, in obvious pain. While your partner obtains vital signs, appropriate management for the stab wounds includes: A) b. Covering the wounds with gauze or trauma dressings B) a. Applying wet sterile dressings over each wound and then an occlusive dressing C) d. Packing each wound with gauze to control internal bleeding D) c. Only covering them with an occlusive dressing

You are on scene with a 16-year-old runner who was stung by a bee. She is having no difficulty in breathing, but there is significant swelling at the site. Her heart rate is 102 beats/min, her respiratory rate is 22 breaths/min, and her blood pressure is 110/88 mm Hg. Which of the following would be an appropriate initial treatment for this patient? A) a. Diphenhydramine B) d. Solu-Medrol C) b. Dopamine D) c. Epinephrine

You are on scene with a 24-year-old who is 31 weeks' pregnant. She states that she has to push, and you anticipate delivery. Which of the following is a true statement regarding this delivery? A) a. Delay transport. B) c. Prepare the mother for a negative outcome. C) b. Prepare for resuscitation. D) d. Provide rapid transport.

You are on scene with a child who has multiple injuries that lead to suspicions of abuse. What is the most appropriate action to take in this situation? A) d. Report the abuse. B) a. Confront the parents. C) c. Inspect the home. D) b. Do nothing.

You are on scene with a patient who has severed his leg in a farming accident. There is considerable blood loss. Which of the following is an appropriate fluid therapy for this patient? A) d. Isotonic crystalloid solution B) b. Ringer's lactate, 100 mL/hr C) a. D5 1/2NS, 500-mL bolus D) c. NS fluid bolus titrate to wet lung sounds

You are on scene with a patient who is having significant bleeding from the rectum. You obtain a history. Which of the following findings would indicate a rationale for the severe bleeding? A) d. Warfarin (Coumadin) use B) b. Obesity C) a. A history of surgery 5 years ago D) c. A sedentary lifestyle

You are on scene with a patient who recently suffered a heart attack. He has been told that his cardiac output has decreased since this heart attack. Which of the following is the direct cause of this decreased cardiac output? A) d. Stroke volume B) a. Afterload C) c. Preload D) b. Atrial kick

You are transporting a patient who is intubated and is now becoming bradycardic. What is the most appropriate intervention to perform first? A) b. Reassess and confirm tube placement. B) d. Turn up the oxygen. C) c. Suction the endotracheal tube. D) a. Immediately remove tube and reintubate.

You are treating a 13-month-old who has sustained burns to the anterior portion of his torso and the entire right leg. Using the 'rule of nines,' what percentage of burns has this infant sustained? A) b. 31.5% B) c. 53.5% C) a. 27% D) d. 63%

You are treating a 3-year-old patient who is unconscious, tachycardic, hypotensive, and bradypneic, and has a diffuse, nonblanchable, reddish-purple rash throughout the trunk and face. Which of the following is the first action you should complete? A) c. Don a face mask. B) b. Begin cardiac compressions. C) a. Assist ventilations. D) d. Transport immediately.

You are treating a 42-year-old woman who was the unrestrained driver of a car that crashed head-on into a tree at approximately 45 miles per hour. Both femurs are obviously fractured, and she has an unstable pelvis. She is unresponsive, tachycardic, tachypneic, and severely hypotensive. Based on her vital signs, you suspect the woman to be in what stage of shock? A) c. Irreversible B) a. Early C) d. Cardiogenic D) b. Late

You are treating a 44-year-old female patient who was struck by a car while crossing the street and was thrown 25 feet. She is responding to verbal stimuli, does not move appropriately, and has a pulse rate of 132 beats/min, a respiratory rate of 32 breaths/min, a blood pressure of 88/68 mm Hg, and pale and clammy skin. When you remove her clothing, her upper abdominal quadrants are bruised, rigid, and tender. Appropriate care for this patient includes: A) b. Establishing a large-bore IV B) d. Providing oxygen via nasal cannula C) c. Positioning her in the left lateral recumbent position to protect her airway D) a. Administering fentanyl for pain

You are treating a newborn who is apneic with a heart rate of 98 beats/min. What is the next most appropriate intervention? A) d. Begin positive-pressure ventilations. B) a. Administer atropine. C) b. Administer epinephrine. D) c. Begin chest compressions.

You arrive at the scene of a two-vehicle crash. Your patient, the unrestrained driver of a vehicle sustaining significant lateral impact, is complaining of back pain and numbness and tingling to the lower body and legs, primarily below the umbilicus. As you continue to treat this patient, he becomes progressively worse and now has no feeling below the nipple line. Considering the patient's chief complaint and the dermatome involved in the initial presentation, you suspect that the initial injury is in the area of: A) c. T10 B) d. T4 C) b. S1 D) a. C2 to C4

You arrive on scene to treat a 22-year-old woman who states that she is having terrible lower right abdominal pain. She states that she is having normal periods, but noticed some bleeding today. She also uses an IUD to prevent pregnancy. Which of the following conditions should you suspect in this patient? A) a. Ectopic pregnancy B) c. Hyperemesis gravidarum C) d. Septic abortion D) b. Endometriosis

You have arrived on scene to treat a patient who is approximately 8 weeks' pregnant. She is crying and states she is bleeding and feels she may be miscarrying. You notice a large amount of blood on the floor. Which of the following should be your first action? A) b. Assess airway and breathing; give supplemental oxygen. B) a. Assess blood loss. C) c. Contact her primary obstetrician. D) d. Pack the vaginal area to prevent further bleeding.

You have just assisted in the delivery of the baby's head. Which of the following best describes how to proceed with the delivery? A) c. Direct the head down and allow the anterior shoulder to deliver. B) d. Pull on the neck and head. C) b. Direct the head up and allow the posterior shoulder to deliver. D) a. Deliver both shoulders together.

You respond to a motor vehicle crash and find the patient trapped between the steering wheel and the seat. Extrication efforts are under way. Your initial examination reveals that the patient has a purplish discoloration to the face and JVD. The most likely injury is: A) d. Traumatic asphyxia B) c. Myocardial rupture C) b. Diaphragmatic rupture D) a. Crushing chest syndrome

Your 33-year-old male patient is conscious and alert after falling to the ground while exiting his vehicle. He is complaining of an isolated injury to his left leg. There is tension in his muscles during relaxation, loss of distal sensation, and extreme pain on extension that seems to be out of proportion to his injury. What has most likely occurred to your patient? A) A. Compartment syndrome B) B. Dislocation of his hip C) C. Dislocation of his patella D) D. Oblique fracture

Your crew is called to a local nightclub for a 23-year-old male with a hand injury. The patient tells you that he hit a brick wall when he missed his intended target. The patient's knuckles and the entire back of his hand are edematous and painful. His hand has limited movement of the distal phalanges. His hand is open and his fingers are bent. To immobilize this injury, you should: A) c. Immobilize the hand in a position of function B) b. Close the hand into a fist and then immobilize the hand C) a. 'Buddy splint' the fingers together D) d. Straighten the fingers and then immobilize the hand

Your crew is called to an assisted-care facility for a 73-year-old female who fell while getting out of the shower. On arrival you observe that the patient is in a considerable amount of pain and complains of left proximal leg pain. The knee of the affected leg is flexed and the leg is shortened and internally rotated. This presentation is typical of what type of injury? A) a. Dislocation of the hip B) b. Dislocation of the knee C) c. Distal femur fracture D) d. Proximal femur fracture

Your patient is a 34-year-old female who just rear-ended another vehicle at a high rate of speed. Your patient is 23 weeks pregnant and is complaining of intense cramping, uterine pain and tenderness, occasional contractions, and an increase in vaginal bleeding. What is your patient most likely suffering from? A) A. Abruptio placentae B) B. Imminent childbirth C) C. Placental previa D) D. Preeclampsia

Your patient is a 35-year-old male unrestrained driver who has been involved in a head-on motor vehicle crash. There is significant damage to the steering wheel. The patient is complaining of left-sided chest pain and difficulty breathing. Initial assessment discloses pain and crepitus around ribs 3 through 8 with diminished breath sounds on the left side. En route to the hospital, your ongoing assessment shows that the injured portion of the chest is moving in an opposite direction from the rest of the thorax during respiration. This movement is known as: A) b. Opposite directional shift B) d. Paradoxical movement C) a. Antagonist movement D) c. Paradigm shift

Your patient is a 40-year-old pregnant woman who is gravida 6, para 5. She is complaining that this labor is unlike her others. She has sharp, constant abdominal pain and vaginal bleeding, and she feels like something is 'tearing.' You suspect: A) d. Uterine rupture B) a. Abruptio placentae C) b. Placenta previa D) c. Spontaneous abortion

Your patient was hit in the back with a baseball bat. Shortly after the incident, he began to experience lightheadedness and blurry vision. You notice bruising around his umbilicus. What does this indicate? A) A. Cullen's sign B) B. Kehr's sign C) C. Stop sign D) D. Turner's sign

A. critical.

A burn patient who has signs and symptoms of inhalation injury with associated respiratory compromise should be classified as:

C. Increasing respirations.

A closed head injury may present with a set of signs known as Cushing's triad. All of the following are part of Cushing's triad EXCEPT:

D. Direct, diffuse

A concussion is best described as which of the following types of brain injuries?

B. Popliteal artery

A dislocated knee is most likely to damage which of the following vascular structures?

A fracture of the femur may result in a hematoma that contains enough blood to make it a Stage ________ hemorrhage.

B. Normal left pupil; dilated, nonreactive right pupil

A growing lesion in the right cranial hemisphere will most likely result in which of the following?

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a Stage ________ hemorrhage.

D. all of these.

A laceration that is perpendicular to the tension lines of the body is more likely to:

A. Lumbar

A patient unable to extend the leg or flex the hip is most likely to have incurred an injury in which nerve plexus?

B. Autonomic Hyperreflexia Syndrome

A patient who had a spinal cord T-4 injury 2 years ago calls 911 for pounding headache, blurred vision, and flushing. On arrival, vital signs include a blood pressure of 240/120 and pulse of 58. What is this condition called?

D. Cervical hyperextension

A patient who was involved in a frontal motor vehicle crash in which his face struck the windshield is most likely to have which of the following types of injuries?

A. paraplegia.

A spinal cord lesion that results in paralysis of both lower extremities is known as:

D. Partial or complete tearing of the ligaments of the joint capsule

A sprain is an injury best defined as which of the following?

C. III

A trauma center that is committed to special emergency department training and has a degree of surgical capability but that usually stabilizes and transfers seriously injured patients is a Level ________ trauma center.

D. surgical

A trauma system is based on the principle that serious trauma is a ________ disease.

The left-rear passenger

A vehicle is struck in its right front as it passes through an intersection, resulting in a rotational impact. Which of the passengers is subjected to the greatest acceleration forces?

What is the mammalian diving reflex? A) a. A complex cardiovascular reflex that constricts blood flow everywhere but the brain B) c. The ability of mammals to over time train their bodies to maintain more dissolved oxygen in the bloodstream so that they can hold their breath for ever longer periods of time C) b. An inherent instinct that signals the mammal when to surface for oxygen D) d. A mammal's ability to consciously hold one's breath while submerged

A) a. A complex cardiovascular reflex that constricts blood flow everywhere but the brain

You are evaluating a 28-year-old female patient who was the belted driver in a car-versus-tree motor vehicle crash. She is also 30 weeks' pregnant. She is complaining of severe abdominal pain with cramping, and you can see blood soaking into her shorts and onto the driver's seat. As you prepare for a rapid extrication, you are worried that she may have experienced: A) a. Abruptio placentae B) c. Liver laceration C) b. Femoral artery laceration D) d. Premature labor

A) a. Abruptio placentae

You have been called to the home of a 37-year-old male patient in respiratory distress. He has no previous medical conditions and takes no medications. However, you can see the patient is in obvious severe distress; he is in the tripod position, and you hear rales as you walk into his house. While obtaining his history, you learn that he was the victim of a near-drowning event the day before and had required a brief period of positive-pressure ventilations. You suspect that this patient is now experiencing: A) a. Adult respiratory distress syndrome B) d. Pneumonia C) c. Congestive heart failure D) b. Chronic obstructive pulmonary disorder

A) a. Adult respiratory distress syndrome

Which statement best describes considerations of extricating a patient who has been trapped under an overturned tractor for approximately 3 hours? A) a. Avoid lifting the tractor off the farmer too quickly. B) b. Lift the tractor off the farmer as quickly as possible. C) d. Transport the patient and tractor as one unit. D) c. Replenish spilled hydraulic fluids before lifting the tractor.

A) a. Avoid lifting the tractor off the farmer too quickly.

Sprains are categorized according to the: A) a. Extent of ligament damage B) d. Type of tissue involved C) b. Number of cartilages damaged D) c. Type of tendons damaged

A) a. Extent of ligament damage

If you determine the musculoskeletal injury is isolated, then you can perform a(n): A) a. Focused assessment B) b. Ongoing assessment C) c. Rapid trauma assessment D) d. Head-to-toe assessment

A) a. Focused assessment

Mortality secondary to solid abdominal organ injury is primarily caused by: A) a. Hemorrhagic shock B) d. Organ death C) c. Infection D) b. Ileus

A) a. Hemorrhagic shock

Which agent causes respiratory distress and smells of rotten eggs? A) a. Hydrogen sulfide B) c. Nitrous dioxide C) d. Unsanitary chicken farm D) b. Methane gas

A) a. Hydrogen sulfide

One expected landmark in the evolution of wilderness EMS as a field is: A) a. National standardization of curricula B) d. State standardization of certification C) b. National standardization of position titles D) c. State recognition of wilderness educational programs

A) a. National standardization of curricula

What is occurring during decompression illness? A) a. Nitrogen bubbles are developing in the bloodstream and body tissues. B) b. Not enough oxygen is available to the patient. C) d. Too much pressure is being exerted on the bloodstream. D) c. The body is swelling rapidly.

A) a. Nitrogen bubbles are developing in the bloodstream and body tissues.

At what altitudes does high-altitude pulmonary edema generally develop? A) b. 8000 to 12,000 feet B) a. 5000 to 6000 feet C) c. 12,000 to 15,000 feet D) d. Above 15,000 feet

A) b. 8000 to 12,000 feet

Which penetrating object is least likely to have a straight trajectory through the body? A) b. Bullet B) c. Glass shard C) d. Knife D) a. Arrow

A) b. Bullet

A mnemonic for remembering signs and symptoms of musculoskeletal injury is: A) b. DCAP-BTLS B) a. AVPU C) d. SAMPLE D) c. OPQRST

A) b. DCAP-BTLS

Heat stroke can be present with or without: A) b. Dehydration B) c. Increased body temperature C) d. Mental status changes D) a. A very hot environment

A) b. Dehydration

A) b. Establishing a large-bore IV

As a paramedic, you realize that your ability to quickly recognize and treat a musculoskeletal injury helps to limit: A) b. Loss of use B) a. Disease C) c. Morbidity D) d. Mortality

A) b. Loss of use

A patient who has been resuscitated following drowning in raw sewage is at great risk for experiencing ______ when compared to a freshwater drowning victim? A) c. Alveolar damage B) b. Mutations C) d. Psychologic problems D) a. Cancer

A) c. Alveolar damage

Your crew is called to an assisted-care facility for a 73-year-old female who fell while getting out of the shower. On arrival you observe that the patient is in a considerable amount of pain and complains of left proximal leg pain. The knee of the affected leg is flexed and the leg is shortened and internally rotated. This presentation is typical of what type of injury? A) c. Distal femur fracture B) d. Proximal femur fracture C) a. Dislocation of the hip D) b. Dislocation of the knee

A) c. Distal femur fracture

'Buddy splinting' refers to a technique in which a broken: A) c. Finger or toe is taped to an adjacent but uninjured finger or toe B) b. Arm is secured to a rigid splint C) d. Leg is secured by holding the injury in place against a long backboard D) a. Arm is secured to a long backboard

A) c. Finger or toe is taped to an adjacent but uninjured finger or toe

You are working in the first aid station of a ski resort. Your base is at 7500 feet, and the peak of the mountain is 9200 feet. A 23-year-old female patient comes into the clinic appearing weak and pale. She tells you that she arrived yesterday and did not sleep well last night, and today she has a mild headache, is nauseated, feels like she has no energy, coughs continuously regardless of what she does to relieve it, and feels short of breath. When you take her vital signs, you notice her SpO2 is 85%. You suspect that she has: A) c. High-altitude pulmonary edema B) a. Acute mountain sickness C) b. Altitude cerebral edema D) d. Pneumonia high

A) c. High-altitude pulmonary edema

Which cause of cardiac arrest is most likely to benefit from CPR alone without a defibrillator present? A) c. Lightning B) d. Warm water drowning C) a. Envenomation D) b. High-altitude cerebral edema

A) c. Lightning

You are evaluating a middle-age male patient who was found walking aimlessly down the street at 3 AM on a wintry night. Witnesses called you to evaluate him because he 'does not seem right.' During your evaluation, you find the patient is stumbling, shivering uncontrollably, fumbling with his zipper, and mumbling words that you cannot comprehend. You determine that this patient has: A) c. Moderate hypothermia B) b. Mild hypothermia C) a. Hypoglycemia D) d. Severe hypothermia

A) c. Moderate hypothermia

Which of the following best describes hazards related to farm machinery? A) c. Pull in points, pinch points, crush points, shear points B) a. Crush points, wrap points, cinch points, crush points C) d. Shear points, pinch points, cinch points, crush points D) b. Pinch points, pull out points, cinch points, crush points

A) c. Pull in points, pinch points, crush points, shear points

Which of the following is the best beverage for a person trying to prevent hypothermia? A) c. Regular Coke or Pepsi B) a. Coffee C) b. Milk D) d. Clear liquids

A) c. Regular Coke or Pepsi

What is an appropriate treatment for a venomous snakebite? A) c. Removing constricting clothes and immobilizing the limb bitten B) a. Applying a lymphatic tourniquet C) d. Suctioning the venom out with a snakebite kit D) b. Applying ice to the bite site

A) c. Removing constricting clothes and immobilizing the limb bitten

In addressing extrication in wilderness EMS, it differs from traditional EMS by: A) c. Requiring more personnel only if needed for traversing difficult terrain B) a. Not requiring more personnel but more equipment C) d. Requiring significantly more personnel than traditional EMS D) b. Not requiring more personnel than traditional EMS activities

A) c. Requiring more personnel only if needed for traversing difficult terrain

Exposure to oxides of nitrogen from a silo results in a condition known as: A) c. Silo filler's disease B) b. Nitrogen toxicity C) a. Nitric oxide narcosis D) d. Silicosis illness

A) c. Silo filler's disease

Your crew is called to a local skating rink to treat a 42-year-old female who fell. She is complaining of severe elbow pain and is supporting the affected limb against her body. To manage this situation effectively, you should: A) c. Splint the arm in the position found, using a pillow or blanket B) a. Rotate the arm to 90 degrees and secure it with a rigid splint C) b. Rotate the arm to 90 degrees and secure it with a sling and swathe D) d. Splint the arm in the position found, using a traction splint

A) c. Splint the arm in the position found, using a pillow or blanket

While performing a scene size-up for a silo rescue, the paramedic is told that the fermentation of the silage ended 2 months earlier. What does this information tell the paramedic? A) c. Toxic gasses have ceased accumulating and may have dissipated. B) d. Toxic gasses have reached their maximum concentration. C) b. Toxic gasses are still present but at less than flash point levels. D) a. Nothing, as toxic gasses are continually produced and are still accumulating.

A) c. Toxic gasses have ceased accumulating and may have dissipated.

The less toxic families of pesticides are known as: A) d. Cholinesterase inhibitors B) c. Cholinesterase agonists C) b. Catecholamine inhibitors D) a. Acetylcholinesterase agonists

A) d. Cholinesterase inhibitors

The most likely cause of pulmonary edema in the base of the lungs of someone who had experienced difficulty breathing while working with a conventional silo is: A) d. Inhalation of nitrogen oxides B) b. Exposure to low levels of oxygen C) a. Congestive heart failure D) c. Ingestion of organophosphates

A) d. Inhalation of nitrogen oxides

Which organ can have an 'organ fracture,' causing massive internal hemorrhage? A) d. Liver B) a. Appendix C) c. Intestine D) b. Bladder

A) d. Liver

You are evaluating a 33-year-old female patient who was ejected from a motorcycle when her husband lost control on a corner. After exposing her body, you observe abrasions across her right flank and abdomen and note that bruising is developing along the posterior aspect of her right flank. Based on this information, you suspect that your patient: A) d. May have internal abdominal injuries B) a. Has fatal injuries C) b. Is in decompensated hemorrhagic shock D) c. Likely has superficial abdominal injuries only

A) d. May have internal abdominal injuries

When assessing musculoskeletal injuries, paramedics should: A) d. Not be concerned with differentiating among sprains, strains, and fractures B) a. Make every attempt to diagnose the injury correctly C) c. Manage patients as though they have a strain D) b. Manage patients as though they have a sprain

A) d. Not be concerned with differentiating among sprains, strains, and fractures

The most important aspect of drowning victim management is to: A) d. Not become a victim yourself B) c. Get the patient out of the water C) b. Get the patient dry D) a. Get the airway open

A) d. Not become a victim yourself

What would you expect to find during your assessment of a patient you believe may have internal abdominal traumatic injuries? A) d. Tenderness B) a. A soft abdomen C) c. Obvious external blood loss D) b. Early development of a rigid and distended abdomen

A) d. Tenderness

You are treating a 40-year-old female patient who was stabbed in the right upper quadrant with a steak knife. Oxygen has been administered, and the entry wound has been covered with a sterile dressing. Appropriate care for this patient includes: A) d. Transport to the closest trauma center B) c. Transport to the closest emergency department for a blood transfusion C) a. Administration of IV epinephrine to help the patient compensate D) b. IV fluids infusing at a KVO rate

A) d. Transport to the closest trauma center

C. staphylococcus.

The bacteria most often associated with infection of open soft-tissue injury is:

D. Tension pneumothorax

The finding of jugular venous distension in a patient with thoracic trauma would be most consistent with which of the following?

B. Hemothorax

The finding of jugular venous distension in the patient with thoracic trauma is LEAST likely to be associated with which of the following?

A. hemostasis.

The first stage of wound healing is:

A. brush away as much of the powder as possible.

The first step for treating a patient who has been contaminated with dry lime is to:

Frank-Starling law of the heart.

The increase in myocardial contraction as a result of increased blood return to the heart BEST describes:

B. evisceration.

The injury in which abdominal organs protrude through a large, deep laceration of the abdominal wall is best described as:

B. liver.

The largest reserve of blood of any body organ is contained in the:

B. higher, expiratory

The level of the diaphragm is ________ when it relaxes during the ________ phase of breathing.

C. 40

The liver is injured ________ percent of the time with penetrating abdominal trauma?

A. inferior margin of the associated rib.

The location of the neurovascular bundles containing the intercostal arteries is best described as the bundle that runs along the:

C. Ventilation/perfusion mismatch

The morbidity associated with simple pneumothorax is primarily due to which of the following?

Which of the following statements about acute respiratory distress syndrome (ARDS) is FALSE?

The mortality rate is 40 to 50 percent.

C. soft tissue.

The most common type of trauma is:

A. clavicle.

The most commonly fractured bone(s) in the human body is/are the:

C. periosteum

The pain associated with skeletal fractures is transmitted by nerves in the ________.

trajectory

The path a projectile follows during a flight is called its:

cavity

The pathway of injury left in the wake of a penetrating mechanism of injury is called the:

vascular

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the ________ phase.

A. diaphragm.

The primary muscle(s) of ventilation is(are) the:

D. anticipate your patient's injuries.

The purpose of determining the mechanism of injury and the index of suspicion for the trauma patient at the same time is to allow you to:

C. Posterior for minor abrasions or lacerations.

The rapid trauma exam focuses on finding injuries that may cause shock. Components of the rapid trauma assessment include all of the following EXCEPT:

D. Direct, diffuse

The shearing, stretching, and tearing associated with rapid acceleration/deceleration forces acting on the brain result in which of the following types of brain injury?

D. the mechanism of injury.

The suspicion of blunt abdominal trauma should be based primarily on:

D. All of these

The term head injury refers to which of the following?

C. duration, distance, and shielding.

The three primary factors that determine the severity of radiation are:

A. fascia.

The tough, fibrous sheaths that bundle skeletal muscle are called:

acceleration and deceleration.

The two factors that refer to the rate of change of speed are:

C. alternating, muscle tetany

The type of electricity supplied to homes is ________ current. Contact with this type of current may result in ________.

C. Pelvic fracture

The use of PASG is indicated in the treatment of which of the following musculoskeletal injuries?

C. 100,000, 50,000

The voltage of a bolt of lightning may be as much as ________ volts, and its temperature may reach ________ degrees Fahrenheit.

B. 25

Thoracic trauma accounts for approximately ________ percent of motor vehicle collision mortality.

100

To gain an appreciation for the potential for trauma from high-velocity projectiles, it is important to remember that the shock wave produced can exceed atmospheric pressure by up to ________ times.

C. compression

Traumatic asphyxia is a(n) ________ type of injury.

venous

Under normal circumstances, at any given moment, most of the blood is in the ________ system.

Compression injury of the cervical spine

Upon arriving at the scene of a single-vehicle collision in which the vehicle struck a utility pole, you note that the windshield is "spidered," or "starred," and that the driver was not restrained. Which of the following injuries is most likely?

C. Call immediately for air medical transport to reduce the "Golden Hour."

Upon arriving on a scene where the mechanism of injury indicates a potentially life-threatening injury, which of the following interventions will BEST help deliver the care that is needed?

Lumbar

When a patient falls and lands on his or her feet, which section of the spinal column is the most prone to compression injury?

C. 3

When assessing a long bone injury, you should assume you are dealing with a joint injury when the site of injury is within ________ inch(es) from the joint?

A large exit wound

When assessing a patient with a gunshot wound to the chest, which of the following findings would tell you the most about the amount of damage?

The zone of injury is larger than that expected with other types of weapons.

When assessing someone with a gunshot wound from a rifle, which of the following is important to remember?

B. Dullness to percussion

When assessing the chest during rapid trauma survey, what would indicate major internal hemorrhage?

B. Little chest movement, exaggerated abdominal movement

When assessing the patient with a potential spinal cord injury, which of the following findings would indicate diaphragmatic breathing?

C. Periorbital ecchymoses or "Racoon eyes"

When caring for a patient with a basilar skull fracture in the prehospital setting, which of the following would be an unexpected finding?

C. Mast cells release histamine, resulting in dilation of capillary sphincters and an increase in tissue perfusion.

When cells become hypoxic and the amount of carbon dioxide in them increases, reducing tissue pH, which of the following occurs to restore homeostasis?

All of these

When inspecting the interior of a vehicle involved in a frontal collision, you note that the dash panel beneath the steering wheel is broken. Which of the following injuries does this indicate?

C. Partial-thickness

Which classification of burn is characterized mainly by blisters?

B. Tunica media

Which layer of the arteries controls the diameter of the vessel?

B. II

Which level of trauma facility can handle the most common trauma emergencies but for more specialized care will have to transfer the patient to a regional trauma center?

C. III

Which level of trauma facility has minimal surgical support but can stabilize before transferring to a higher-level trauma facility?

D. IV

Which level of trauma facility stabilizes and prepares to transport trauma patients to a higher-level facility but does NOT necessarily have surgical capabilities?

Pneumothorax, ruptured bowel

Which of the following "paper bag syndrome" injuries may occur due to sudden compression of the thorax or abdomen?

C. < 8

Which of the following Glasgow Coma Scale scores indicates serious brain injury?

Bowel

Which of the following abdominal organs is the least affected by the pressure wave associated with penetrating trauma?

C. Administer fluids as needed to maintain a systolic blood pressure above 90 mmHg.

Which of the following about the use of prehospital fluid resuscitation in the patient with a traumatic brain injury is true?

B. Inhalation of superheated steam

Which of the following accounts for the most severe thermal burns of the airway?

C. Highway Safety Act of 1966

Which of the following acts resulted in the development of modern EMS systems?

B. Fentanyl

Which of the following agents is indicated for pain control in a patient with 4.5 percent partial-thickness burns?

B. 4-8

Which of the following are the most commonly fractured ribs?

C. Ventilation and maintaining adequate blood pressure

Which of the following are the two most important prehospital considerations for reducing secondary brain injury?

The capacity to do work

Which of the following best defines the term energy?

B. The nucleus pulposa extrudes through a tear in the fibrous layer of the disk, applying pressure to the spinal cord.

Which of the following best describes a herniated intervertebral disk?

C. Puncture

Which of the following best describes a wound in which pathogens may be introduced deep into the tissues, increasing the risk of infection?

C. It is a normal phenomenon. When a penlight is shone into one eye, both pupils constrict.

Which of the following best describes consensual reactivity of the pupils?

B. Immediate surgery

Which of the following best describes definitive care for the trauma patient with ongoing, significant hemorrhage?

C. Tearing of the organ in which the organ is fixed at its point of attachment but free to move otherwise

Which of the following best describes shear injuries to the abdominal organs?

C. It is detrimental due to vasoconstriction, resulting in decreased cerebral perfusion.

Which of the following best describes the effect of hyperventilation in the brain-injured patient?

B. It is not reliably present in patients with tension pneumothorax.

Which of the following best describes the finding of tracheal deviation in the trauma patient?

C. It reduces the weight of bones while allowing for support.

Which of the following best describes the function of cancellous bone?

C. Preventing movement of the head in any direction; applying a gentle lifting force of a few pounds to relieve some of the pressure the head exerts on the cervical spine

Which of the following best describes the goals of manual cervical spine stabilization?

B. It prevents pyruvic acid from being converted to lactic acid.

Which of the following best describes the importance of oxygen in cellular metabolism?

C. It occurs in less than 2 percent of all patients with serious chest trauma.

Which of the following best describes the incidence of pericardial tamponade?

B. Compression and decompression

Which of the following best describes the mechanism of blunt thoracic trauma associated with blast injuries?

A. Heat causes evaporation of water and denatures protein.

Which of the following best describes the pathophysiology of most burns to the human body?

C. 75 to 80

Which of the following best describes the percentage of mortality from penetrating trauma to the cranium?

C. 80

Which of the following best describes the percentage of musculoskeletal trauma in multisystems trauma patients?

A. Increased cerebral edema due to carbon dioxide retention

Which of the following best describes the probable effect of using transtracheal jet insufflation through a needle cricothyrotomy to ventilate the patient with traumatic brain injury?

B. It enables the seated patient's hips and torso to be rotated as a unit for positioning onto a long backboard.

Which of the following best describes the purpose of the vest-type, short spinal immobilization device?

C. It is controversial due to conflicting study results.

Which of the following best describes the role of rapid sequence induction (RSI) in the prehospital management of patients with traumatic brain injury?

D. Rhabdomyolysis

Which of the following best describes the skeletal muscle degeneration secondary to crushing trauma that causes the release of metabolic by-products?

C. Entry of gastric contents into the mediastinum

Which of the following best describes the threat to life associated with traumatic rupture of the esophagus?

The body of the vehicle and its occupants absorb the energy.

Which of the following best describes what happens to the kinetic energy of a vehicle traveling at 65 miles per hour when it collides into a concrete barrier wall?

The energy gradually dissipates as heat due to the friction of braking, rather than transfers to the vehicle and its occupants.

Which of the following best describes why the occupants of a vehicle moving at 50 miles per hour will be injured when the vehicle strikes a tree but not when it brakes to a stop?

C. Different functions of the spinal tracts are located in anatomically different areas of the spinal cord, resulting in specific patterns of dysfunction depending on the location and mechanism of injury.

Which of the following best explains the presentation and prognosis of partial spinal cord transection injuries?

C. Capillaries cannot contract.

Which of the following best explains why capillary oozing from minor, open, soft-tissue trauma may not stop immediately?

D. All of these

Which of the following body area(s) warrant special attention when burned?

C. Nerves

Which of the following body structures is the best electricity conductor?

"Mushrooming" or flattening on impact

Which of the following bullet characteristics would create the most damage?

D. Partial-thickness < 30% BSA

Which of the following burns would be classified as a moderate one?

D. All of these

Which of the following can reduce the potential for abdominal injury?

The victims usually have defensive wounds on their forearms.

Which of the following characteristics of stab wounds is associated with a male attacker?

C. Sodium metal

Which of the following chemicals reacts violently with water and must be brushed off the skin and covered with vegetable oil?

Lack of a crumple zone

Which of the following contributes to a greater degree of injury than anticipated from vehicle damage alone in a lateral-impact motor vehicle collision?

D. Helmet usage results in a more than 50 percent reduction in serious head injuries.

Which of the following correctly describes the impact of motorcycle helmet use?

D. Rapid surgical intervention

Which of the following describes definitive care of the patient with traumatic intra-abdominal hemorrhage?

Dropping level of consciousness

Which of the following does NOT indicate compensated shock?

Tachycardia

Which of the following early signs of shock is easily missed?

D. All of these

Which of the following factors increases the criticality of burn injuries?

Wind resistance

Which of the following factors is NOT a consideration in the severity of injury related to falls?

A. It is rigid and unyielding.

Which of the following features of the cranium exacerbates the severity of intracranial trauma?

Dropping level of consciousness

Which of the following findings indicates a progression from compensated shock to decompensated shock?

A. Lactated Ringer's

Which of the following fluids is appropriate for the prehospital management of hypovolemic shock?

C. Males, ages 16-30

Which of the following groups is at highest risk for spinal cord injuries?

D. Middle-aged males

Which of the following groups is not among those with the highest incidence of serious head trauma?

D. In most cases, fluid administration should be limited to 3 liters of isotonic crystalloid solution.

Which of the following guidelines applies to prehospital fluid resuscitation of hypotensive patients with intra-abdominal hemorrhage?

Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic shock?

C. Improved design of firearms

Which of the following has NOT been a factor in decreasing mortality due to thoracic trauma?

C. Improved building codes and construction and sprinkler and smoke detector use

Which of the following has contributed most significantly to the decline in U.S. burn mortality?

D. All of these

Which of the following impairs blood clotting?

"Mushrooming" on impact and tumbling 180 degrees upon impact

Which of the following increases a bullet's profile?

Hypotension

Which of the following indicates that a patient has transitioned from compensated to decompensated shock?

Pneumothorax

Which of the following injuries is associated with the pressure wave produced by a blast?

Entrapment

Which of the following injuries is associated with the tertiary phase of a blast?

Head and neck injuries

Which of the following injuries is most likely to occur to the occupants of a vehicle struck from behind?

A. An autotransfusion of up to 2000 ml of blood from the lower extremities

Which of the following is NOT a benefit of PASG?

C. Pupillary reaction

Which of the following is NOT a component of the Glasgow Coma Scale?

Tertiary impact

Which of the following is NOT a type of collision that must be considered when analyzing a motor vehicle collision?

B. Fall of less than 5 feet

Which of the following is NOT considered a significant mechanism of injury in pediatric patients?

A laceration on the forehead as a result of being struck with a metal pipe

Which of the following is NOT considered penetrating trauma?

C. Hip flexion

Which of the following is NOT included in the prehospital neurological examination of the patient with a potential spinal cord injury?

C. Auscultating bowel sounds

Which of the following is NOT part of the prehospital examination or the patient with suspected abdominal trauma?

B. The most common place of injury is the ascending aorta.

Which of the following is NOT true of trauma to the thoracic aorta?

B. When patients meet any of the trauma triage criteria, you should transport the patients to the closest facility, because they do not meet all the criteria for immediate transport.

Which of the following is NOT true of trauma triage criteria?

C. Increased heart rate

Which of the following is a function of the sympathetic nervous system?

D. Your patient's blood pressure is 142/90 when she is supine, but 116/88 when she sits up.

Which of the following is a manifestation of orthostatic hypotension?

D. All of these

Which of the following is a potential complication of crush injury?

Multiple wounds

Which of the following is associated with assault rifle wounds but not hunting rifle wounds?

B. Hematoma

Which of the following is best described as the accumulation of a pocket of blood in the tissues?

Rifle

Which of the following is considered a high-velocity weapon?

The distance from the shooter

Which of the following is most important when assessing the damage done by a gunshot?

Clavicle

Which of the following is most likely to be fractured due to a fall onto outstretched hands?

A. Shearing injury of the liver

Which of the following is most likely to occur as a result of rapid deceleration without actual contact between the patient's body and the interior of the vehicle?

It will remain intact.

Which of the following is most likely to occur when military ammunition is used?

B. Auto accidents

Which of the following is most prominent mechanism of injury associated with spinal cord injuries?

A. Fanning of the toes with dorsiflexion of the great toe

Which of the following is noted in the patient with a positive Babinski reflex?

C. Anticipating hypovolemic shock

Which of the following is the highest priority when managing a patient with bilateral closed femur fractures?

Maintaining cervical spine stabilization while opening the airway

Which of the following is the most important priority when caring for a patient with a shallow-water diving injury?

D. Whole blood

Which of the following is the preferred fluid for resuscitation in hemorrhagic shock?

A. Hypovolemia

Which of the following is the primary concern in the patient with a hemothorax?

A. Secure the body first, then the head.

Which of the following is the proper sequence for securing the patient's body and head to a long backboard?

C. A significant amount of blood can accumulate in the abdominal cavity before signs and symptoms of abdominal injury appear.

Which of the following is true of abdominal trauma?

D. All of these are true.

Which of the following is true of pulmonary contusion?

A shotgun may either fire one slug or use ammunition with multiple pellets.

Which of the following is true of shotgun ammunition?

They may deploy during rescue operations, injuring the patient and/or EMS personnel.

Which of the following is true of supplemental restraint systems?

D. All of these are true.

Which of the following is true of the basilar skull?

Children tend to turn toward the vehicle.

Which of the following is true of the differences between adult and pediatric pedestrians when struck by a vehicle?

D. All of these.

Which of the following is true of the elderly trauma patient?

B. Morbidity and mortality due to blunt trauma is decreasing, but morbidity and mortality due to penetrating trauma is increasing.

Which of the following is true of the epidemiology of abdominal trauma?

A. Dry skin offers more resistance to electricity, generating more heat.

Which of the following is true of the heat generated when electricity flows through the body?

A. Pneumothorax may occur even if the thoracic cage is intact.

Which of the following is true of the patient with a suspected penetrating injury to or rupture of the diaphragm?

The shock wave may be transmitted through blood, resulting in damage to blood vessels some distance from the primary wound.

Which of the following is true of the shock wave that accompanies high-velocity penetrating trauma?

It is a space indirectly created by a projectile as tissue moves rapidly away from its path.

Which of the following is true of the temporary cavity formed by penetrating trauma?

The movement is downward as the assailant raises the knife and swings downward.

Which of the following is typical of the trajectory of a knife when a female assailant stabs someone?

D. All of these

Which of the following may confound the assessment of the patient who has a mechanism of injury consistent with significant brain injury?

D. All of these

Which of the following may impact the pattern of injury in abdominal trauma?

A. Morphine sulfate

Which of the following may improve breathing in the patient with isolated rib fractures?

B. Ultraviolet keratitis

Which of the following may occur from watching arc welding without proper protection?

D. All of these

Which of the following may result from an improperly applied tourniquet?

D. All of these

Which of the following may result from seizure, worsening the condition of the patient with a traumatic brain injury?

C. Index of suspicion

Which of the following means "the anticipation of injury to a body region or organ"?

Surgery

Which of the following measures effectively controls bleeding in body cavities?

A. Systemic hypotension combined with increasing intracranial pressure

Which of the following mechanisms causes indirect brain injury?

Sudden deceleration

Which of the following mechanisms in a motor vehicle collision would most likely result in a tear of the liver at the ligamentum teres?

Sudden acceleration from a lateral-impact motor vehicle collision

Which of the following mechanisms is most consistent with diffuse axonal injury?

Anaerobic metabolism

Which of the following mechanisms is responsible for accumulating lactic acid in shock?

A. Motor vehicle crash with a 20-miles-per-hour impact

Which of the following mechanisms of injury does NOT call for immediate transport to a trauma center?

D. Fifty miles per hour motor vehicle crash with partial ejection

Which of the following mechanisms would yield the greatest index of suspicion for injury?

B. Methylprednisolone (Solu-Medrol)

Which of the following medications is NOT warranted in the prehospital management of patients with spinal cord injuries?

D. Furosemide

Which of the following medications may be indicated in the prehospital management of the patient with traumatic brain injury?

A. Pancreas

Which of the following organs is LEAST likely to be injured in penetrating trauma to the abdomen?

Handgun

Which of the following organs is most susceptible to damage from the pressure wave when a bullet enters it?

Liver, diaphragm, lung, kidney

Which of the following organs would most likely be injured by a stab wound to the 6th intercostal space in the midaxillary line on the right side?

B. Maintain an oxygen saturation > 95% and a capnography reading between 35 and 45 mmHg.

Which of the following parameters should be used to guide the oxygenation and ventilation of the patient with a traumatic brain injury?

A. 22-year-old with bilateral open femur fractures

Which of the following patients does NOT require specialty center capabilities beyond that offered by a trauma center?

D. All of these

Which of the following patients has an increased chance of wound infection?

A. Combative trauma patient

Which of the following patients is NOT a candidate for air medical transport?

C. Vital signs: blood pressure 80 by palpation, heart rate 130, and respiratory rate 12

Which of the following physical findings indicates the need for immediate transport?

C. 1 to 2 inches of padding under the head and a rolled blanket under the knees

Which of the following places the patient's spine in a neutral position?

Direct pressure, elevation, pressure point compression

Which of the following represents the correct sequence for controlling hemorrhage from an extremity?

A. Lower extremities are 13.5 percent each.

Which of the following represents the modified body surface area percentages in the "Rule of Nines" for pediatric patients?

A. 47-year-old involved in a motor vehicle crash that resulted in the death of his passenger

Which of the following requires immediate transport to a trauma center?

Metabolic acidosis

Which of the following results from anaerobic metabolism in shock?

"Washout" of microemboli and lactic acid

Which of the following results from relaxation of the postcapillary sphincters in shock?

A. Linear

Which of the following skull fractures are most common?

C. Contusion

Which of the following spinal cord injuries is LEAST likely to result in residual neurological deficit?

D. Emergent

Which of the following stages of burn injury is best described as including a pain response, an outpouring of catecholamines, tachycardia, tachypnea, mild hypertension, and anxiety?

A small, light bullet does the most harm.

Which of the following statements about bullets is true?

D. The actual source of bleeding in crush injuries may be hard to identify.

Which of the following statements about crush injuries is true?

Exit wounds reflect the potential for damage more accurately than entrance wounds.

Which of the following statements about entrance and exit wounds is true?

The degree of injury may be greater than the damage alone would indicate.

Which of the following statements about lateral impact collisions is true?

Knives, arrows, ice picks, and similar weapons cause damage only in their direct path.

Which of the following statements about low-velocity penetrating trauma is true?

Assault rifles generally increase the number of wounds the victim sustains.

Which of the following statements about rifles is true?

D. If the mechanism of injury warrants it, manual stabilization of the cervical spine should be employed. However, if your protocols allow selective spinal immobilization, you can release manual stabilization if the risk of spinal injury can be excluded.

Which of the following statements about spinal immobilization is true?

Male attackers usually strike with an overhand and inward strike.

Which of the following statements about stab wounds is true?

A. Hypoglycemia is associated with a poorer neurological outcome; if the blood glucose level is less than 60 mg/dl, administer 25 grams of dextrose intravenously.

Which of the following statements about the administration of dextrose to the patient with a traumatic brain injury is true?

D. All of these are true.

Which of the following statements about the effect of age on thoracic injury patterns is true?

Helmet use neither increases nor decreases the incidence of spinal trauma.

Which of the following statements about the impact of motorcycle helmet usage is true?

B. Most of these deaths are secondary to injury to the heart and great vessels.

Which of the following statements about the mortality of thoracic injuries is true?

B. Unopposed sympathetic nervous system stimulation results in generalized pallor and diaphoresis.

Which of the following statements about the patient in neurogenic shock is NOT true?

Unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis.

Which of the following statements about the patient in neurogenic shock is NOT true?

D. The presence of pericardial tamponade is indicated by Cushing's triad.

Which of the following statements is NOT true of pericardial tamponade?

D. Most full helmets provide adequate stabilization of the head, but it may be necessary to place a pad under the shoulders to achieve neutral alignment of the head.

Which of the following statements is NOT true regarding spinal immobilization for the patient wearing a helmet?

It fills with disrupted tissues, some air, fluid, and debris.

Which of the following statements is true of the permanent cavity created by penetrating trauma?

A. Nerve-root injuries affect one dermatome; spinal cord injuries affect multiple dermatomes.

Which of the following statements most accurately compares or contrasts nerve-root injuries and spinal cord injuries?

Catecholamines

Which of the following substances has the most rapid effect when compensating for hemorrhage?

Hemorrhage

Which of the following terms is best described as the loss of blood from the vascular space?

D. Greenstick

Which of the following types of fractures occurs in pediatric age groups but not in adults?

C. Transverse laceration of the vessel

Which of the following types of wound facilitates the effectiveness of normal blood-clotting mechanisms?

arterioles

Which of the following vessels has the greatest ability to change diameter?

D. Open defects that are 2/3 the size of the trachea or larger

Which of the following will result in an open pneumothorax?

D. All of these

Which of the following would occur in an untreated right tension pneumothorax?

Baroreceptors

Which of the following, located in the aortic arch, monitor blood pressure and send feedback to the medulla oblingata to maintain homeostasis?

Velocity and mass

Which of the two following factors proportionately affect the kinetic energy of a bullet fired from a gun?

When a bullet yaws, it increases the damage.

Which statement about ballistics is true?

Velocity and mass

Which two factors related to kinetic energy proportionately affect the damage a projectile will do?

Handgun

Which type of firearm usually limits trauma to direct injury?

B. Beta

Which type of radiation particle can travel through 6-10 feet of air, penetrate a few layers of clothing, and cause external and internal injuries?

C. The Rule of Palms

You are assessing a 17-year-old male patient with a burn on the lateral aspect of his thigh. Which of the following guidelines is most helpful when estimating the percentage of total body surface area involved?

D. Consult with medical control concerning rapid sequence induction and endotracheal intubation

You are assessing a 37-year-old woman who was rescued from an apartment fire. She has a harsh, stridorous, "brassy" sounding cough productive of sooty sputum, and the hair around her face, as well as her eyebrows, is singed. You have a 20-minute transport time. Which of the following is the best intervention for this patient?

B. degloving injury.

You are called to a commercial creamery where an employee got his arm trapped in the ice-cream-mixing machinery. You note that the skin has been pulled off his hand and arm from the midforearm down. The patient's muscles, tendons, and bones are exposed. This type of injury is a(n):

A body at rest will remain at rest unless acted on by an outside force.

You are called to the scene of a vehicle crash in which a car was rear ended while stopped at a stop sign. Which of the following laws of physics serves as the basis for analyzing the mechanism of injury and the associated suspicion of index for injuries?

C. Anterograde amnesia

You are caring for a 20-year-old skateboarder who crashed into a brick retaining wall at the bottom of a steep hill. He has blunt trauma to his face with nose deformity, loose teeth, and bleeding from the nose and mouth. Although you have answered him several times, he keeps repeating to you, "What happened? It seems like I'm having a bad day." This is most indicative of which of the following?

C. Retinal detachment

You are caring for a 22-year-old amateur boxer who complained of a sudden obstruction of part of his visual field. This complaint is most consistent with which of the following conditions?

B. Tentorial herniation

You are caring for a patient from a motor vehicle collision who has closed-head trauma. He is combative and has pupillary dilation. En route, he experiences projectile vomiting. Which of the following is this most indicative of?

D. 10.6, 5.3

You are caring for a patient with 30 percent full- and partial-thickness burns. He is an 80 kg male. According to the Parkland formula, he should receive ________ liters of fluid over 24 hours, with ________ liters infused in the first 8 hours.

A. 45

You are dispatched to a structure fire at which there is a report of a burned person. Your patient is a 32-year-old male with blisters on his anterior chest and circumferential superficial burns to both lower extremities. Using the "Rules of Nines," what percentage of burn does this patient have?

B. simple pneumothorax.

You are on the scene of a 13-year-old male whose playmate accidentally stabbed him in the chest with a pitchfork while they were playing in the barn. The patient has penetrating wounds at the 2nd, 4th, and 7th intercostal spaces on the left side of the chest anteriorly. All of the following injuries should be suspected and assessed for in this patient EXCEPT:

D. Brown-Sequard Syndrome

You are on the scene of a domestic assault in which the female victim defended herself against further attack by stabbing her attacker. Your patient is a 36-year-old male who has been stabbed in the posterior thorax about 1 cm to the right of the spinous process of T-6. Your assessment reveals loss of motor and sensory function on the right side distal to T-6 but intact motor function with some loss of sensation on the left side distal to T-6. Which of the following best explains this patient's presentation?

C. 0.9% sodium chloride solution

You are on the scene where a 35-year-old male has his leg trapped under a section of concrete. While awaiting removal of the concrete, which type of IV fluid is indicated for adminstration to this patient?

A. Remove the dressing and see if the patient's clinical status improves, then replace the dressing.

You are treating a patient whose open chest wound has been sealed by EMTs on the scene before your arrival. During transport, the patient becomes more dyspneic, tachycardic, and hypotensive. There are no breath sounds on the affected side, and the patient has JVD. Which of the following is the BEST action?

B. Open the airway and perform aggressive suctioning.

You arrive on the scene of a patient with severe blunt trauma to the face. You hear gurgling as you approach the patient. What should your next action be?

B. Hemothorax

You have arrived on the scene of a paramedic who was shot as she approached a residence on a call. The scene has since been secured. Your patient is a 38-year-old female with one gunshot wound to the left side of the chest at the 5th intercostal space in the midaxillary line. She is pale, cool, and awake but agitated. She is diaphoretic and complaining of pain in her left side and difficulty breathing. The patient's EMT-B partner has applied oxygen by nonrebreathing mask and an occlusive dressing over the entry wound before your arrival. As you continue your assessment, the patient's level of consciousness decreases. She responds to verbal stimuli. Her airway is clear, her breathing rate is 38 per minute and shallow, her neck veins are flat, and her breath sounds are absent on the left side. The patient lacks a radial pulse, and her abdomen is nonguarded and nontender. Which of the following best explains the presentation of this patient?

C. Assist ventilations with a bag-valve-mask device

You have arrived on the scene of a paramedic who was shot as she approached a residence on a call. The scene has since been secured. Your patient is a 38-year-old female with one gunshot wound to the left side of the chest at the 5th intercostal space in the midaxillary line. She is pale, cool, and awake but agitated. She is diaphoretic and complaining of pain in her left side and difficulty breathing. The patient's EMT-B partner has applied oxygen by nonrebreathing mask and an occlusive dressing over the entry wound before your arrival. As you continue your assessment, the patient's level of consciousness decreases. She responds to verbal stimuli. Her airway is clear, her breathing rate is 38 per minute and shallow, her neck veins are flat, and her breath sounds are absent on the left side. The patient lacks a radial pulse, and the abdomen is nonguarded and nontender. Which of the following should you do first?

B. Critical

You have been dispatched to a call for a burn patient. Upon arriving, you find a 23-year-old female who was sunbathing and fell asleep. She is alert and oriented and in moderate pain. She has blisters covering her extremities, abdomen, face, and chest. This patient's burns fall into which of the following categories?

A. Remove the catheter.

You have just inserted a large-bore catheter into the chest of a patient with a tension pneumothorax and received a return of air. Which of the following should NOT be done?

D. Occlusive

You have responded to an injured person at an address you know to be a motorcycle clubhouse. Your patient was attacked by another party with a broken beer bottle. Your patient has a large laceration on her neck with moderate bleeding. Which property of your dressing material is most important in caring for this patient?

C. Initiate rapid transport.

Your patient has a possible pelvic fracture from a frontal motor vehicle collision. She has a blood pressure of 78 by palpation, a heart rate of 130, and responds only to painful stimuli. Before you arrived, BLS providers immobilized the patient to a long backboard. Which of the following should you do next?

B. Damage will be limited to the direct path of the projectile, but the patient's condition should still be considered life threatening.

Your patient has been shot in the anterior right chest with a .38 caliber handgun. He has an exit wound just below the right scapula. Which of the following should you suspect?

C. An escharotomy

Your patient has circumferential full-thickness burns of the thorax. He is intubated, and you have noticed an increase in resistance as you bag him. His skin is very tight and inflexible as you try to ventilate. Which of the following is required to improve this patient's ventilatory status?

C. Penetration of the skin and subcutaneous tissues but no penetration of the body cavity

Your patient has received a shotgun wound from a distance of 30 feet. Which of the following is most likely?

B. Hypothermia.

Your patient has received blunt facial trauma due to an assault. You should maintain a high index of suspicion for all of the following injuries EXCEPT:

A. He is critical, and he most likely has an epidural hematoma with rapidly increasing intracranial pressure.

Your patient is a 12-year-old male who was struck in the right temporal area of the head with a baseball. He had a brief loss of consciousness and is alert on your arrival. You note that he is becoming drowsy and has a strong radial pulse of 60, a blood pressure of 140/70, and a respiratory rate of 12. Which of the following best describes this patient's condition?

C. Compartment syndrome

Your patient is a 15-year-old soccer player who was kicked in the calf by another player. She has a contusion on her calf, but the amount of pain she is experiencing seems out of proportion to the apparent injury. You note that, although you can palpate a pedal pulse, there is swelling in the foot and ankle, and the skin is cool to the touch. You should suspect which of the following at this time?

B. The patient has a spinal cord injury in the midcervical region.

Your patient is a 17-year-old female who fell from a horse. She is complaining of being unable to move. During your assessment, you have placed her arms at her sides, but her arms keeping returning to a "stick-up" or "hold-up" position. Based on this, which of the following is most likely?

A. She has a fracture of the orbit that has trapped the extrinsic eye muscles.

Your patient is a 22-year-old female assault victim. She has blunt trauma to the face with swelling around the right eye and zygomatic area. Upon assessing her eye movement, you note that the right eye cannot follow your finger and does not move. Which of the following most likely explains this finding?

C. You cannot rely on this measure alone to assess oxygenation.

Your patient is a 23-year-old female who was rescued from a burning house. She was asleep in a back bedroom when the fire started, and there was no smoke alarm. During transport, you monitor her EKG and pulse oximetry, as well as her vital signs. She has a pulse oximetry reading of 99% after receiving oxygen by nonrebreathing mask. In which of the following ways is this finding significant?

C. Obstructive and respiratory

Your patient is a 23-year-old male cyclist who was impaled in the chest by a small tree branch as he was riding on a trail. The branch has been removed on your arrival. You note a 1 cm wound in the third intercostal space in the midclavicular line on the right. There is minimal bleeding. You note air being sucked into the wound when the patient inhales, but air does not exit the wound on exhalation. The patient is anxious and has a weak radial pulse of 116 that disappears on inhalation. The patient's respiratory rate is 28, and breath sounds are absent on the right side. The patient is sitting against a tree and refuses to lie down. You note jugular venous distention, but no tracheal deviation. Which types of shock should you suspect in this patient?

Decompensated

Your patient is a 23-year-old male with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal stimuli; has pale, cool, diaphoretic skin; a heart rate of 128; respirations at 24; and a blood pressure of 82/60. These findings indicate which of the following kind of shock?

B. Control bleeding around the neck wound, using suction if necessary to prevent aspiration. Assess whether it is possible to introduce an endotracheal tube into the trachea through the wound.

Your patient is a 26-year-old male who suffered a shotgun wound to the neck and face. Your assessment reveals obstruction of the upper airway due to extensive soft-tissue damage and fractures of the mandible, maxilla, and hard palate. The patient has a bubbling open wound to anterior neck about 1 cm inferior to the cricoid cartilage, opening the trachea to the environment. Which of the following describes the best way to manage this patient's airway?

D. Focused exam, cover the open wound, splint from the foot to above the knee, begin transport, start an IV, and request orders for analgesia.

Your patient is a 27-year-old male ice skater whose left skate was planted when he was struck and knocked down by another skater. He is agitated and complaining of severe pain in his leg. Your examination reveals an open fracture 6 inches proximal to the ankle joint. Which of the following describes the most appropriate management of this patient?

B. Immediately cover the wound with your gloved hand, ask an assistant to prepare an occlusive dressing to be placed on the wound, apply oxygen by nonrebreather, reassess the patient's breathing, auscultate the lungs, assess the pulse, begin transport, and start two large-bore IVs at a keep open rate as long as there are no indications of hypovolemia.

Your patient is a 27-year-old male with one stab wound at the 5th intercostal space posteriorly, on the right. He is ambulatory at the scene, but dyspneic, and has air movement at the site of the injury. Which of the following is the best sequence of actions in caring for this patient?

Your patient is a 29-year-old male who works in a meat-processing plant. He received a knife wound in the proximal antero-medial thigh, which is continuing to bleed on your arrival. He is restless, thirsty, and has pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of 118/88. This patient is exhibiting signs and symptoms consistent with a Stage ________ hemorrhage.

C. laceration.

Your patient is a 3-year-old male who has struck his head on a concrete patio. He has a wound that penetrates the dermis and is approximately 2 cm long. This wound would be best described as a(n):

C. There may be extensive soft-tissue injury, fractures, and damage due to Crush Syndrome.

Your patient is a 30-year-old machinist who had his right hand caught in a press. Upon extrication, there is no evidence of significant trauma. Which of the following best describes the index of suspicion you should have for this patient's injury?

B. Compression fractures on the left side of the cervical spine; torn ligaments on the right side of the cervical spine

Your patient is a 30-year-old male who was playing a backyard game of football and was tackled forcefully from the left side at the level of the shoulder. Based on this mechanism of injury, you should suspect which of the following patterns?

C. The mechanism and patient complaints are suspicious for placental abruption. Both the mother and the fetus are in jeopardy.

Your patient is a 30-year-old pregnant woman at 36 weeks gestation. She was injured in a fall from a horse and is complaining of painful contractions. Her abdomen is tender to palpation over the uterus, and the uterus becomes firm with contractions, but she denies vaginal bleeding. The patient is anxious, but her skin is warm and dry. Her blood pressure is 112/70, her heart rate is 92, and her respirations are 24. Which of the following statements best describes this situation?

D. Administer an antidysrhythmic such as amiodarone or lidocaine.

Your patient is a 31-year-old female with blunt trauma to the chest. You noted a contusion over the sternum and, during transport, the patient develops ventricular tachycardia. She has a radial pulse and a blood pressure 110/60. Which of the following is the best course of action?

C. Sodium bicarbonate

Your patient is a 38-year-old male who is pinned beneath the frame of a vehicle when it slipped off the makeshift jacks. The patient's brother feels he may have been trapped for up to 20 minutes. The rescue unit is preparing to use airbags to lift the vehicle off the patient. Which of the following medications could you consider giving this patient?

A. L-1.

Your patient is a 38-year-old man who jumped 25 feet from a bridge into a dry creek bed. He is most likely to have a compression fracture of:

B. He is in decompensated shock.

Your patient is a 45-year-old male who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and confused, pale, diaphoretic, and cool to the touch. He lacks a radial pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this patient?

C. Nasotracheal intubation

Your patient is a 45-year-old male with extensive blunt trauma to the face. He has decorticate posturing in response to pain; weak, irregular respiratory effort at 6 per minute; and a heart rate of 50 with a good radial pulse. The patient appears to have nasal and mandibular fractures, and an oropharyngeal airway is insufficient to keep the tongue from the posterior pharynx. Which of the following has the MOST potential to negatively impact the patient?

A. Gangrene

Your patient is a 45-year-old type II diabetic who has a nonhealing wound on his right foot. You note that the right leg is discolored, edematous, and has subcutaneous emphysema and a foul odor. Which of the following should you suspect?

C. Perform a rapid trauma assessment and, if nothing significant is noted, assess distal neurovascular status, apply and secure padded long board splints laterally and medially, ensure spinal immobilization, begin transport, start two large-bore IVs of isotonic crystalloid, perform a detailed examination, and consult with medical control for pain management.

Your patient is a 50-year-old motorcyclist who received a lateral impact from an automobile as he went through an intersection. He has a deformity of the right midthigh and an open right tibia/fibula fracture. He also has a fracture of his left forearm and some abrasions. He was wearing a helmet and suffered no loss of consciousness. He currently has a strong radial pulse of 100, his skin is warm and moist, and he has adequate respirations at 20 per minute. Which of the following is the best way to manage this patient's lower-extremity trauma?

B. Oxygen, c-collar, rapid extrication onto a long backboard, rapid trauma exam, application of PASG, begin transport, and start two large-bore IVs of isotonic crystalloid solution.

Your patient is a 60-year-old female driver of a vehicle involved in a moderate-speed frontal collision. She was unrestrained, but airbags deployed. There is no damage to the windshield, but the bottom of the steering wheel ring is deformed. On your initial approach to the vehicle, an EMT is in the back seat with manual cervical spine stabilization. The patient is anxious and complaining of pain "in her legs." She appears pale, her skin is cool but dry, she as a thready radial pulse of 116, respirations of 24, and clear, equal bilateral breath sounds. Her abdomen is soft and nontender, and there is no pain or instability on assessment of the pelvis. Which of the following is the best management of this patient?

C. Intra-abdominal bleeding

Your patient is a 60-year-old female restrained driver involved in a moderate-speed, frontal-impact collision. When you arrive at the scene, she is sitting up in the driver's seat with a chief complaint of a burning sensation of her face. You note abrasions from deployment of the airbag. After immobilizing the patient on a long backboard, you begin transport. As you perform a detailed examination, the patient complains of developing right shoulder pain. Which of the following should you suspect?

D. Determining the presence or absence of cerbrospinal fluid in the blood is a low priority. Loosely cover the ear with a sterile dressing to prevent contamination while allowing blood to flow freely from the ear.

Your patient is a 7-year-old male pedestrian who was struck by a vehicle. Your assessment reveals bleeding from the right auditory canal. Which of the following describes the most appropriate way to manage this?

A. Disruption of bone growth from the epiphyseal plate

Your patient is a 7-year-old male with a fracture of the proximal tibia. Which of the following is the most likely and serious complication of this injury?

C. Spiral

Your patient is a football player who had his right foot planted and was tackled from the left rear, causing his body to rotate around the axis of his right lower extremity. This mechanism is most consistent with which of the following types of fractures?

B. Ensuring an open airway by anticipating vomiting, providing oxygen, keeping the patient warm, and monitoring for and treating shock

Your patient is an 18-year-old male who was slashed across the abdomen with a machete. He has a mass of omentum and small bowel protruding from the wound. Which of the following is your primary concern with this patient?

C. Intubation and positive pressure ventilation

Your patient is an 80-year-old male who was the unrestrained driver of a vehicle without airbags that was involved in a frontal collision with a parked car. Your assessment reveals that he is dyspneic, tachypneic, and tachycardic. He is awake but unable to respond to questions. There are no obvious signs of injury to the head or neck. The patient has paradoxical movement of the sternum with breathing, along with crepitus and subcutaneous air noted on palpation. Chest excursion is limited, and the patient has cyanosis of his lips, ears, and nail beds. Which of the following is MOST needed in this patient?

C. Relative to body weight, a smaller amount of hemorrhage may result in shock.

Your patient is an obese 39-year-old woman involved in a lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this patient?

C. Compression and deceleration

Your patient was the unrestrained driver of a motor vehicle without airbags. The vehicle struck a large utility pole at about 45 miles per hour. Your patient has a contusion over his chest and upper abdomen consistent with the shape of the steering wheel. You should suspect which of the following types of injury in this patient?

Abruptio placentae

Your patient, a 23-year-old woman who is 6 months pregnant, was the unrestrained driver of a vehicle that rear-ended a parked car. The airbag deployed. For which of the following injuries should you maintain a high index of suspicion?

1. Which of the following terms is defined as using the correct amount of a drug according to the manufactures guidelines? a. Dosage b. Indication c. Side effect d. Therapeutic effect

102. Where is the last place that should be auscultated for lung sounds on the anterior chest? a. Fifth intercostal space midaxillary b. Fifth intercostal space midclavicular c. Inferior to the clavicles d. Third intercostal space lateral to the sternum

11. Improper verbal communications can lead to: a. An incomplete or incorrect exchange of information b. Disagreements c. Improper terminology d. The paramedic being fired

112. While performing auscultation of the heart sounds, what does S2 signify within the hearts contraction? a. Pulmonic and aortic valve closing b. Pulmonic and aortic valve opening c. Tricuspid and mitral valve closing d. Tricuspid and mitral valve opening

128. Paramedics are responding to a male patient who is complaining of pain in the genitalia region after being hit by a baseball. When assessing this patient, which of the following would be an inappropriate method of performing an examination? a. Have bystanders in the room to serve as witnesses. b. Have the patient examine himself and tell the paramedic if there are any abnormalities. c. Maintain the patient's privacy as much as possible. d. Try to have at least two rescuers present.

13. Which of the following drugs is derived from minerals or mineral products? a. Bismuth b. Insulin c. Nicotine d. Salicylate

13. Which of the following medications is commonly used during hemodialysis to prevent the formation of blood clots? a. Diabinese b. Heparin c. Mevacor d. Paxil

133. A patient is complaining of seeing bright red blood on the toilet paper when cleaning after a bowel movement. This is most likely a sign of which of the following? a. Hemorrhoids b. Lower GI bleed c. There is nothing significant with this finding d. Upper GI bleed

135. When assessing the patient's pelvis, it is important to perform which of the following assessments to determine whether the pelvis is stabile? a. Flex and compress b. Have the patient sit up c. Immobilize d. Rotate

14. Errors involving the use of abbreviations when charting can be prevented by: a. Avoiding abbreviations that are not universally accepted b. Never using abbreviations c. Placing all abbreviations in quotes d. Using abbreviations only when documenting a patient's statement

14. Use of a translator with a patient who speaks a foreign language is: a. A good way to enhance verbal communications b. An example of an impediment to verbal communication c. Not important as the treatment is the same d. Not important if you speak a little of the language

14. Which of the following drugs is an example of a synthetic drug? a. Barbiturates b. Heroine c. Opium d. Quinine

14. Which of the following is the most like cause of a weak pulse? a. A narrow pulse pressure b. A wide pulse pressure c. A child or infant is being assessed d. Underlying respiratory compromise

141. When doing a neurologic assessment, it is important to examine what system? a. Both systems b. Central nervous system c. Neither system d. Peripheral nervous system

142. Which of the following is a general rule to consider when assessing pediatric patients regarding their vital signs? a. The younger the patient, the faster pulse and respirations. b. The younger the patient, the slower pulse and respirations. c. There are only small changes between adults and pediatrics patients. d. Vital signs are the same as in adults.

143. Which of the following is one of the most important things to remember when assessing a pediatric patient? a. Gain the caregiver's trust. b. Intimidate the patient to gain her or his trust. c. Make loud noises when approaching the patient. d. Use technical terms to explain what will be done.

144. When should the primary assessment be repeated as part of the patient reassessment? a. Each time the patient is reassessed b. Only when ordered by medical control c. Each time a treatment is given d. Every hour as directed

146. When should a patient be reassessed? a. Any time there is a change in the patient's condition b. Approximately every two minutes c. Only when ordered by medical direction d. There is no need to reassess a patient after the detailed examination

147. Which of the following is considered a general guideline of recording examination information? a. Document all completed portions of the physical examination. b. Document incomplete portions of the physical examination. c. Document only abnormal physical examination findings. d. Document only normal physical examination findings.

15. Atrovent is classified as which type of drug? a. Anticholinergic b. Antiemetic c. Cholinergic d. Dopaminergic

15. Which of the following best describes written communications in EMS? a. Completing a patient care report to submit to the agency for billing b. Giving a patient report to the staff upon arrival at the hospital c. Receiving a call for help from an injured person over the telephone d. Receiving an emergency call over the radio from the dispatcher

15. Which of the following drugs comes from a recombinant DNA technology source? a. Erythropoietin b. Estrogen c. Insulin d. Oral contraceptives

15. You are on scene with a 15-year-old male who was hit by a car while riding his bike. He has a cut that is 3 cm in length, and he is bleeding over the right forehead. He also has a deformed right arm near the wrist. He has a dark colored area over his right eye and bruising behind his ears. Which of the following is the appropriate use of medical terminology when describing this patient? a. Battle's signs bilaterally b. Broken wrist c. Bruise over right eye d. Cut on forehead

16. Which of the following are examples of the three main areas of drugs classifications used by the Anatomical Therapeutic Chemical Classification System? a. Body system, mechanism of action, and class of agent b. Body system, method of creation, and level of addiction c. Generic name, trade name, and chemical name d. Toxicity, level of addiction, and mechanism of action

16. Which of the following pulse points should be assessed initially in the infant patient? a. Brachial b. Carotid c. Pedal d. Popliteal

16. You arrive on scene to a 24-year-old male who was involved in a stabbing. He is able to tell you his name, where he is located, and the complete details of the stabbing. Which of the following abbreviations would be appropriate when documenting your findings on this patient? a. A

17. Which of the following statements is most accurate when assessing the ventilations of a 2-year-old child? a. Respirations are primarily diaphragmatic in the under-7 age group. b. Respirations are primarily diaphragmatic in the under-13 age group. c. Respirations are primarily intercostal in the under-7 age group. d. Respirations are primarily intercostal in the under-13 age group.

18. A paramedic's documentation of a call is important: a. As a legal record, for continuity of patient care, and for quality management b. As documentation of work done c. Because it is required of each call d. Only if something bad or a problem occurred during the call

18. What complication may develop when diaphragmatic breathing is impeded in a 4-year-old child? a. Effective breathing may be compromised. b. Effective circulation may be compromised. c. Effective communication may be compromised. d. There is no complication for this patient.

19. Which of the following terms is the best example of the use the classification system when describing the selective calcium channel blocker verapamil? a. Class of agent b. Method of action c. Physiologic classification d. Therapeutic classification

2. When corrections or revisions are needed on a prehospital care report, the paramedic should: a. Draw a single line through the error and date and initial it. b. Scratch out the wrong information and write the correct information beside it. c. Use a U.S. Department of Transportationapproved supplement form. d. Write a revision on a carbon copy of the original form.

21. Proper documentation should include: a. Patient information b. The 5 H's and 5 T's c. The 5 W's and 1 H d. Your personal opinion

21. What scale is used to initially assess a patient's mental status? a. AVPU scale b. Mental scale c. Mentation scale d. Pain scale

22. As a paramedic, you are called to court for a case that occurred 3 years ago. Your primary source of information and defense would be your: a. Documentation b. Memory c. Partner's memory d. Service record

22. Which of the following is a correct part of the SOAP acronym? a. A = Assessment data b. O = Observations c. P = Patient history d. S = Signs

23. Which act or amendment established the five schedules (classifications) of substances based on their accepted medical use in the United States, abuse potential, and potential for addiction? a. The Comprehensive Drug Abuse Prevention and Control Act b. The Controlled Substances Act c. The Harrison Narcotics Act d. The Pure Food and Drug Act

23. You and your partner get into a minor accident upon arrival at a call. The owner of the other car, whom you hit while opening your door, says it is no big deal and wants to just leave. What should you do? a. Document the event completely, as you may be called to court. b. Document the event only if there is damage to your ambulance. c. See if there are any other witnesses, and if there are not, do not report it. d. Thank the person in the other car and treat your patient.

24. According to the Schedule of Controlled Substances, what is the drug schedule classification of marijuana? a. I b. II c. III d. IV

26. Which of the following drugs would be the most correct pharmacologic agent to treat a patient with a suspected morphine overdose? a. Dextrose b. Heparin c. Naloxone d. Thiamine

27. Which of the following best lists the technology currently available to EMS for exchanging patient information electronically? a. Electronic PCR, PDA, fax machine, radio communications b. NCR paper duplicates, telephone, fax machine c. PDA, PDF, fax machine, electronic PCR, radio communication d. PDA, fax machine, telephone, NCR paper duplicates

27. Which of the following pharmacologic agents could be used to premedicate a patient before transcutaneous pacing? a. Ibuprofen b. Lidocaine c. Midazolam d. Naloxone

28. Which of the following terms best describes the use of activated charcoal for a patient with an ingestion of a corrosive material? a. It has a side effect. b. It is a classification. c. It is contraindicated. d. It is indicated.

28. You arrive on scene to find 18-year-old male in a motor vehicle crash. You smell alcohol in the vehicle. The patient is walking with a staggering gait and has slurred speech. Which of the following is appropriate to place in your report? a. The patient has a staggering gait. b. The patient is intoxicated. c. The patient is uncooperative. d. The patient's speech indicates intoxication.

29. Which of the following best describes the legal aspects of an electronically transmitted patient care report or other information? a. The information is considered legal documentation. b. The information is not considered legal documentation. c. The information is only legal documentation if printed. d. The information is only legal if the hospital receives it.

3. When you must correct an entry on a prehospital care report, you should: a. Draw a single horizontal line through the entry so that it remains legible, and date and initial it. b. Erase the entry and write the new entry in its place. c. Mark through the entry with a black permanent marker, and write the new entry nearby. d. Tear up the prehospital care form, and start over with a new one.

30. Computers, especially tablet computers, are now commonly being used in EMS in the field for: a. Electronic PCRs b. Instant messaging c. Internet access d. Watching DVDs

30. What do you do if a patient refuses EMS treatment or transport? a. Carefully document the events, assessments, and recommendations to patients. b. Contact medical direction to have them document the events. c. Documentation is required only if you feel the patient refused care inappropriately. d. There is no need to document the EMS response.

30. Which of the following statements about NSAIDs is most correct? a. They are antiinflammatory drugs. b. They contain narcotics. c. They contain steroids. d. They promote actions of prostaglandins.

34. You are dispatched to a motor vehicle accident and informed that three cars are involved; you will have a 20-minute response time from your base hospital. Additionally, you are informed that all vehicles have sustained heavy damage and one is on its side with a possible fuel leak. Based on this scenario, what additional units should be requested to respond to the scene? a. Additional ambulances, a helicopter, and fire suppression unit b. Additional ambulances, a helicopter, the power company, and a fire suppression unit c. A fire suppression unit only d. A helicopter only

37. The parasympathetic division of the nervous system is composed of which cranial nerves? a. III, VII, IX, and X b. IV, VII, IX, and XI c. VII, VIII, IX, and X d. IX, X, and XI

37. Which of the following statements most accurately describes the reason for identifying the need for additional help or assistance? a. Is an important component of the scene size-up. b. It forms part of the detailed patient assessment. c. It should be delayed until a full assessment of all patients has been made. d. It should be left to the highest-level trained medical provider on scene.

4. Which of the following is not part of a complete medical history? a. Ability to pay for prehospital medical care b. Conditions currently being managed by a physician c. Prior hospital admissions d. Prior surgeries

40. The radio communications system that uses two frequencies and enables both parties to communicate simultaneously is referred to as a _____ system. a. Duplex b. Multiplex c. Simplex d. Truncated

41. Ketamine is an example of which type of anesthetic? a. Dissociative anesthetic b. General anesthetic c. Neuroleptic anesthetic d. Topical anesthetic

41. Which of the following statements most accurately describes the effect that a drug has on the body? a. Changes an existing body function b. Gives body tissues or organs new functions c. Only dilates blood vessels d. Replaces tissues in the body

42. Which of the following statements is most correct regarding the properties of medications? a. Drugs give an existing function a new advantage. b. Drugs give tissues and organs new functions. c. Drugs provide temporary support for declining tissues. d. Drugs replace the tissue and organ functions.

43. Which of the following is the most appropriate method of opening the airway of an adult patient with no apparent traumatic injuries? a. Head tilt/chin lift b. Head tip/neck lift c. Jaw thrust d. No mechanical method is needed

43. Which of the following statements is most correct regarding the general action of a drug in the body? a. A chemical reaction occurs with molecules in the body. b. A toxic reaction to the drug occurs at the cellular level. c. It blocks receptor sites in the body to alleviate illness. d. It reconfigures receptor sites to enhance body functions.

44. Which governmental agency is responsible for regulating communications as well as for establishing and enforcing communications rules and guidelines? a. Federal Communications Commission b. Federal Communications Regulatory Agency c. Federal Information and Technologies System d. United States Department of Interior

46. Antineoplastic agents are used to treat which type of medical condition? a. Cancer b. Heart disease c. Hypertension d. Stroke

48. How are the solid forms of drugs most frequently administered? a. Enteral b. Inhalation c. Intravenous d. Parenteral

48. Which of the following is considered one of the best methods to control external bleeding found during the assessment of the circulatory system? a. Apply direct pressure to the site of the bleeding. b. Apply pressure distal to the bleeding. c. Apply pressure to the general area of the bleeding. d. No bleeding control is needed.

49. Which of the following methods of medication administration is described as readily available, painless, and noninvasive but has limited value in an emergent situation with slow or erratic absorption? a. Oral b. Rectal c. Sublingual d. Topical

50. What method of medication administration is best described as painless, has a rapid onset of action, but requires a responsive, cooperative patient with an intact gag reflex? a. Buccal b. IV c. Oral d. Topical

50. Which type of drug would be indicated for administration to an actively seizing patient? a. Benzodiazepines b. Diuretics c. Narcotics d. Steroids

51. A radio system that transmits and receives on two separate frequencies is known as a: a. Duplex system b. Multiplex system c. Simplex system d. Telematic system

51. Which of the following drugs are classified as benzodiazepines? a. Diazepam, alprazolam, and midazolam b. Lorazepam, tolnaftate, and miconazole c. Morphine, meperidine, and Librium d. Stadol, Demerol, and Xanax

52. Which of the following medication administration methods has an immediate onset and is easily accessible, but is painful, time consuming, and has a significant potential for causing adverse reactions? a. IM b. IV c. Rectal d. SL

54. Which of the following molecules is the most abundant plasma protein that binds with the widest range of drugs? a. Albumin b. Cytokines c. Fibrinogens d. Globulins

54. Why should paramedics prioritize patients for care and transport? a. To determine which patient requires immediate transport for care that cannot be provided at the scene b. To provide legal justification for the transport c. To verify that the patient is mentally competent for the transport d. To reduce the workload at the local care facility

55. Which of the following commonly used drug types is used to suppress hunger and is often abused? a. Amphetamines b. Barbiturates c. Calcium channel blockers d. Narcotics

56. Which of the following best describes the absorption of topical nitroglycerin in a patient with poor peripheral circulation? a. Absorption decreases, and the results may be less than desired. b. Absorption decreases, and the results may be stronger than expected. c. Absorption is enhanced, and the results may be stronger than expected. d. Absorption is unchanged, and the results can be typical.

57. Atropine is commonly used to treat which of the following conditions? a. Bradycardia b. Cardiac chest pain c. Pulmonary edema d. Tachycardia

58. What are the four main processes of pharmacokinetics? a. Absorption, distribution, metabolism, elimination b. Administration, absorption, metabolism, elimination c. Adsorption, bioavailability, diffusion, metabolism d. Concentration, administration, solubility, biotransformation

59. The method of administration of a drug will have the greatest impact on which of the following actions? a. Absorption b. Elimination c. Excretion d. Metabolism

6. The CAGE mnemonic can be used to assess for what? a. Alcohol abuse b. Illicit drug abuse c. Sexual abuse d. Tobacco abuse

6. You are on the scene of a medical emergency and use the medical radio to speak with medical control about the patient. This is an example of: a. Electronic communications b. Nonverbal communications c. Verbal communications d. Written communications

60. The amount of drug and the speed at which it reaches its intended site of action is best defined by which of the following terms? a. Bioavailability b. Dosage c. Solubility d. The pH

61. Why should a paramedic perform a rapid trauma assessment? a. It focuses on finding major injuries. b. It focuses on finding minor injuries. c. It is done for documentation purposes. d. There is no need to perform a rapid trauma assessment on any patients.

62. Which of the following patients would warrant a rapid trauma assessment? a. An unresponsive patient b. A patient who is complaining of chest pain c. A patient with a minor mechanism of injury d. A patient with an isolated foot injury

65. The paramedic is late getting off shift and the dispatcher is giving the crew another emergency call. Proper verbal etiquette for the radio transmission includes: a. Accepting and completing the emergency call b. Cursing at the dispatcher to show displeasure c. Immediately calling the supervisor to complain d. Slamming the open radio microphone onto the dash

65. What is the trade name for diltiazem? a. Cardizem b. Celexa c. Corospodol d. Lopressor

66. The paramedic should repeat the information received in order to: a. Confirm receipt and understanding of the information b. Let others know the paramedic is responding c. Rebroadcast the information through the repeater system d. Take up airtime and annoy the dispatcher

66. What comprises the detailed physical examination? a. A head-to-toe assessment of the patient b. A level-of-consciousness check c. A sample history d. The six vital signs

67. Which of the following routes of administration provides the fastest rate of absorption? a. IV b. IM c. PO d. Sub-Q

67. Which of the following techniques enhances radio communications? a. Confirm that the receiving party has received the message. b. Deliver a long, detailed message to present a clear picture of the patient's condition. c. Hold the microphone at least 5 inches away from your mouth. d. Use local dialect or slang to ensure understanding.

68. Which of the following drugs would be the most appropriate pharmacologic intervention for a symptomatic patient experiencing SVT with a heart rate of 220 beats/min? a. Adenosine b. Amiodarone c. Diltiazem d. Lidocaine

68. Which of the following patients should receive a focused history assessment and a physical examination? a. A conscious patient with a medical condition b. A patient with a minor finger laceration c. An unconscious patient with a leg injury or an ankle injury d. An unresponsive patient with no gag reflex

68. Which of the following statements is most correct when referring to the biotransformation that takes place in the liver? a. Change of the drug to inactive metabolites b. Direct transport to the kidneys for excretion c. Irreversible damage to the liver d. Removal of the drug through the bile duct

69. The paramedic is communicating with medical control over the radio and giving the doctor information about the patient. The information that should be relayed includes: a. Description of the scene, patient's signs and symptoms, care rendered b. Name or identification of the paramedic, description of the scene, patient's name c. Patient's name, patient's signs and symptoms, past medical history d. Pertinent past medical history, signs and symptoms, Medicare number

7. Norepinephrine has the greatest affinity for which of the following receptor sites? a. Alpha receptors b. Beta receptors c. Muscarinic receptors d. Nicotinic receptors

70. How are IV medications typically administered to severely hypothermic patients? a. At longer than normal intervals b. At shorter than normal intervals c. Once their body temperature returns to normal d. Only if they are in cardiac arrest

70. The 'echo' procedure for communications: a. Means to repeat directions received from the dispatcher or orders received from a physician b. Means transmitting information twice to medical direction to ensure clarity of the transmission c. Refers to the relaying of instructions received by medical direction to the EMS crew d. Refers to the use of 10 codes to ensure patient privacy

70. What areas of the body are evaluated during the detailed physical examination? a. All areas of the body are evaluated. b. No areas of the body are evaluated. c. Only isolated areas of the body are evaluated. d. This examination is deferred to the hospital.

71. You are en route to the hospital with a 53-year-old victim of a shooting. After relaying patient information and, with medical direction, developing a treatment plan for this patient, the patient's condition suddenly deteriorates. After stabilizing the patient, what is your next course of action? a. Advise medical direction of the change in the patient's condition. b. Immediately contact the receiving facility. c. Immediately reroute to the closest medical facility. d. Proceed with the physician's orders as originally directed.

75. A patient has been given a medication and shortly afterward starts to have difficulty breathing, hypotension, and urticaria. The patient is having what type of reaction to the drug? a. Anaphylactic reaction b. Hypersensitivity c. Summation d. Tachyphlaxis

75. Which of the following drugs is the most appropriate antiplatelet therapy for a patient with a previous stroke? a. Aspirin b. Dopamine c. Lidocaine d. Lopressor

76. Lopid is commonly used as a pharmacologic treatment for which of the following conditions? a. Elevated blood cholesterol b. Hypertension c. Ischemic chest pain d. Kidney malfunction

76. Which of the following is considered an abnormal finding when assessing a patient's skin, hair, and nails? a. Pale skin noted in one limb b. Pink color to the fingers and nail beds c. Pink coloration of all limbs d. Resistance to deformation when pinched

78. Which of the following methods is the best way to determine pediatric drug dosages? a. A length-based resuscitation tape b. Age of the patient c. Asking the parent d. Asking the child

8. The chemical formula 7-chloro-1,3-dihydro-1-methyl-5-phnyl-2H-1,4-benzodiaepin-2-one is an example of which type of drug name? a. Chemical name b. Generic name c. Official name d. Trade name

80. Battle's sign and raccoon eyes are most often associated with which of the following injuries? a. A basilar skull fracture b. A depressed skull fracture c. Cranial nerve dysfunction d. Infraorbital hemorrhage

81. Ipratropium bromide is classified as which type of drug? a. Anticholinergic b. Antihypertensive c. Anxiolytic d. Sympathomimetic

81. Visual acuity is most commonly tested in the field setting by which of the following techniques? a. The paramedic holds up several fingers a few feet from the patient's face and asks a series of questions. b. The paramedic places a Snellen chart in a patient's house and conducts the examination in a usual manner. c. The paramedic uses a modified Snellen chart in the back of the ambulance while en route to the hospital. d. Visual acuity cannot be tested in the prehospital environment because of a lack of resources.

83. Which of the following phrases best describes the term polypharmacy? a. Use of multiple medications by the patient b. Use of one medication by several older adults c. Use of one medication to treat multiple conditions d. Use of several drug stores to fill prescriptions

84. What class of drugs is used to treat seasickness? a. Antiemetics b. Antiflatulents c. Cannabinoids d. Emetics

85. Which of the following is an example of an emetic drug?

86. Which of the following statements best describes the reason for difficulty controlling bleeding in a patient taking aspirin, Coumadin, and eating garlic? a. A drug interactions with garlic, aspirin, and Coumadin b. A possible overdose on his prescribed Coumadin c. Aspirin blocking the effects of Coumadin d. Garlic blocking the effects of Coumadin

87. Diamox and timolol are drugs used to treat which of the following medical problems? a. Glaucoma b. Fungus c. Ulcers d. Warts

87. Presence of cerebrospinal fluid upon inspection of the ears could indicate which of the following conditions or injuries? a. Head trauma b. Hypertension c. Ocular trauma d. Presence of a foreign body

88. Synthroid is used to treat which of the following medical problems? a. Cardiac problem b. Gastrointestinal problem c. Respiratory problem d. Throid problem

89. Upon examining the nose of a 12-year-old male who has fallen from his bicycle, you test for cerebrospinal fluid by catching some drainage on a gauze pad. If positive, what would you expect to find to indicate the presence of cerebrospinal fluid? a. There would be a halo around the blood on the gauze pad. b. There would be a milky substance on the gauze pad. c. A paramedic should not test for cerebrospinal fluid on a pediatric patient. d. There is no way to test for cerebrospinal fluid drainage from the nose.

9. If a prehospital care report contains the quoted sentence, 'He was driving at least 90 miles per hour,' what does this mean? a. Bystanders report the patient was traveling at 90 miles per hour. b. Damage to the car suggests the patient was traveling at 90 miles per hour. c. Police reports verify that the car was traveling at 90 miles per hour. d. The EMS providers witnessed the car traveling at 90 miles per hour.

9. What additional history information is important regarding the care of a child but typically is not inquired about for an adult? a. Immunizations b. Sexual history c. Social skills d. Special needs testing performed

9. You are assessing a 24-year-old woman with a vague medical complaint. You ask, 'When was your last oral intake?' The patient looks puzzled and states, 'I don't take birth control pills.' This is an indication of: a. A question that needs to be rephrased b. No medication use by the patient c. The patient's altered mental status d. The patient's denying any allergies

92. What is the desired effect of Depo Provera administration? a. Contraception b. Prevention of pelvic inflammatory disease c. Correction of renal insufficiency d. Treatment of gastroenteritis

93. Tracheal deviation toward an injured lung suggests which of the following injuries or conditions? a. A simple pneumothorax b. A tension pneumothorax c. Acute respiratory compromise d. Increased respiratory drive

94. How are dermatologic medications administered? a. Dermal application b. Ingested c. Inhaled d. Taken sublingually

95. What pharmacologic agent is most appropriate for the treatment of a patient with an organophosphate poisoning? a. Atropine b. Calcium chloride c. Epinephrine d. Lidocaine

96. What term is used to describe the use of a drug when it is not advisable? a. Contraindication b. Classification c. Indication d. Side effect

Lung perfusion depends on all of the following EXCEPT:

an intact alveolar membrane.

1. A medical history literally means: a. A general overview of an individual's serious medical problems and hospitalizations b. A summary of an individual's past state of health c. An exact and flawless account of one's medical problems d. Any medical problems related to an individual's current complaints

10. Aspirin is an example of which of the following types of drug names? a. Chemical name b. Generic name c. Official name d. Trade name

10. What term is used to describe the sound heard between the S1 and S2 heart sound? a. Bruit b. Gallop c. Normal d. Pitting

10. Which of the following techniques aids EMS providers in efficient communications? a. Giving long and detailed reports over the air to avoid confusion b. Using clear English when communicating c. Using radio codes to shorten communication time d. Using semantic jargon that only by EMS personnel from their own service will understand

104. What type of sound is produced with normal bronchovesicular lung sounds? a. High-pitched b. Medium, low-pitched c. Soft, low-pitched d. Stridor

105. What is the first thing a paramedic should check when assessing the efficiency of the cardiovascular system? a. Bilateral pedal pulses b. Bilateral radial pulses c. Carotid pulses d. Skin color

107. While auscultating the heart, what does a whooshing sound represent? a. Bruit b. Murmur c. S2 d. Ventricular failure

11. Which of the following drugs comes is derived from a plant? a. Alpha interferon b. Atropine c. Insulin d. Milk of magnesia

111. What is an abnormal but early sign of heart failure or cardiac overload? a. Bruit b. Gallop c. Influx d. Point of maximum impulse (PMI)

113. Lateral displacement of the point of maximal impulse suggests which of the following conditions? a. Heart atrophy b. Heart enlargement c. Heart palpitations d. There is no significance to this finding

114. You are at the bedside of a bed-confined patient who is in possible right ventricular failure. What is one thing you can do to assess the severity of the condition? a. Check pupils b. Compress the sacrum c. Determine skin turgor d. Determine the FAST score

115. When assessing the abdomen, how many sections should be visualized and assessed on a patient? a. 2 b. 4 c. 6 d. 9

117. When should paramedics listen to bowel sounds during the assessment? a. After palpation b. Before palpation c. Before visual inspections d. There is no need to listen to bowel sounds

124. When is inspection of the female genitalia necessary? a. During every secondary assessment b. When childbirth is imminent c. When patient has a urinary infection d. When the patient asks for the inspection

13. A paramedic's knowledge level, communication skills, life experience, and prejudices can affect: a. Effective mental models b. Effective verbal communication c. The paramedic's appearance d. The paramedic's service

13. How frequently should vital signs be assessed for the most seriously ill or injured patients in order to properly assess trending components? a. Every 2 minutes b. Every 5 minutes c. Every 10 minutes d. Every 15 minutes

14. Which classification of medication is designed to dissolve clots after their formation? a. Antiplatelets b. Fibrinolytics c. Plasma blockers d. Plasma enhancers

140. When assessing for CSM in the upper extremities, what information can be attained? a. Detailed information regarding the injury b. Neurovascular bundle is intact c. Nothing of significance d. The patient can obey commands

15. Which of the following pulse points should be assessed initially in the adult and child patient? a. Brachial b. Carotid c. Femoral d. Pedal

16. The paramedic is attending a 70-year-old woman who is complaining of chest pain. In speaking with her, the paramedic talks loudly and is almost shouting at the woman. This is an example of: a. Assuming a patient's medical condition needs to be addressed quickly b. Assuming that an older adult is also hard of hearing c. Misunderstanding the patient's cultural influences on her condition d. Thinking that the woman cannot understand English

16. Which of the following responses would you anticipate in reaction to stimulation of the beta-receptors by the administration of albuterol (2.5 mg)? a. Stimulation of the heart (increased heart rate) and bronchial constriction b. Stimulation of the heart (increased heart rate) and bronchial dilation c. Suppression of heart activity (decreased heart rate) and bronchial constriction d. Suppression of heart activity (decreased heart rate) and bronchial dilation

19. Ingesting too much of a substance has the potential to cause which medical condition? a. Gastric lavage b. Overdose c. Therapeutic effect d. Underdose

19. Which of the following allows for easy access and interpretation of data from patient care reports? a. Check box b. Computer based c. Dictation d. Hand-written report

2. In which of the following publications would a paramedic find a list of substances (drugs) with their formulas, uses, and methods of preparation? a. A dictionary b. A formulary c. A pharmacopeia d. An almanac

2. What is the most appropriate pharmacologic intervention for a patient that presents with an altered level of mentation, cool and clammy skin, and a blood glucose level of 40 mg/dL? a. D5W b. D50W c. Naloxone d. Orinase

2. You can obtain the most accurate information from your patient by: a. Asking short, direct questions b. Building a rapport with the patient c. Speaking in a commanding and controlling tone d. Speaking slowly and asking vague questions

20. Activated charcoal works through which of the following processes? a. Absorption b. Adsorption c. Detoxification d. Emesis

20. Sloppy handwriting on your documentation/written communication may lead the reader to believe which of the following? a. Proper care was given b. Sloppy care was given c. The patient was sloppy d. You were busy

20. Statements or remarks made by patients or bystanders that might be pertinent to medical care should be: a. Documented as factual statements b. Documented as quotes c. Reported to police at the scene d. Reported to the receiving medical facility without prehospital care report documentation

23. Which drug stimulates the liver to break down glycogen? a. Bilirubin b. Glucagon c. Insulin d. Levothyroxine

24. Which of the following is the primary hormone that regulates glucose metabolism? a. Glycogen b. Insulin c. Levothyroxine d. Thyroxine

25. According to the Schedule of Controlled Substances, cocaine is classified as what schedule of drug? a. I b. II c. III d. IV

25. Information such as ECG, pulse oximetry, and blood glucose readings belong where in the SOAP documentation format? a. S b. O c. A d. P

26. Which of the following is the most correct statement in regard to the potential hazards present at the scene of a traumatic event? a. Hazards assessment should be performed by rescue personnel after patient contact b. Hazards should always be assessed in the scene size-up. c. Hazards should be assessed as a component of the secondary assessment. d. Hazards should not inhibit immediate patient care.

27. Where should a clear and concise chronological description of a call be documented on the prehospital care report? a. Heading boxes b. Narrative portion c. On a supplemental report form d. Under the mechanism of injury or event

27. Which of the following tests evaluates the effects of a substance on an organism? a. Assay b. Bioassay c. Biotransformational d. In vivo

28. Which of the following statements most accurately reflects when a paramedic should improve scene safety? a. When it compromises patient safety b. When it does not compromise the paramedic's safety c. When the dispatch center orders the paramedic to do so d. When the patient requests it

31. What phase of the approval process for investigational drugs includes being tested on a relatively small number of patients to evaluate the common short-term side effects and risks? a. Phase I b. Phase II c. Phase III d. Phase IV

31. You arrive at a residence to find a patient lying on the ground, complaining of left ankle pain, after tripping over some debris on the sidewalk. What is the mechanism of injury or nature of the illness on this call? a. A medical problem b. A traumatic injury c. No mechanism or nature noted d. An unknown medical problem

32. If an EMS response is cancelled en route to the scene, what should the paramedic do? a. Contact medical direction for advice. b. Document who canceled the response and the time of cancellation. c. Request dispatchers to document the events. d. Return to the station; no documentation is necessary.

32. The S in the SOAP acronym stands for: a. Signs b. Subjective data c. Symptoms d. Systems

33. Findings such as level of consciousness, ECG, and blood glucose levels belong where in the SOAP format? a. A b. O c. P d. S

33. What are the most common adverse effects of narcotic administration? a. Analgesia and salivation b. Dry mouth and hypotension c. Increased respiratory and hypertension rate d. Muscle spasms and twitching

33. Which of the following statements is true regarding documentation during a mass casualty incident involving several patients? a. Brief documentation for each patient should be completed by the staging sector officer. b. Comprehensive documentation may have to be postponed until all patients are triaged and transported. c. One general report for the incident and all patients should be produced. d. Thorough documentation for each patient should be completed by the incident commander.

34. The phases of communications necessary to complete a typical EMS call are: a. Detection of the emergency, response by EMS, transfer of care b. Occurrence, detection, notification and response, treatment and transport, preparation for the next event c. Occurrence, detection, response, transport, conclusion d. Written communication, verbal communication, and electronic communication

34. Which of the following characteristics should be included in the PCR evaluation? a. Subjective findings b. Legible with correct spelling c. Opinions d. Turned in after 24 hours

36. A fixed communication unit within an emergency vehicle that transmits at 50 to 100 watts is a: a. Base station b. Mobile radio c. Portable radio d. Repeater

36. Which of the following would be an example of a sympathomimetic response from the administration of epinephrine? a. Bronchoconstriction b. Bronchodialation c. Increased gastric motility d. Pupil constriction

37. How many basic levels of sedation have been identified? a. 3 b. 4 c. 5 d. 8

38. Vehicle-mounted transmitters usually have lower output than base stations and provide a range of approximately _____ miles over average terrain. a. 5 to 7 b. 10 to 15 c. 25 to 30 d. 40 to 50

39. What sign or symptom should be expected in a patient who has overdosed on a beta-blocker? a. Bronchodialation b. Decreased heart rate c. Increased heart rate d. Vasodialation

39. Which of the following is a component of the three main areas for consideration when forming a general impression? a. Age b. Appearance c. Sex d. Weight

4. Which of the following drugs was discovered in the mid-1940s and used widely in World War II to fight infection? a. Bactrim b. Penicillin c. Phenobarbital d. Tetanus antitoxin

40. What is the primary benefit of performing an initial assessment? a. It assesses the patient's financial status. b. It assesses the patient's need for care. c. It determines the validity of the call for help. d. It establishes the need for additional resources.

41. A radio communications system that allows voice and telemetry transmission simultaneously is called a(n) _____ system. a. Encoded b. Multiplex c. Simplex d. Trunked

41. Of the following, which is not a good reason for taking cervical spine precautions on a trauma patient? a. Helps with extrication b. Keeps the crew involved with patient care c. Prevents injuries to the spine d. Stabilizes any injuries to the spine

42. When should cervical spine stabilization occur as paramedics assess a trauma patient? a. Before making a general impression b. While checking the airway c. Once the entire primary survey is complete d. Unnecessary at any time

42. Which of the following anesthetics are commonly used in the field for rapid sequence intubation? a. Amidate and Narcan b. Amidate and Sublimaze c. Amidate and tetracaine d. Sublimaze and lidocaine

42. Which of the following is one advantage of a simplex system? a. Both parties can engage in a discussion of the patient, interrupting for clarification as needed. b. Each speaker can transmit his or her message without interruption. c. Messages are digitally encoded automatically, providing greater privacy. d. Telemetry can be transmitted as well as verbal messages.

45. Which of the following actions is the most appropriate care for a patient with gurgling respirations? a. Insert an oropharyngeal airway b. Provide immediate suctioning c. Re-tip the patient's head d. Take no action

46. What federal agency issues frequencies and licenses and monitors radio operations? a. ECC b. FCC c. FDA d. FEMA

47. Antineoplastic agents have which common side effect? a. Light sensitivity b. Rashes c. Sedation d. Syncope

47. When should a patient be assessed for external bleeding? a. During the focused physical exam b. During the primary survey c. During the secondary survey d. No assessment is needed

47. Which of the following is an enteral method of administering drugs? a. Intranasal b. Rectal c. Topical d. Tracheal

48. What is an example of a duplex communication system? a. Base radio b. Cellular phone c. Megaphone d. Portable radio

49. Vitamins A, D, E, and K are examples of which type of vitamin? a. Children's b. Fat soluble c. Mineral based d. Water soluble

49. You are performing a primary survey on a 5-year-old patient in a warm environment. What is the normal capillary refill time for this patient? a. 1 second b. 2 seconds c. 3 seconds d. 4 seconds

5. Atropine affects the parasympathetic nervous system by which of the following mechanisms? a. Blocking both muscarinic and nicotinic receptor sites for the heart, causing paralysis b. Blocking muscarinic receptor sites in the heart, thus slowing the heart rate c. Stimulating both muscarinic and nicotinic receptor sites in the heart, thus slowing the heart rate d. Stimulating muscarinic receptor sites while blocking the nicotinic receptor sites, thus slowing the heart rate

51. Which of the following methods of medication administration is easily accessible during an active seizure if an IV is unobtainable? a. IO b. Rectal c. SL d. Tracheal

52. Paramedics may reconsider the treatment that is given to a patient based on mechanism of injury information from which of the following? a. Dispatch information b. Information gathered at the scene c. Information gathered prior to arrival d. Information given by family members not on scene

52. The paramedic is attending a patient who is complaining of significant chest pain. The paramedic wants to transmit the patient's ECG while speaking with the physician. The paramedic must use a: a. Duplex system b. Multiplex system c. Simplex system d. Telematic system

52. Which of the following drugs could be used to reverse the effects of chlordiazepoxide? a. Fentanyl b. Flumazenil c. Furosemide d. Naloxone

53. Which of the following drugs would be used to control seizures? a. Amidate b. Phenytoin c. Solu-Medrol d. Zyprexa

53. Which of the following patients would not warrant spinal immobilization precautions? a. A patient complaining of neck pain resulting from a fall b. A patient who is experiencing an anaphylaxis reaction c. A patient who was diving and struck their head on bottom of a pool d. A patient who was struck by a car at a crosswalk

54. The paramedic is headed toward the hospital that is approximately 10 miles away. During the trip, the paramedic is in constant communication with the emergency department physician using a portable radio because of the gravity of the patient's condition. Which of the following best describes how the paramedic is able to stay in constant contact with the physician? a. Using a multiplex system b. Using a system of repeaters c. Using a trunked radio system d. Using a very powerful portable radio

55. Which of the following terms is described as the science of preparing and dispensing drugs? a. Bioavailability b. Pharmaceutics c. Pharmacodynamic d. Pharmacokinetics

56. Atropine is an example of which class of drug? a. Adrenergic b. Parasympatholytic c. Sympatholytic d. Sympathomimetic

56. Who is considered the 'first, first responder' that is responsible for alerting and directing response in addition to prearrival instructions? a. Bystanders b. Dispatcher c. Firefighters d. Police officers

57. The role of the dispatcher in an EMS communications system includes: a. Call taking, billing the call, providing prearrival instructions b. Call taking, directing the response, providing prearrival instructions c. Directing the response, providing prearrival instructions, billing the call d. Maintaining incident records, call taking, directing the response

6. The manufacturer's name 'amiodarone hydrochloride' is an example of which type of drug name? a. Chemical name b. Generic name c. Official name d. Trade name

6. The prehospital care report provides an area for administrative and billing information. This portion of the form: a. Has minimal effect on the financial viability of the EMS agency b. Is part of the form and should be completed accurately c. Is separate from the legal record d. Is the responsibility of the billing department, not the EMS provider

62. In a call-prioritization-prearrival instructions system, the emergency medical dispatcher: a. Chooses the destination hospital before EMS arrives on scene b. Determines what type of assistance is needed for an emergency call c. Dispatches the closest available ambulance d. Tells the EMS providers what equipment to take to the scene

62. Which of the following terms is used to describe the physiologic response of a drug with the receptor to which it is bound? a. Affinity b. Agonist c. Antagonist d. Partial agonist

63. What term is used to describe the action that occurs when naloxone blocks an opioid? a. Agonist b. Antagonist c. Partial antagonist d. Receptor

63. When should non-life-threatening injuries be treated while performing a physical exam for a trauma patient? a. There is no need to treat these injuries until after transport. b. Treat these injuries after the secondary survey. c. Treat these injuries as they are found. d. Treat these injuries before the secondary survey.

63. Why is it important for the paramedic unit to relay information to the hospital? a. It is used for documentation purposes. b. It ensures the continuity of care. c. It is legally required. d. It helps to maintain a good relationship with the hospital.

64. What areas are included in the rapid trauma assessment and what should be evaluated? a. Head, neck, and chest evaluation focusing on minor injuries b. Head-to-toe evaluation focusing on major injuries c. Head-to-toe evaluation focusing on minor injuries d. Head-to-toe evaluation focusing on superficial injuries

65. Which of the following statements is most correct when referring to a drug with a low therapeutic index? a. It takes a low dose to have an effect on the body. b. The dosage of the drug must be carefully monitored and adjusted. c. The drug is relatively safe. d. The therapeutic threshold is low.

69. Which of the following actions is most likely to occur when a patient with chronic renal failure receives a medication? a. A need for a diuretic to help eliminate the drug b. Delayed excretion of the drug c. Kidney stones from an excess of drug in the system d. Liver failure along with renal failure

7. While transporting a patient with severe chest pain, you realize that you haven't taken a set of vital signs for more than 30 minutes. What should you do? a. Contact medical direction for advice. b. Document the reasons for the omission of taking vital signs. c. Document the vital signs taken at the patient's home as the vital signs during transport. d. Take vital signs immediately and document them as though they had been taken 15 minutes earlier.

71. Diazoxide and minoxidil are classified as which type of drug? a. Antiemetics b. Arterial dilator drugs c. Emetics d. Venous dilator drugs

71. What additional care should be provided while performing the detailed physical examination? a. Intravenous therapy b. Only life-saving care c. Patient counseling d. Splint any injuries before the examination

72. Patients who take loop diuretics are at a risk for which of the following adverse effects? a. Hypervolemia b. Hypokalemia c. Overhydration d. Weight gain

72. What additional care should be provided while performing a detailed physical examination? a. There is no need to treat these injuries until after transport. b. Treat life-threatening problems as they are found. c. Treat these injuries before the secondary survey. d. Treat these life-threatening injuries after the secondary survey.

73. What is the generic name for Lasix? a. Flonase b. Furosemide c. Lidocaine d. Lopressor

75. How can you to assess a patient's skin temperature? a. Use just the fingertips b. Use the backside of the hand c. Use the forearm d. Use the palm of the hand

77. Hydroxyzine and promethazine are classified as which type of drug? a. Antifungals b. Antihistamines c. Beta-blockers d. Steroids

79. As you conduct a rapid trauma assessment for 23-year-old male who has fallen from the roof a house, you notice a soft spot in the cranium upon palpation of the scalp. This finding suggests which of the following injuries? a. A basilar skull fracture b. A depressed skull fracture c. Battle's sign d. Impairment of cranial functions

8. It is important to use proper terminology that is simple and to the point while speaking with medical staff, patients, and their families: a. Because paramedics are not trained with more detailed terminology. b. To avoid errors c. To impress the patient and staff d. To prove your intelligence

8. The most reliable information about a child's medical history is typically obtained from: a. A babysitter b. A parent c. A sibling d. A teacher

8. What is the effect of parasympathetic stimulation on the heart? a. Constriction of coronary arteries b. Increased force of contraction c. Increased rate d. Slowed rate

80. Albuterol is often used as a pharmacologic intervention for which of the following medical conditions? a. Anxiety b. Bronchospasm c. Palpitations d. Tremors

80. From the following responses, choose the most appropriate action a paramedic should take when asked to administer a category A drug to a pregnant patient? a. Give half the dose b. Give the medication c. Question the order d. Refuse the order

82. What is the trade name for aminophylline? a. Bronkodyl b. Theo-dur c. Theophylline d. Xanthine

83. Simethicone drops are used to treat which of the following medical conditions? a. Dermatitis b. Flatulence c. Nausea d. Vomiting

84. Which of the following interactions best describes what occurs when a patient takes nitroglycerin and Cialis at the same time? a. Drug-drug interaction b. Drug-food interaction c. Incomplete interaction d. Malabsorption interaction

85. Abnormalities on funduscopic examination may represent which of the following? a. Double vision b. Primary ocular disease c. Spontaneous ocular edema d. Vitreous hemorrhage

86. Examination of the ears should include looking for which of the following? a. Airway obstructions b. Drainage of cerebrospinal fluid c. Drainage of mucus d. Ocular trauma

88. Examination of the nose should include which of the following? a. Assessing b. Looking for cerebrospinal fluid c. Looking for ocular trauma d. Looking for shape and positioning of the eyes

88. While checking the drug box at the beginning of a shift, a paramedic notices that some of the medications have ice crystals in the solution. What is the paramedic's best course of action? a. Place the drug box in the cab of the ambulance to warm the medications. b. Replace the entire stock of drugs because they were damaged by the cold. c. Report the incident to the supervisor, and ask to park the ambulance inside. d. Turn on the heater in the patient compartment to defrost the drugs.

90. Which of the following would be considered an abnormal finding when inspecting the mouth and pharynx? a. The patient has wisdom teeth. b. The patient has a swollen tongue. c. The mucous membranes are pink. d. There is no blood noted in the mouth.

91. What are the side effects of colchicine administration? a. Dyspnea b. Hematuria c. Syncope d. Vertigo

94. Which of the following is the abnormal sound made when blood in an artery passes over built-up plaque? a. Borborygmus b. Bruit c. Fluctuance d. Rush

96. The finding of JVD while the patient is supine is most likely a sign or symptom of which of the following? a. Hypotension b. Natural in a patient with adequate blood volume c. Subcutaneous emphysema d. Tracheal backflow

98. The drug name Liqui-char is an example of which of the following? a. Chemical name b. Classification c. Generic name d. Trade name

When pressure within a closed muscle compartment exceeds the perfusion pressure and blood flow, resulting in ischemia. This is known as: A) d. Silo filler's disease B) b. Compartment syndrome C) a. Atelectatic necrosis D) c. Debilitating syndrome

b. Compartment syndrome

1. The patient is a 68-year-old male who is hearing impaired. He asks you to write your question on a piece of paper. The patient's hearing deficit is a problem with what phase of communication? a. Decoding b. Encoding c. Medium d. Message

10. Which hormone, released from the adrenal medulla, stimulates beta-2 receptors in the lungs to promote bronchodilation? a. Acetylcholine b. Albuterol c. Epinephrine d. Methylprednisolone

100. Proper examination of the posterior chest wall includes which of the following? a. Assessing for tracheal deviation and jugular venous distension b. Auscultating tracheal breath sounds c. Feeling for flail segments d. Palpating the cervical spine for step-offs

106. A patient with a normal pulse strength felt in the radial artery would be considered to have which grade on the pulse strength scale? a. 0 b. 1+ c. 2+ d. 3+

108. When performing auscultation of the heart sounds, what does S1 signify within a heart's contraction? a. Pulmonic and aortic valve closing b. Pulmonic and aortic valve opening c. Tricuspid and mitral valve closing d. Tricuspid and mitral valve opening

109. Where would a paramedic listen to identify the mitral valve? a. Second intercostal space left parasternal border b. Second intercostal space right parasternal border c. Fourth intercostal space left parasternal border d. Fifth intercostal space right parasternal border

11. Assessment findings, such as the absence of diminished breath sounds that warrant no medical care or intervention but show evidence of a thorough examination and history of the event, are called: a. Assessment norms b. Essential findings c. Pertinent negatives d. Relevant positives

118. When auscultating the abdomen, how long should each quadrant be evaluated? a. 5 seconds b. 10 seconds c. 30 seconds d. 1 minute

12. The patient is a 30-year-old woman who speaks only Spanish. When communicating with the woman, it is clear that she does not understand. There are several bystanders in the room where the patient is located. You ask the bystanders, 'Does anyone speak English?' One bystander raises his hand and replies, 'I do.' You instruct the man to ask the woman if she has any pain. The bystander gets close to the woman and yells, 'Do you have any pain?' This is an example of: a. Clear and concise communication b. Inappropriate use of words c. Ineffective communication d. Poor choice of bystander

12. Which of the following drugs has been derived from an animal source? a. Bismuth b. Digitalis c. Insulin d. Morphine

12. Which of the following is classified as an anticoagulant? a. Digoxin b. Dobutamine c. Heparin d. Lorazepam

12. Which of the following statements is true regarding documenting physical examination findings? a. Document negative findings. b. Document pertinent subjective findings. c. Document positive and negative findings. d. Document positive findings.

120. Of the following abnormal findings, which one is consistent with a possible rupturing abdominal aortic aneurysm? a. Cullen's sign b. Ecchymosis c. Grey-Turner's sign d. Redness

122. Hyperactive bowl sounds can indicate which of the following conditions? a. Appendicitis b. Cholysisites c. Gastroenteritis d. Pancreatitis

123. When assessing a female patient with a gynecologic complaint, which of the following is the most correct statement about this examination? a. Do an internal examination when necessary. b. Exam the patient in an isolated area. c. Have a female or another paramedic in the room when treating the patient. d. Have bystanders in the room to be witnesses.

125. Paramedics are assessing a patient who is complaining of uncontrolled vaginal bleeding. Which of the following treatments is most appropriate for this situation? a. Pack the vagina with gauze. b. Transport without assessing the area. c. Use a sanitation pad to control bleeding. d. Wait for a female paramedic to take over the call.

126. Paramedics are assessing a patient who was involved in bicycle accident and is bleeding from the vagina. With no cervical spine precautions needed, what is the next appropriate step? a. Call for a female paramedic to take over patient care. b. Expose the patient on scene and begin any treatments. c. Help the patient control bleeding with external padding. d. Move the patient to the ambulance and then perform any treatment.

127. When assessing a male patient who is complaining of pain in the genitalia region, what is the most appropriate way to perform an examination? a. Do an external examination. b. Examine the patient with multiple witnesses in the room. c. Have the patient examine himself and tell the paramedic if there are any abnormalities. d. No need to examine the patient; simply transport.

13. You are on scene with a 33-year-old patient who has fallen and hit her head. You notice that the patient has a laceration and is bleeding. You note that there is no bleeding from the nose or ears. She does not have any other contusions, and she does not have any palpable neck pain. Which of the following is a pertinent positive in this patient encounter? a. Bleeding from nose and ears b. Contusions c. Laceration with bleeding d. Neck pain

130. When is it appropriate to examine the male genitalia? a. When the patient has lower leg pain b. When the patient has severe anal pain c. When the patient has suffered a traumatic injury d. When the patient is having chest pain

132. Which of the following statements is most accurate when a paramedic needs to perform an examination on a patient who is complaining of rectal bleeding? a. Defer the examination until the patient is admitted. b. Expose the area immediately, regardless of bystanders. c. Protect the patient's privacy when possible. d. There is no need to expose the area.

136. You respond to a patient who has fallen and is now complaining of pain in hip. Which of the following signs would not help determine if the patient has a fractured or dislocated hip? a. Decreased range of motion b. Outward rotation of the leg c. Pain in the knee d. The injured leg is shorter than the other

137. When assessing the extremities, it is important to check for which of the following? a. ABC b. CMC c. CSM d. QRS

138. Of the following, which is not an indication to perform a full neurologic assessment? a. Alterations of strength b. Altered mental status c. Increase in function of an extremity d. Loss of consciousness

17. The patient is a 90-year-old man who is hearing impaired. Which of the following may impair communications with the patient? a. Allowing the patient to lip-read if he is able b. Placing the stethoscope in the patient's ears to help him hear c. Talking as loud as possible and exaggerating mouth movements d. Using written notes to ask questions and get information

17. What are the primary actions of the xanthine drugs? a. Decreases diaphragmatic contractility b. Promotes diuresis c. Relaxes smooth muscle d. Stimulates bronchial smooth muscle

17. Which of the following describes the best time to complete a PCR? a. Within 48 hours b. During transport c. Immediately following the scene d. Within 2 hours

17. Which of the following drug classifications is an example of a drug's mechanism of action? a. Cardiac therapy b. Chemical classification c. Therapeutic classification d. Physiologic classification

18. Which of the following drug classifications would best describe the bronchodilation effects of Brethine? a. Body system b. Class of agent c. Mechanism of action d. Physiologic classification

18. Which of the following statements best describes how loop diuretic agents function? a. Facilitate sodium and chloride reabsorption in the loop of Henle b. Facilitate sugar and water reabsorption in the loop of Henle c. Inhibit sodium and chloride reabsorption in the loop of Henle d. Inhibit sugar and water reabsorption in the loop of Henle

18. Which of the following statements is true regarding the writing of a hand-written report? a. Cross errors with multiple marks b. Erase errors c. Use a pen d. Use a pencil

19. Which of the following best applies to the patient care report? a. It is only important for legal reasons. b. It is only used within your service. c. It is part of the patient's continuum of care. d. It is required only if your service bills insurance agencies.

19. Which of the following would be considered a normal tidal volume for a patient at rest? a. 1 to 2 mL/kg b. 3 to 5 mL/kg c. 5 to 7 mL/kg d. 7 to 9mL/kg

2. Which of the following devices is used to visualize the inner ear and tympanic membranes? a. Laryngoscope b. Ophthalmoscope c. Otoscope d. Sphygmomanometer

20. What is the total minute volume of a patient with a tidal volume of 300ml breathing 24 times a minute? a. 12.5 mL/min b. 324 mL/min c. 7200 mL/min d. 12,000 mL/min

21. What is the mechanism of action of emetics? a. Binds to red blood cells to prevent transport of a drug throughout the body b. Binds to the ingested drug or poison to prevent absorption c. Induces vomiting to rid the body of a drug d. Promotes rapid and forceful diarrhea to speed the elimination of the ingested drug or poison

21. You have just completed a call that involved multiple vehicles in an accident. Which of the following acronyms is the most inclusive for documenting the narrative portion of your report? a. A

22. Which of the following is the most accurate definition of mental status? a. The best measurement of the body's blood pressure b. The best measurement of the body's circadian rhythm c. The best measurement of the body's homeostasis d. The best measurement of the body's minute volume

24. Which of the following is considered as a potential hazard at the scene of a traumatic injury? a. Ambient temperature of 80° F b. Bystanders c. Downed power lines d. Patient's family

24. You are on scene with a 68-year-old female whose chief complaint is difficulty breathing. She states she cannot catch her breath. She also defines a burning chest pain that radiates to her shoulder. Her vital signs show a heart rate of 120 beats/min, a respiratory rate of 27 breaths/min, and a blood pressure of 120/80 mm Hg. Which of the following is an objective finding? a. Burning chest pain b. Feeling she cannot catch her breath c. Heart rate of 120 beats/min d. Pain radiating to her shoulder

25. Which of the following should be considered when performing a hazard assessment of the scene? a. Age of the patient b. Height of the patient c. Mechanism of injury d. Sex of the patient

26. Information supported by fact or direct observation is termed: a. Clinical facts b. Direct information c. Objective information d. Subjective information

26. Transmitting a 12-lead ECG to the hospital is an example of: a. A legal document b. A waste of time c. Electronic communication d. Good patient care

27. You arrive at the scene of a motor vehicle accident where a vehicle has struck a telephone pole. Power lines are draped across the hood of the vehicle. Which of the following actions would be most appropriate to make this scene safe? a. Ask law enforcement officials to remove the power lines. b. Ask the fire department to remove the power lines. c. Contact the local power company to remove the power lines. d. Remove the power lines using a rope.

28. Technology continues to change the way EMS collects and exchanges information. Which of the following statements is true? a. Data entered into electronic devices must be reentered into a final report and patient record. b. Electronic devices increase the time to in-hospital diagnosis because of the wait for electronic reports. c. Electronic documentation allows for real-time data transfer. d. Electronic documentation techniques do not affect the role of medical direction in patient care.

29. Once a bioassay is conducted, the results are compared to agreed-upon standards as set by which of the following agencies? a. DEA b. FDA c. USP d. USPS

29. Which of the following scenarios would prohibit the paramedic from allowing the patient to refuse treatment? a. Age greater than 80 b. Broken leg c. Ingestion of alcohol d. Life-threatening injury

29. Which of the following scenes would be considered safe? a. A chemical exposure in a manufacturing facility b. An ill patient with possible exposure to carbon monoxide c. A medical call inside a residence, with no report of contamination d. A traumatic injury secondary to a structural collapse with a trapped patient

3. What is the assessment usage of an ophthalmoscope? a. It is used to examine simple pupillary response by method of illumination into the outer part of the eye. b. It is used to examine the inside of an ear. c. It is used to examine the inside of an eye. d. It is used to examine the reflex arc.

3. Which of the following drugs is derived from the leaves of the foxglove plant? a. Atropine b. Benzodiazepine c. Digitalis d. Morphine

30. Assessing the mechanism of injury or nature of a patient's illness is part of which of the following assessments? a. Detailed assessment b. Focused history and physical examination c. Scene size-up d. Secondary survey

30. How many phases are there in the FDA-approval process for investigational drugs? a. One b. Three c. Four d. Five

31. Ibuprofen and naproxen sodium are examples of which type of medication? a. Antipsychotics b. Calcium channel blockers c. NSAIDs d. Steroids

32. Morphine and Demerol are examples of which type of medication? a. Antipsychotics b. Benzodiazepines c. Narcotics d. NSAIDs

32. You have responded to a motor vehicle crash, and the scene size-up reveals an unrestrained patient who hit the windshield with her forehead upon colliding with another vehicle at a high rate of speed. Based on the following injuries, what type of injury patterns can you predict by this mechanism of injury? a. A diabetic emergency b. Pelvic injuries c. Possible head trauma d. Traumatic injuries to the lumbar region of the spine

33. Why is it important to know and understand the medications a patient is taking? a. For billing purposes b. For documentation purposes c. For safe medication administration d. For testing purposes

34. Meperidine hydrochloride would be contraindicated in which situation? a. Patient with severe pain b. History of bypass c. History of MOA usage d. Severe headache

34. What is the best course of action to take if there is any doubt about the administration of a medication? a. Administer the medicine if you think it will help the patient. b. Confer with your partner. c. Contact medical control. d. Do not administer any medications when you have doubts.

35. An online physician orders morphine sulfate (100 mg) to be given to a patient for pain. What is the paramedic's best course of action? a. Administer the medication. b. Give another pain drug. c. Question the doctor about the order. d. Verify the dose with the partner.

35. Four of the five phases of EMS communication include: a. Calling for help, help arriving, treating the patient, transferring care to doctor b. Dispatching resources, assessing patient, treating patient, transfer care to doctor c. Occurrence, calling for help, dispatching resources, patient treatment d. Occurrence, calling for help, dispatching resources, termination of care

35. Which of the following drugs are opioid agonist-antagonists? a. Butorphanol and Naloxone b. Morphine and ASA c. Nubain and Stadol d. Stadol and Narcan

36. Which of the following factors would be a reason for identifying the total number of patients at the scene? a. It may cause overtime for the local response agency b. To determine the need for a chaplain c. To determine the need for additional resources d. To determine the need for physicians at the scene

38. Which of the following statements is most accurate when referring to stage 4 anesthesia? a. It is common. b. It is desirable. c. It is usually avoided. d. There is no stage 4.

39. A device that retransmits a signal at a higher power on another frequency to increase coverage is called a(n): a. Base station b. Encoder c. Repeater d. Transmitter

4. What is the generic name for Demerol? a. Ethyl 1-methyl-4-phenylisoni-pecotate hydrochloride b. Meperidine citrate c. Meperidine hydrochloride, USP d. Narcan

4. Which of the following statements is most correct when describing the use of an ophthalmoscope? a. The examiner should close both eyes while examining the patient's eye. b. The examiner should never examine the patient's eye. c. The examiner should use his or her corresponding eye to examine the patient's eye. d. The examiner should use his or her opposing eye to examine the patient's eye.

40. Procaine is an example of which type of anesthetic? a. Antagonist b. General anesthetic c. Local anesthetic d. Sedative

40. What is the term used to describe a molecule that relays signals from a receptor on the surface of a cell to target molecules in a cell's nucleus? a. Binding regulator b. Down regulator c. Second messenger d. Up regulator

43. Which of the following is a role of an emergency medical dispatcher? a. Decide to which hospital the patient should be transferred b. Provide on-scene medical direction to EMS c. Provide prearrival instructions to the caller d. Relay instructions from command physicians

44. Which of the following is a possible indication of airway compromise? a. Breathing b. Crying c. Snoring d. Speaking

45. What is a device that takes low power signals and retransmits them at a higher power? a. Base station b. Mobile transmitter c. Repeater d. Retransmitter

46. Which of the following is the most appropriate method of opening the airway of a child with a traumatic injury? a. Head tilt/chin lift b. Head tip/neck lift c. Jaw thrust d. No mechanical method is needed

49. Your portable radio is what type of communication device? a. Duplex b. Multiplex c. Simplex d. Trunked

5. For ideas to be transmitted, the sender must organize meaning through a medium. This is called: a. Assignment b. Derivation c. Encoding d. Syntax

5. What is the minimum number of vital signs that should be taken or assessed to establish a trend? a. 1 b. 2 c. 3 d. 4

5. Which of the following patients is least likely to provide accurate information about his or her current illness? a. A 14-year-old male patient with abdominal pain who is also vomiting b. A 16-year-old female patient experiencing shortness of breath at school c. A 23-year-old male patient who is suspected of taking prescriptions medications in a suicide attempt d. A 62-year-old female patient at a skilled nursing facility complaining of shortness of breath

50. A localized area of the patient's skin is very warm. What conditions may cause this temperature increase? a. Heat cramps b. Heat exhaustion c. Inflammation or infection d. Muscle fatigue

51. Your patient has been vomiting for the past 2 days. Upon assessment of his skin, you notice some tenting. What does this finding indicate? a. Congestive heart failure b. Decreased respiratory drive c. Dehydration d. Hyperhidrosis

53. While speaking with the dispatcher, the paramedic must finish speaking then allow the dispatcher to speak before sending another radio signal. This type of radio system is known as a: a. Duplex system b. Multiplex system c. Simplex system d. Telematic system

54. Parafon forte and methocarbamol are examples of which type of medication? a. Antiinflammatories b. Benzodiazepines c. Skeletal muscle relaxants d. Steroids

56. Which of the following types of assessment is performed on an unresponsive patient? a. A complete secondary survey b. A DCAPBTLS survey c. A rapid medical assessment d. A rapid SAMPLE assessment

57. Which of the following terms is best defined as the passive transport of solutes? a. Absorption b. Concentration c. Diffusion d. Osmosis

58. Which of the following is one of the trade names for norepinephrine? a. Diltiazem b. Isoproterenol c. Levarterenol d. Naltrex

59. Which of the following is the most accurate description of the rapid trauma assessment? a. A complete and thorough head-to-toe assessment of an unresponsive medical patient b. A quick head-to-toe assessment of a responsive medical patient c. A quick head-to-toe assessment of a trauma patient with a significant MOI d. A quick head-to-toe assessment of an unresponsive medical patient

6. Inspection, palpation, percussion, and auscultation are all examples of what type of assessment? a. Assessment techniques not performed in the prehospital environment b. Assessment techniques that provide general information about the patient's condition c. Assessment techniques that provide unique information essential to performing a thorough and complete assessment d. Assessment techniques that should not be performed as part of the initial patient assessment

61. By staying in constant contact with the caller and the ambulance that is responding, the dispatcher can: a. Direct additional responding units where to go if they are needed b. Relay information on critical care from the paramedic to the caller c. Relay information on scene hazards to the responding paramedic d. Take the mind of the caller off the seriousness of the call

64. Amiodarone is indicated for the treatment of which of the following? a. Asystole b. PEA c. Refractory V-Tach d. Third-degree AV block

64. Which of the following terms describes the amount of a drug that is required to provide a beneficial effect in 50% of the drug-tested population? a. Lethal does b. Plasma-level profile c. Therapeutic dose d. Therapy state

65. When should a detailed physical examination be done on a patient? a. When the patient arrives at the hospital b. When the patient has an isolated injury c. When there are no immediate life threats d. When we have nothing else to do

66. Diltiazem is contraindicated in which of the following? a. Atrial flutter b. Multifocal atrial tachycardia c. Second- and third-degree AV block d. Supraventricular tachycardia

67. Verapamil is classified as which type of drug? a. A mineral b. Beta-blocker c. Calcium channel blocker d. Nucleoside

67. What areas of the body are assessed in a detailed physical examination? a. Abdomen and pelvis only b. Head and chest only c. The entire body d. The extremities only

69. Which of the following are considered components of the secondary survey? a. Assessment of airway and respiratory effort b. General impression, appearance, and work of breathing c. Physical exam, SAMPLE history, and vital signs d. Vital signs only

7. When assessing the chest and abdomen of a patient, which of the following assessment techniques should be used? a. Endoscopy b. Manipulation c. Palpation d. Radiographic

7. Your patient adamantly states he does not have diabetes. He admits that he has a 'sugar' problem. This is an example of: a. A language barrier b. An encoding deficit c. Confusion caused by medical terminology d. Therapeutic communication

71. Which of the following medication response relationships is most affected by a patient taking a medication once a day instead of three times a day? a. Affinity b. Efficacy c. Therapeutic concentration d. Therapeutic index

73. What is the term or phrase defined as an unintentional disease or drug effect produced by a prescribed therapy? a. Anaphylactic reaction b. Hypersensitivity c. Iatrogenic response d. Idiosyncrasy

73. You respond to a 65-year-old male who is complaining of chest pain and difficulty breathing. Given this information, how should you focus your examination? a. Perform a head-to-toe assessment looking for DCAPBTLS. b. Spend time on the thoracic cavity assessment, and rapidly begin transport. c. Spend time on a detailed history and an abbreviated physical examination. d. This is a load-and-go high-priority patient, and no assessment should be done.

74. You respond to a 16-year-old juvenile who has been shot in the abdomen following an assault. You have assured scene safety and begin to assess the patient. Which type of primary physical assessment should be performed? a. A detailed physical exam focusing on any major life threats b. A rapid medical assessment focusing on any major life threats c. A rapid trauma assessment looking head-to-toe for DCAPBTLS d. No assessment is needed

76. When should a drug with of a pregnancy risk category of X be given to a pregnant patient? a. If patient's condition warrants the use of the drug b. If the potential benefits outweigh the risks to the fetus c. It is contraindicated and should not be given d. Only if the patient is in her third trimester

78. Which of the following is considered a normal finding when assessing a patient's mouth and pharynx? a. Broken teeth b. Foreign objects noted c. Pink color noted in mucous membranes d. Swollen tongue

79. Many of the over-the-counter cough syrups contain which of the following expectorants? a. Codeine b. Diazepam c. Guaifenesin d. Oxycodone

8. What term is used to describe bruising around the orbits of the eyes? a. Battle's signs b. Cushing's sign c. Raccoon eyes d. Supraorbital bruising

81. Which of the following concerns should be considered when giving water-soluble medications to a geriatric patient? a. Higher amount of body water leading to a lower concentration of drug b. Higher amount of body water leading to rapid elimination of the drug c. Lower amount of body water leading to a higher concentration of drug d. Lower amount of body water leading to difficulty with biotransformation

82. When testing a patient's visual acuity, you should place the Snellen chart at eye level at a distance of how many feet from the patient? a. 5 b. 10 c. 20 d. 25

83. Which of the following are ways to examine the eyes in the prehospital environment? a. Using a Braslow chart b. Using a laryngoscope c. Using a penlight d. Using a stethoscope

84. Discoloration of the sclera might indicate that a patient is suffering from which of the following? a. Heart failure b. Hypohidrosis c. Liver failure d. Respiratory failure

85. Which of the following responses best describes the possible drug interaction that can occur if a patient ingests multiple antacids and is prescribed an oral medication? a. High gastric acidity may impair absorption. b. Intestinal obstruction may prevent absorption. c. Low gastric acidity may impair absorption. d. The dose may be too low for the patient's weight and size.

86. Which of the following drugs would be the proper pharmacologic agent for a patient with peptic ulcers? a. Benadryl b. Compazine c. Cytotec d. Lopressor

87. Which of the following best describes the improper action that occurs if a paramedic leaves nitroglycerin out in the sun while taking care of a patient? a. Carefulness b. Expediency c. Improper drug storage d. Proper drug storage

89. The proper prehospital management of the hypoglycemic patient may include administration of which of the following medications? a. Dexamethasone b. Epinephrine c. Glucagon d. Orinase

89. Upon checking the vehicle and medication supplies, a paramedic notices that the lock on the controlled substances lockbox is broken and medications are missing. What is the next best step the paramedic should take? a. Get replacement medications, and store in the locked glove box. b. Refuse to carry controlled substances until the cabinet is fixed. c. Report the incident to the supervisors and other authorities per protocol. d. Tape the cabinet shut with duct tape, and get replacement medications.

90. Which of the following factors should be considered when assisting a patient with the administration of her or his own nitroglycerin? a. Improper exposure to heat may have degraded the patient's nitroglycerin. b. Nitroglycerin has been stored in a dark medicine cabinet. c. Nitroglycerin must be shaken to be activated. d. The patient's nitroglycerin may not be a recognized brand.

91. The examination of the neck should include which of the following assessments? a. Assessing the ABCs b. Auscultation of breath sounds c. Inspection for swelling, bruising, or inflammation d. Percussing to determine density

97. What is the proper angle to elevate an upper torso to evaluate for jugular vein distension? a. 15 degrees b. 30 degrees c. 45 degrees d. 60 degrees

97. What term is used to describe the appropriate use of a drug to treat a condition? a. Classification b. Contraindication c. Indication d. Side effect

99. What does accessory muscle use suggest? a. Normal respirations b. Respiratory arrest c. Respiratory distress d. Respiratory failure

You are transporting a patient from a fire scene to the emergency department. Clinical exam findings are all within normal limits, yet your pulse oximeter is indicating an oxygen saturation of 38 percent. All of the following could contribute to this reading EXCEPT:

carbon monoxide poisoning.

1. What is the best assessment tool to assess for cerebrospinal fluid in the ear and nose after a traumatic brain injury? a. A penlight b. A sphygmomanometer c. An ophthalmoscope d. An otoscope

1. When was the oldest prescription known to be written? a. 700 BC b. 700 years ago c. 5000 BC d. 5000 years ago

1. Which of the following is the most serious consequence of an illegible patient care report? a. Frustration by peers and hospital staff b. Inability to recall an event years later c. Loss of job promotion d. Misinterpretation of patient care

10. You arrive on the scene of a shooting. The patient has no vital signs upon your arrival. Which of the following is a critical piece of information that should be documented on this case? a. Age of patient b. Date c. Race of patient d. Time

101. Examination of the posterior chest wall should include what type of assessment of lung sounds? a. Assessment in all 10 locations b. Assessment midaxillary only c. Assessment one time over each lung d. Assessment over all lobes

103. Which of the following is the most accurate description of rhonchi? a. Caused by inflamed pleural surfaces rubbing against each other b. High-pitched crackling sounds that do not clear with coughing; caused by air passing through moisture c. High-pitched whistling sounds caused by air moving through passages narrowed by mucus or bronchospasm d. Loud, low, coarse sounds that resemble snoring and often clear with coughing; caused by a buildup of mucus or fluid in the trachea or large bronchi

11. What is the proper name or term for a bracelet or necklace that a patient wears to identify potential medical conditions? a. Dog tag b. ID tag c. Insurance ID tag d. Medical alert tag

11. Which of the following classifications of pharmacologic agents would be appropriate for the treatment of pulmonary edema? a. Antihyperlipidemics b. Antiemetics c. Bronchoconstrictors d. Diuretics

110. At what level on the rib cage can the mitral valve sounds be found? a. First intercostal space b. Second intercostal space c. Third intercostal space d. Fourth intercostal space

116. What is an abnormal finding that would indicate a ruptured abdominal aortic aneurysm? a. Borborygmus b. Commotio cordis c. Cullen sign d. Grey-Turner's sign

119. Of the following abnormal findings, which one is consistent with inflammation of the underlying tissue? a. Cullen's sign b. Ecchymosis c. Grey-Turner's sign d. Redness

12. What term is used to describe an electronic device that patients wear to notify a call center for assistance? a. Dog tag b. ID tag c. Insurance ID tag d. Medical alert tag/device

121. When auscultating the abdomen, normal bowl sound could be described as which of the following? a. Air constantly moving b. Nothing should be heard c. Water dripping at a slow rate d. Water tumbling through pipes

129. Paramedics are treating a male patient complaining of pain in the genitalia region. Of the following, which is an abnormal sign? a. Lack of bleeding b. Lack of irritation c. Lack of trauma d. Swelling of the scrotum

131. When is it appropriate to examine the patient's anus? a. When the patient is complaining of abdominal pain b. When the patient is complaining of isolated leg trauma c. When the patient is complaining of minor anal pain d. When the patient is complaining of rectal bleeding

134. A patient is complaining of black tarry stools. This is most likely a sign of which of the following? a. Hemorrhoids b. Lower GI bleed c. There is nothing significant with this finding d. Upper GI bleed

139. Which of the following indicates the need to perform a full neurologic assessment? a. Chest pain b. Diabetic emergency c. Respiratory distress d. Syncopal episode

145. While performing a reassessment on a patient, you notice the patient begin to vomit. What two assessments or surveys must be repeated? a. Initial assessment and detailed assessment b. Primary survey and rapid assessment c. Vital signs and detailed assessment d. Vital signs and primary survey

148. What is a way a paramedic can keep documentation consistent and reduce the chances of making an error? a. Ask a more experienced colleague to write it. b. Copy other responder's paperwork. c. Use a thesaurus. d. Use the same format for every call.

2. Why is it important to repeat the address back to your dispatcher upon receiving a call? a. For documentation purposes b. So that the dispatch information can be recorded c. To encode the message correctly d. To provide feedback to ensure the message was received correctly

20. Which of the following is designated as the official reference source for drugs marketed in the United States? a. American Hospital Formulary Service b. Medical Drug Consult c. Physician's Desk Reference d. United States PharmacopeiaNational Formulary

21. How frequently is the Physician's Desk Reference updated? a. Weekly b. Monthly c. Biannually d. Annually

22. Which of the following acts was the first in the United States to standardize the name, strength, quality, and purity of drugs? a. The Durham-Humphrey Amendments b. The Federal Food, Drug and Cosmetic Act c. The Harrison Narcotics Act d. The Pure Food and Drug Act

22. Zantac, Tagamet, and Pepcid all work because of their antagonistic action at which receptor site? a. Alpha-2 b. G-1 c. Gastro-2 d. H-2

23. In the CHART format for documentation, treatment from standing orders or protocols are documented in: a. C b. H c. A d. R

23. Which of the following mnemonics can be used to remember the possible causes of a loss of consciousness? a. AVPU b. DCAPBTLS c. PAT d. STOPEATS

24. Use of a paramedic's run forms to review the appropriateness and effectiveness of the prehospital care provided is an example of: a. A legal review of your documentation b. 'Big Brother' watching you c. Systematic review d. The importance of proper written communication/documentation

25. The accumulated PCRs for your service and others in your area can be used for: a. Billing purposes only b. Communication between prehospital providers c. Documentation of weather conditions d. Research on the effectiveness of prehospital care

25. Uricosuric drugs may be used to treat which of the following medical conditions? a. A skin fungus b. Cardiac compromise c. Hypovolemia d. The gout

26. Which of the following agencies has the authority to set public standards for prescription and over-the-counter medicines? a. Food and Drug Administration b. Medical Drug Control c. Physician's Desk Reference d. United States Pharmacopeia

28. Which of the following best describes why standardization of drugs is necessary? a. Drugs are produced by the same company under different names. b. Drugs do not vary by dose and length of action based on where the drug is made. c. Drugs have different doses depending on whether they are brand-name or generic drugs. d. Drugs may vary by strength and activity among drug manufacturers.

29. A paramedic is on scene with a patient who presents with vomiting, hyperpnea, hyperactivity, and seizures after an ingestion of a nonprescription medication. Which of the following is the most likely cause of this patient's signs and symptoms? a. A benzodiazepine overdose b. A narcotic overdose c. An alcohol overdose d. An aspirin overdose

3. A paramedic is preparing to administer glucose to a patient with a history of alcohol abuse. What of the following pharmacologic agents should be administered before the glucose? a. Brethine b. Calan c. Narcan d. Thiamine

3. Which of the following best describes electronic communications in EMS? a. Completing a patient care report to submit to the agency for billing b. Giving a patient report to the staff upon arrival at the hospital c. Receiving a call for help from an injured person over the telephone d. Receiving an emergency call over the radio from the dispatcher

3. Which of the following is most likely to lead to an inaccurate differential diagnosis? a. Asking open-ended questions and allowing the patient to speak freely b. Learning about the patient's complete medical history c. Multiple systems and complaints d. Poor communication and interviewing skills

31. The SOAP acronym is used as a memory aid for: a. Assessing the patient's medical complaint b. Assessing the patient's trauma complaint c. Gathering patient history d. Organizing written and verbal reports

31. You are on the scene of a 43-year-old man whose car hit a tree. He states that he wants to refuse treatment. He is unable to state his name or age. He denies alcohol or drug use. Which of the following is the most appropriate action? a. Contact police for breath analysis. b. Declare this patient competent. c. Restrain this patient. d. Treat and transport patient.

32. Once a drug has been developed, what is the next step the pharmaceutical company must take to gain FDA approval? a. List the medication on the stock market to recoup development costs. b. Put the drug into the U.S. Pharmacopoeia before allowing any sales. c. Secure a patent on the medication, then sell it to various pharmacies. d. Test the drug's effectiveness as an investigational medication.

33. When should a paramedic reconsider the mechanism of injury (MOI)? a. Only during the transport of the patient b. Only when ordered by a physician c. The mechanism of injury should never be reconsidered d. When the injuries seem inconsistent with the MOI

35. To facilitate quality-improvement reviews and ensure the completeness of the prehospital care report, the paramedic should: a. Always complete a supplemental report form b. Have risk management review the prehospital care report c. Print all important items on the forms d. Use a standard format established or approved by medical direction

35. Which of the following factors would effect the number of rescuers needed at any particular scene? a. The distance to the local hospital b. The lunar cycle c. The time of day d. The total number of patients

36. Which of the following drugs should be administered to a patient who has ingested a large dose of morphine? a. Activated charcoal b. Flumazenil c. Ipecac d. Naloxone

37. Which of the following best describes the portable radio carried by the paramedic? a. Because of high power, it can be used in places where other radios cannot be used. b. Because of low power, it requires a very tall antenna for adequate transmission. c. It has tremendous power and can transmit from nearly every location. d. The power is limited to 1 to 5 watts with a limited transmit range.

38. Which of the following is the most accurate reason to perform a general impression of the patient? a. To determine the age of the patient b. To determine the patient's ability to pay for treatment c. To determine the weight of the patient d. To determine whether the patient is stable or unstable

38. Which of the following responses would occur in a patient who has had a prior heart transplant and has vagus nerve stimulation? a. Decreased heart rate b. First an increased then a decreased heart rate c. Increased heart rate d. No change in heart rate

39. What is the most common route of administration for etomidate? a. Inhalation b. IM c. IV only d. Suppository

4. You are called to a private residence for a 'child not breathing.' Upon arrival, you find an 18-month-old child lying on the living room sofa. After thoroughly assessing the child, you discover that the child is a victim of child abuse and has been deceased for several hours. No patient care is delivered. Which of the following best describes the written report that you will submit? a. Brief incident report describing what you saw b. Canceled on scene—no medical need for care c. Copy of the police report when available d. Detailed patient care report with all information

4. You are on scene to a motor vehicle accident with four passengers in the vehicle. The vehicle was struck on the driver's side. Which of the following statements would be important for emergency care providers at the hospital? a. Determination of who was at fault b. Exact age of patient's c. Patient primary care physician d. Restraint systems used

43. Hepatitis A and B, rabies, and rubella are examples of which types of immunizations? a. Antidotes b. Bacterial c. Immunoglobulin d. Viral

44. Tonsillitis, dental infections, otitis media, and sinusitis are commonly treated with which type of antibiotic? a. Antivirals b. Immunoglobulin c. Macrolides d. Penicillins

44. Which of the following terms most accurately describes a medicine consisting of an extract in an alcohol solution? a. Elixir b. Emulsion c. Spirit d. Tincture

45. Baby aspirin is an example of which type of drug form? a. Capsule b. Gelcap c. Suppository d. Tablet

45. How do cephalosporins differ from penicillins? a. Cephalosporins are used to treat dental infections only. b Cephalosporins stay in the system five times longer than penicillins. c. Cephalosporins work faster than penicillins. d. Cephalosporins work on both gram-positive and gram-negative bacteria.

46. Which of the following is a parenteral method of administering a drug? a. Oral b. Rectal c. Sublingual d. Topical

47. Which of the following best describes the role of the Federal Communications Commission (FCC)? a. Conducts quality improvement evaluations of EMS communications b. Governs air traffic control patterns for flights in the United States c. Levies fines for inappropriate conduct on radio or television d. Regulates radio communications and assign frequencies

48. Pantothenic acid and cobalamin are examples of which type of medication? a. Antifungal b. Beta-blockers c. Sedatives d. Vitamins

5. Which of the following is a critical reason for the prehospital care report (PCR) to be legible and accurate? a. Close friends of the patient may want the information. b. The media may collect information. c. Prospective data may be collected. d. Retrospective data may be collected.

5. Which of the following is the best description of the FDA classification of a drug developed for the diagnosis or treatment of rare diseases? a. A class II drug b. An expensive drug c. An experimental drug d. An orphan drug

50. What type of communication system is computer based and picks the next frequency to be used from a bank of frequencies? a. Computerized b. Electronic c. Repeater d. Trunked

53. Which of the following methods of medication administration is limited to the administration of naloxone, atropine, vasopressin, epinephrine, and lidocaine? a. IM b. Intralingual c. IO d. Tracheal

55. A trunked communication system provides which of the following advantages? a. A receiver is required only for the party sending the message, not the party receiving the message. b. It allows telemetry as well as verbal messages to be transmitted. c. It is designed for a single user only, allowing for uninterrupted communication. d. It is useful in major metropolitan areas where radio frequencies are heavily used.

55. Which of the following patients would be considered a priority patient requiring expedited transport? a. A conscious patient with an isolated ankle injury b. A conscious patient with mild nausea c. A patient with a minor finger injury d. An unresponsive patient with no gag reflex laceration

57. Which of the following types of assessment is performed on a responsive patient with a medical complaint? a. A complete secondary survey b. A DCAPBTLS survey c. A rapid medical assessment d. A rapid SAMPLE assessment

58. When the dispatcher receives a call for assistance, he or she will send the responding unit and remain on the line with the caller in order to do which of the following? a. Make sure the ambulance responds to the right place. b. Make sure the paramedic gets the correct billing information. c. Offer sympathy to reassure the distraught caller. d. Provide instructions to help the caller care for the patient.

58. Which of the following is the most accurate description of the rapid medical assessment? a. A complete and thorough head-to-toe assessment of an unresponsive medical patient b. A quick head-to-toe assessment of a responsive medical patient c. A quick head-to-toe assessment of a trauma patient with a significant MOI d. A quick head-to-toe assessment of an unresponsive medical patient

59. Life-saving information given by the dispatcher to bystanders, family, or the patient before EMS is considered: a. Alerting and directing response b. Dangerous c. Helpful d. Prearrival instructions

59. Which of the following is a special consideration with regard to the use of norepinephrine? a. Cardiogenic shock b. Hypotension c. Neurogenic shock d. Tissue necrosis

6. Benadryl has some anticholinergic properties that may produce which of the following adverse effects? a. Bradycardia, diarrhea, nausea, and drowsiness b. Salivation, lacrimation, defecation, and urination c. Shortness of breath, tachycardia, and nausea d. Tachycardia, constipation, inhibition of secretions, and sedation

60. Prearrival instructions that the dispatcher may provide to benefit the patient include: a. Advice on how to unlock the car and extricate the victim b. Compliments to the caller for recognizing the emergency c. Directions to the hospital so the caller does not have to wait d. Information that the caller can use to care for the victim

60. Which of the following statements is most correct when referring to sympathomimetics? a. They block calcium channels. b. They block the release of norepinephrine. c. They block the sympathetic nervous system. d. They mimic the sympathetic nervous system.

60. You have arrived at the scene of a motorcycle accident to find a 37-year-old male lying unconscious on the ground near motorcycle. Which of the following treatment plans would be most appropriate for this patient? a. Perform a complete medical assessment, and treat the patient on scene. b. Perform a complete secondary survey, and treat the patient on scene. c. Perform a rapid medical assessment, and determine the need for expedited transported. d. Perform a rapid trauma assessment, and determine the need for expedited transport.

61. What term describes a drug's ability to produce a physiologic response? a. Affinity b. Agonist c. Antagonist d. Efficacy

61. Which of the following cardiac problems could be treated with lidocaine? a. AMI b. Asystole c. Atrial fibrillation d. Ventricular rhythms

62. Lidocaine would be contraindicated in which of the following rhythms? a. Perfusing ventricular tachycardia b. Ventricular fibrillation c. Ventricular tachycardia d. WPW and heart blocks

63. Lopressor is an example of which type of drug? a. Beta-blocker b. Calcium channel blocker c. Carbohydrate d. Nucleoside

64. When relaying information to the receiving hospital staff, the paramedic must be aware of: a. Getting the right billing information b. Giving the patient's name to the admissions clerk c. Keeping the report as short as possible d. Maintaining the patient's right to privacy

66. Which of the following factors is most correct regarding the absorption of a drug? a. Fat-soluble drugs are absorbed more readily. b. Protein-soluble drugs are absorbed more readily. c. Solubility of the medication is not a factor in absorption. d. Water-soluble drugs are absorbed more readily.

68. Your verbal report to medical direction should: a. Be as complete as possible b. Be as concise as possible c. Be completed in less than 20 seconds d. Vary with local protocol and be based on the patient's severity

69. Which of the following adverse effects may occur with the use or administration of digoxin? a. Chest pain b. Dyspnea c. Tachycardia d. Visual disturbances/headache

7. Information about the patient's allergies is important because: a. Emergency medications often produce allergic reactions. b. Food allergies often do not develop for hours after a person has eaten that food. c. Many unresponsive patients are suffering an allergic reaction. d. This information may affect the care you or other caregivers provide.

7. Valium is an example of which type of drug name? a. Chemical name b. Generic name c. Official name d. Trade name

70. Rauwolfia derivatives come from which of the following sources? a. Animal byproducts b. Cactus c. Seaweed d. Tropical trees and shrubs

72. Which of the following terms is used to describe a predictable effect of a drug other than the one for which it is given? a. Adverse effect b. Antagonism c. Interaction d. Side effect

74. Aldactone is an example of which type of drug? a. Aspirin derivative b. Beta-blocker c. Calcium channel blocker d. Potassium sparing diuretic

74. Which of the following terms is defined as a prolongation or increase in the effect of a drug by another drug? a. Adverse effect b. Cumulative action c. Drug antagonism d. Potentiation

77. What is the term used to describe a geriatric patient taking a number of prescription and over-the-counter medicines? a. An additive effect b. Drug dependence c. Pharmacogenetics d. Polypharmacy

77. Which of the following is considered an abnormal finding when assessing a patient's mouth and pharynx? a. Pink color noted in mucous membranes b. No foreign objects noted c. Normal dentition d. Swollen tongue

78. Which of the following is an adverse effect from the administration of diphenhydramine? a. Antiemetic effects b. Bronchial asthma c. Decreased histamine release d. Drowsiness

79. When giving a medication to a pregnant patient, what must a paramedic consider before administration? a. A drug may be stored in breast milk and given to the baby after birth b. Giving half the normal dose to avoid drug toxicity in the fetus c. Giving twice the normal dose because some drug is given to the fetus d. The drug may pass the placental barrier and affect the fetus

8. You arrive on scene and are taking care of an unconscious 44-year-old male. His wife states that he had a headache for 1 hour before your arrival. Which of the following is a correct statement for the PCR? a. 'Bystander states patient had a headache.' b. 'History bypassed because of patient's current condition.' c. 'Information unobtainable; patient is unconscious.' d. 'The patient's wife states he had a headache 1 hour before our arrival.'

82. What type of drug interaction is likely to occur with a patient who has eaten a large meal before taking a PO medication? a. A greater response to the medication b. A lesser response to the medication c. Faster absorption of the medication d. Slower absorption of the medication

9. A paramedic is palpating a patient's chest at the fifth intercostal space and can feel the hearts apical impulse. What is the most correct term for this location? a. A murmur spot b. An S1 heart sound location c. An S2 heart sound location d. Point of maximum impulse

9. From the following list, choose one of the undesirable effects of nonselective adrenergic drugs? a. Bronchodilation b. Increased risk of cerebrovascular accident c. Increased risk of hemorrhage d. Muscle tremors

9. Vitamin B1 is the trade name for which of the following drugs? a. Cordarone b. Diazepam c. Quinine d. Thiamine hydrochloride

90. Solu-medrol and Solu-cortef are classified as which type of medication? a. Antiemetics b. Emetics c. NSAIDs d. Steroids

91. What information would be found in a drug profile? a. Chemical name b. Cost c. Pharmacogenetics d. Pharmacokinetics

92. What condition or injury may be indicated if JVD is present when the patient is raised at a 45-degree angle? a. Decreased cardiac output b. Hypotension c. Swollen lymph nodes d. Venous system overload or hypertension

92. Which of the following most accurately lists the components of a drug profile? a. Drug interactions, chemical name, and side/adverse effects b. Generic, trade and chemical names, indications, and dosage c. Indications, dosage, trade and chemical names, and antidotes d. Pharmacokinetics, pregnancy risk, how supplied, dosage

93. Azathioprine and cyclosporine are classified as what type of drugs? a. Antihypertensives b. Beta-blockers c. Diuretics d. Immunosuppressants

95. Which of the following is the best method to determine JVD? a. Lay the patient prone, with head lower than 45 degrees. b. Lay the patient prone, with head raised to 45 degrees. c. Lay the patient supine, with the head lower than 45 degrees. d. Lay the patient supine, with the head raised to 45 degrees.

98. When assessing a patient involved in a 20-foot fall, you notice that a portion of the chest appears to be moving in the opposite direction of the rest of the chest wall. Which of the following is the most probable cause of this finding? a. Abdominal trauma b. Accessory muscle use c. Bronchitis d. Multiple broken ribs

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The carpopedal spasms that occur due to hyperventilation syndrome are a result of a relative ________, secondary to ________.

hypocalcemia, decrease in unbound calcium

All of the following are characteristic of the second phase reaction of an asthma attack EXCEPT:

loss of surfactant in the alveoli.

A 19-year-old female with difficulty breathing produces a peak expiratory flow rate of 425, indicating:

normal ventilatory state.

Your patient is a 72-year-old female, alert and oriented, sitting up in bed at a nursing home. She is in mild respiratory distress. Staff describe a 4-day history of fever, malaise, and productive cough. The patient also states that she has been experiencing chills and chest pain with deep inspiration. Physical examination reveals rales and rhonchi in the right upper lobe and warm, moist skin. HR = 116, BP = 104/76, RR = 20, SaO2 = 93%. Based on the clinical exam findings, the most appropriate diagnosis would be:

pneumonia

A hyperresponsive airway is likely to be in all of the following conditions EXCEPT:

pulmonary embolism.

Your patient is a 24-year-old male experiencing an acute onset of shortness of breath. Expiratory wheezing is auscultated in all lung fields. HR = 124, BP = 112/68, RR = 42. Your primary goal in managing this patient is to:

reverse bronchospasm.

A 72-year-old female has a 1-week history of 101°F fever, chills, and dark brown sputum production. She also has rhonchi and rales throughout her right lung. If this condition is left untreated, it could result in:

septic shock.

Management of a patient who is hyperventilating should include:

the administration of oxygen and "coaching" the patient to reduce the rate and depth of ventilations.

Improving ________ is a primary treatment goal in a patient with bronchospasm.

ventilation of the alveoli

C. Rectum

Damage to which of the following organs is most likely to induce a severe infection in the abdominal cavity?

Your patient is a 30-year-old male who is alert and oriented. He does not appear to be in respiratory distress, but after lifting a heavy box he complains of acute onset of shortness of breath associated with sharp, right-sided chest pain. HR = 100, BP = 122/76, RR = 16, SaO2 = 94%. Physical examination reveals cool, slightly pale, and diaphoretic skin. Which of the following is the MOST likely finding upon auscultation of the lungs?

Decreased lung sounds at the apex on the right side

C. second, fourth

Despite the declining incidence of burn injuries in the United States, burns remain the ________ leading cause of death in children under 12 and the ________ leading cause of trauma deaths in the overall population.

If inhaled, which of the following chemicals would NOT form a corrosive acid or alkali in the airway?

Dihydrogen oxide

B. The ascending reticular activating system

Drowsiness following trauma to the head is indicative of dysfunction of which of the following?

C. Assessing the patient for level of consciousness and orientation to person, place, and time

During the initial assessment of the patient with suspected traumatic brain injury, which of the following best describes the approach to assessing the patient's neurological functioning?

C. Fluid shift

During which phase of a burn injury does extravasation of proteins, water, and electrolytes occur, resulting in edema and potential hypovolemia?

Your patient is a 68-year-old male complaining of difficulty breathing for the past 2 days. He is sitting up, conscious, alert, and oriented and appears to be in mild respiratory distress. Physical examination reveals cool, dry, pink skin; he is thin with well-defined accessory muscles, and you note diffuse wheezing to all lung fields. HR = 102, BP = 136/96, RR = 20, SaO2 = 92%. The patient gives a 20-pack-a-year history of smoking. Based on these clinical exam findings, which of the following is most likely?

Emphysema

Your patient is a 72-year-old male with a history of emphysema. He is alert and oriented but in severe respiratory distress, able to answer only "yes" or "no" to your questions. He has had progressively more trouble breathing all day and has gotten no relief from his various metered dose inhalers. Physical examination reveals pale, cool, diaphoretic skin; pursed lip breathing; and accessory muscle use. Auscultation of his lungs reveals very little air movement with diffuse expiratory wheezing. HR = 142, BP = 146/100, RR = 30, SaO2 = 86%. As your partner is taking the patient's vital signs, you note that his head is starting to "bob." In addition to an IV of normal saline, nebulized albuterol and Atrovent, which of the following is the best course of prehospital management?

Endotracheal intubation, ventilation with 100% oxygen, IV corticosteroids

Your patient is a 23-year-old male in severe respiratory distress. The patient was working in a small, enclosed space when he spilled a 5-gallon drum of ammonia onto the floor and was quickly overcome by the fumes. A coworker pulled him from the room to safety and ensured that no liquid ammonia had splashed onto the patient or his clothing. The patient is complaining of a burning sensation to his throat and lungs, and you note that his voice is becoming progressively more hoarse. Auscultation of lung sounds reveals crackles and wheezes to all lung fields. HR = 144, BP = 150/100, RR = 30, SaO2 = 90%. In addition to an IV of normal saline at a keep open rate, which of the following is the best course of prehospital management?

Endotracheal intubation, ventilation with 100% oxygen, nebulized albuterol and Atrovent

Even with intervention, survival is unlikely with blood loss over ________ percent of the total blood volume.

A. Air is highly resistant to the passage of electricity, generating intense heat.

Flash burns associated with electricity occur due to which of the following?

C. 35 and 40 mmHg.

For the head injury patient without signs of herniation, adjust ventilation rates to maintain an end-tidal CO2 reading of between:

C. on a long backboard with the head of the backboard elevated 30 degrees.

For the patient with suspected traumatic brain injury, the ideal positioning of the patient for transport is:

D. A 52-year-old male with a 1-inch-wide, full-thickness burn across the entire width of the palm of his right hand resulting from picking up a hot grate from a barbecue grill

For which of the following burn patients could you use local cooling?

Frontal-impact motor vehicle collision at 45 miles per hour

For which of the following mechanisms of injury should you maintain the highest index of suspicion for hemorrhagic shock?

Hip and femur fractures

Frontal impacts in which the patient takes a "down-and-under" pathway typically result in which of the following injury patterns?

flatter, straighter

Greater velocity of a bullet will cause a ________ path of travel and a ________ trajectory.

Why is the oxygen-hemoglobin dissociation curve curved and not linear?

Hemoglobin and oxygen undergo cooperative binding, making it easier for each additional oxygen molecule to bind to hemoglobin.

Design the bullet to become more unstable

If you were to design a bullet to have the highest energy exchange, what would you do?

The heart continues its forward motion until it strikes the chest wall.

In a motor vehicle collision, when the driver's chest strikes the steering wheel, what produces injury next?

Neurogenic

In a previously healthy individual, which of the following types of shock may NOT result in the typical signs of cool, pale, moist skin; tachycardia; and narrowed pulse pressure?

A. I

In addition to handling all types of specialty trauma, which level of trauma center provides continuing medical and public education programs?

up and over

In frontal impact collisions, which pathway of patient travel results in higher mortality?

B. A 26-year-old male with a gunshot wound involving the popliteal artery

In which of the following patients with hemorrhagic shock can you employ aggressive fluid resuscitation?

lateral

In which of the following types of impact should you have a higher index of suspicion because the degree of injury may be greater than the damage alone indicates?

A. Avulsion

In which type of soft-tissue injury is the skin cut or torn, leaving a flap of skin attached?

Which of the following statements about capnography is FALSE?

It can give objective feedback on the efficacy of ventilations being provided to a patient in full cardiac arrest.

Your patient is a 52-year-old male complaining of shortness of breath. He is sitting up, alert, and oriented and appears to be in moderate respiratory distress. He states that he "always gets a chest cold in the winter" and describes a 3-week history of productive cough and increasing shortness of breath. Physical examination reveals coarse rhonchi to the upper lobes bilaterally, air movement is decreased in the bases, and his skin is cool with peripheral cyanosis. You note that he is overweight and describes an 18-pack-a-year smoking history. Based on these clinical exam findings, you might also expect to find:

JVD, pedal edema, hepatic congestion.

direct pressure.

Managing a laceration with arterial bleeding most often requires:

C. Toxic inhalation

Most inhalation injuries in burn patients are due to which of the following?

A. rarely

Musculoskeletal trauma is best described as ________ life threatening.

B. Unstable pelvis

Not considering other injuries, which of the following musculosketal findings warrants immediate transport of your patient?

B. tension in the limb.

One of the earliest indications that compartment syndrome is developing in an injured extremity is:

Your patient is a 44-year-old female, alert and oriented, in moderate distress, and complaining of difficulty breathing. She gives a 1-week history of fever and malaise, with shortness of breath developing 3 days ago. She also has left-sided chest pain with deep inspiration and a "phlegmy" cough. Physical examination reveals hot, pale, dry skin and rhonchi and rales throughout the left lung. The right lung sounds are clear. HR = 134, BP = 88/64, RR = 24, SaO2 = 92%. She has a history of two previous mycocardial infarctions and takes nitroglycerin as needed. Which of the following is the best course of prehospital management?

Oxygen via nonrebreathing mask 15 lpm, IV of NS with fluid challenge

Your patient is a 42-year-old female with a history of COPD. She is alert and oriented, in mild respiratory distress, and complaining of shortness of breath. She gives a 3-day history of worsening shortness of breath, sputum production, fever, and malaise. Physical examination findings include warm, dry, pale skin; rhonchi and wheezing auscultated in the upper lung lobes bilaterally; and jugular venous distension. HR = 128, BP = 96/60, RR = 18, SaO2 = 94%. In addition to an IV of normal saline, which of the following is the best course of prehospital treatment for this patient?

Oxygen via venturi mask 24-35%, nebulized metaproterenol, IV corticosteroids

A male patient with an acute exacerbation of his emphysema presents in severe distress with decreased air movement and diffuse inspiratory wheezes in all fields. HR = 132, BP = 142/88, RR = 30, SaO2 = 88%. Which of the following blood gas values is most likely?

PCO2 of 70 torr

B. 20

Paralysis of the muscles of respiration may occur when there is body contact with electrical currents as low as ________ mA.

A. Infection

Patients who survive the first several days of a moderate to critical burn are most likely to die from which of the following complications?

Cardiogenic

Pericardial tamponade would most likely result in which of the following types of shock?

Your patient is 24-year-old male Chinese citizen on vacation in the United States. He is in moderate distress complaining of difficulty breathing and gives a 4-day history of runny nose, sore throat, and general malaise with a productive cough. His sputum production was significantly worse when he woke this morning, and he developed difficulty breathing this afternoon. You note cool, pale, and diaphoretic extremities and lung sounds with rhonchi bilaterally. He gives a medical history of asthma treated with an albuterol inhaler as needed. HR = 134, BP = 132/84, RR = 26, SaO2 = 90%. Which of the following is the best course of prehospital treatment for this patient?

Provider use of PPE, oxygen via nonrebreathing mask 15 lpm, IV of NS KVO, cardiac monitor, notify receiving hospital, transport

In which of the following events is the primary issue decreased lung perfusion?

Pulmonary embolism

Which of the following statements comparing pulse oximetry and end-tidal CO2 detection is TRUE?

Pulse oximetry gives the care provider feedback on the effectiveness of oxygenation, while capnography provides feedback on the effectiveness of ventilation.

Which of the following statements about pulse oximetry is FALSE?

Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia

B. Use of a short catheter with a large internal diameter

Rapid volume replacement is best achieved under which of the following conditions?

Which of the following statements about severe acute respiratory syndrome (SARS) is FALSE?

SARS is caused by the SARS-CoV bacteria.

C. muscles, bones

Tendons connect ________ to ________.

C. 2nd intercostal space anteriorly

The Angle of Louis serves as a landmark for performing needle thoracostomy at which of the following locations?

B. temporal

The ________ cranial bone is fractured most often.

B. 40

The ability of bone to maintain its structure begins to decrease around age ________.

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