EMT Block Six
A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: Choose one answer. A. attempt cooling measures, offer oxygen, and transport. B. place the child in cold water to attempt to reduce her fever. C. allow the mother to drive her daughter to the hospital. D. suspect that the child has meningitis and transport at once.
A
A chronic inflammatory condition in children that is characterized by broncoconstriction and excessive mucous production is: Choose one answer. a. asthma. b. emphysema. c. bronchitis. d. pneumonia.
A
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: Choose one answer. A. pregnant patients have an overall increase in blood volume. B. pregnant patients can dramatically increase their heart rate. C. pregnancy causes vasodilation and a lower blood pressure. D. blood is shunted to the uterus and fetus during major trauma.
A
According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? Choose one answer. A. Check the mechanical ventilator for malfunction. B. Listen to breath sounds to assess for a pneumothorax. C. Look for blood or other secretions in the tube. D. Attempt to pass a suction catheter into the tube.
A
Airway management can be challenging in patients with Down syndrome because their: Choose one answer. A. teeth are misaligned and they have a large tongue. B. tongue is relatively small and falls back in the throat. C. mandible is large, which inhibits a mask-to-face seal. D. occiput is round, which causes flexion of the neck.
A
An infant or small child's airway can be occluded if it is overextended or overflexed because:Choose one answer. A. the occiput is proportionately large and the trachea is flexible. B. the back of the head is flat, which prevents a neutral position. C. the tongue is proportionately small and can fall back into the throat. D. he or she has a long neck, which makes the trachea prone to collapse.
A
An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may: Choose one answer. A. cause the child to vomit. B. result in airway swelling. C. depress the gag reflex. D. result in a soft-tissue injury.
A
At what point in the delivery process would the EMT first suction the baby? Choose one answer. a. After the head is delivered and meconium is present b. When the chest is delivered but before the legs are free of the vaginal canal c. Before the cord has been cut but after the baby has been assessed and determined stable d. When the baby has been delivered and has been dried and warmed
A
During the attempted resuscitation of an infant with suspected SIDS: Choose one answer. A. allow the family to observe if they wish. B. a law enforcement officer must be present. C. give detailed updates to the infant's parents. D. discourage the family from observing.
A
Emergency care providers should assume that any female of childbearing age with lower abdominal pain is experiencing: Choose one answer. a. an ectopic pregnancy. b. mittelschmertz. c. a spontaneous abortion. d. a ruptured ovarian cyst.
A
In children, the rule of nines assigns ________ percent of the body surface area to the head. Choose one answer. a. 18 b. 9 c. 10 d. 14
A
Management of a prolapsed cord should include: Choose one answer. a. inserting two fingers of a gloved hand into the vagina to raise the presenting part off the cord. b. encouraging the mother to continue pushing to expedite delivery. c. pushing the cord back into the birth canal. d. wrapping the cord in dry sterile dressing to prevent infection.
A
Scenario: A pregnant patient's systolic blood pressure is 30 mmHg higher than it was early in her pregnancy. She presents with edema and a dramatic decrease in urine output. The MOST likely diagnosis is: Choose one answer. a. pregnancy induced hypertension. b. normal for pregnancy. c. plecenta abruptio. d. placenta previa.
A
The leading cause of death in the geriatric patient is:Choose one answer. A. heart disease. B. altered mental status. C. hypertension. D. arthritis.
A
To best communicate with a geriatric patient with diminished eyesight, the EMT would: Choose one answer. a. Stand in front of the patient and talk calmly. b. Write questions in large print on paper. c. Increase both the pitch and volume of your voice. d. Obtain needed information from family members.
A
When preparing a pregnant patient for delivery, you should position her: Choose one answer. A. on a firm surface with her hips elevated 2″ to 4″. B. on her left side with the right leg elevated. C. in a supine position with her legs spread. D. in a sitting position with her hips elevated 12″.
A
Which of the following indicates the different stages of labor in the order that they occur? Choose one answer. a. Dilation, Expulsion, Placental b. Uterine, Delivery, Recovery c. Dilation, Delivery, Placental, Afterbirth d. Uterine, Expulsion, Placental, Recovery
A
Which of the following is NOT generally considered an obstetrical emergency? Choose one answer. A. return of contractions following delivery of the baby B. significant bleeding after delivery of the placenta C. more than 500 mL of blood loss before placental delivery D. failure of the placenta to deliver after 30 minutes
A
Which of the following observations or statements represents the "E" in the GEMS diamond?Choose one answer. A. The patient's residence is cold due to a malfunctioning heater. B. The patient's medications have not been filled in 2 months. C. Elderly patients present atypically and deserve your respect. D. A patient is assisted with his or her activities of daily living.
A
Which of the following patients may have injuries that suggest maltreatment? Choose one answer. a. A 6-year-old with bruises on the back b. A 4-year-old with bruises to the shins c. A 10-year-old with a laceration on the forearm d. An 8-year-old with a laceration on the face
A
Which of the following statements regarding gastrostomy (gastric) tubes is correct?Choose one answer. A. Patients with a gastrostomy tube may still be at risk for aspiration. B. Most gastrostomy tubes are temporary and are not sutured in place. C. Gastrostomy tubes are used for patients who cannot digest food. D. Gastrostomy tubes are placed directly into the small intestine.
A
Which of the following statements regarding hearing aids is correct?Choose one answer. A. Hearing aids cannot restore hearing to normal levels. B. Over time, hearing aids can restore normal hearing. C. A whistling sound indicates correct hearing aid placement. D. In-the-canal hearing aids fit in the outer part of the ear.
A
Which one of the following statements regarding ventilation of the pediatric patient is true? Choose one answer. a. The bag valve device should not have a pop-off valve. b. The diameter of the correctly sized mask is equal to the distance from the earlobe to the corner of the mouth. c. The use of a flow-restricted, oxygen-powered ventilation device is preferred. d. A reservoir is not needed to provide 100 percent oxygen to the pediatric patient.
A
You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should: Choose one answer. A. assess her for crowning. B. place her on her left side. C. transport her immediately. D. apply 100% oxygen.
A
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:Choose one answer. A. avoid placing him in a supine position if possible and administer oxygen. B. notify the receiving facility and advise them of the patient's weight and status. C. perform a secondary assessment, focusing on his respiratory system and back. D. ask a member of your team to locate the best route to move him to the ambulance.
A
You are assessing an 81-year-old female patient. She appears to have a diminished mental status. To further evaluate her mental status you should do all of the following EXCEPT: Choose one answer. a. Assume the diminished mental status is normal. b. Take your time, speak slowly and clearly, and give the patient extra time to respond. c. Ask a family member if this is her normal condition. d. Consider what underlying condition might be causing her diminished mental status.
A
You are responding to a low-income apartment complex for a 16-year-old female who is 5 weeks pregnant and experiencing vaginal bleeding. When mentally reviewing possible causes of hemorrhage for this patient, which of the following would you be prepared to encounter? Choose one answer. a. Spontaneous abortion b. Dysfunctional placenta c. Ruptured uterus d. Drug addiction
A
You are transporting an ill 3-year-old to the hospital for evaluation when he suddenly starts having a seizure. The most common cause of seizures in pediatric patients is: Choose one answer. a. Fever. b. Poisoning. c. Hypoxia. d. Hypoglycemia.
A
You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is: Choose one answer. A. 8 B. 6 C. 7 D. 9
A
You have responded to a 3-year-old patient who has awakened with a loud, brassy cough. The mother reports recent cold-like symptoms managed with over the counter medications. There is a slight fever present, the child is awake and holding tightly to his mother, and breathing well with some inspiratory stridor. The mother reports that his cough has gotten worse over the past three nights and is worse at night. What is the most likely cause of the child's condition? Choose one answer. a. Croup b. Epiglottitis c. Pneumothorax d. Foreign body airway obstruction
A
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:Choose one answer. A. a subdural hematoma. B. acute ischemic stroke. C. acute hyperglycemia. D. diabetic ketoacidosis.
A
Your patient is a 4-year-old male with a history of asthma. He ran out of his inhaled bronchodilator while visiting his grandparent's farm. On your arrival, you learn that the patient has been having increasing respiratory distress for 20 minutes. The patient has pale, cool, moist skin with cyanosis of his nail beds. He is sitting on the edge of a kitchen chair, leaning forward to breathe. He has a respiratory rate of 50 with the use of accessory muscles and a heart rate of 130. He is anxious and unable to speak more than one or two words at a time. Auscultation of the chest reveals scattered wheezing. As you prepare to treat the patient, he becomes drowsy and his respiratory rate decreases to 12. You can no longer auscultate his wheezes. Which of the following best explains the significance of the change in your patient's status? Choose one answer. a. Because of decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have fatigued and he is now in respiratory failure. b. The child has realized that you are going to treat him and is more relaxed than he was initially and has stopped hyperventilating. c. The absence of wheezing indicates that bronchospasm has resolved spontaneously and the child now only needs supplemental oxygen. d. This makes no sense in an asthma patient, and it is likely that the child ingested or was exposed to a toxic substance, which explains the decreased level of consciousness.
A
A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should: Choose one answer. A. position her supine and elevate her legs 12″. B. place her in a left lateral recumbent position. C. assist her ventilations with a bag-mask device. D. carefully place sterile gauze into her vagina.
B
A service dog is easily identified by its: Choose one answer. A. color. B. harness. C. breed. D. size.
B
An EMT is presenting a continuing education class on care of the pregnant female. When discussing the amniotic sac, he would be correct when emphasizing which of the following points? Choose one answer. a. "The amniotic sac must rupture during the second trimester of pregnancy for fetal development to progress." b. "The amniotic sac protects and insulates the baby during pregnancy." c. "The amniotic sac contains a fluid called Wharton's jelly that enables the baby to breathe and move." d. "The amniotic sac contains fluid and surrounds and protects the uterus."
B
Assessment indicates that a newborn's respiratory rate is 40 and his heart rate 80 beats per minute. The EMT would: Choose one answer. a. Start chest compressions. b. Initiate positive pressure ventilation. c. Administer high-flow oxygen. d. Continue to monitor the baby.
B
Autism is MOST accurately defined as a:Choose one answer. A. mental disability caused by insufficient cognitive development of the brain. B. pervasive developmental disorder characterized by impairment of social interaction. C. congenital condition caused by factors such as malnutrition or birth complications. D. psychiatric condition related to an imbalance of serotonin in the brain.
B
Scenario: You arrive on scene for a 74-year-old male found sitting on the floor in the bathroom. His wife advises you that he is responding slowly to questions and appears to be a little confused. You note one-sided weakness. Based on the history, what do you suspect is the cause of his signs and symptoms? Choose one answer. a. vagal episode b. cerebrovascular accident (CVA) c. acute myocardial infarction (AMI) d. transient ischemic attack (TIA)
B
Signs of ectopic pregnancy include all of the following EXCEPT: Choose one answer. a. vaginal bleeding. b. hypertension. c. late or missed menstrual period. d. severe unilateral abdominal pain.
B
The MOST common cause of dehydration in pediatric patients is: Choose one answer. A. refusal to drink fluids. B. vomiting and diarrhea. C. high fever. D. internal blood loss.
B
Treatment of newborns follows: Choose one answer. a. toe-to-head assessment. b. inverted pyramid of care. c. establishing chest compressions early. d. none of the above.
B
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: Choose one answer. A. at the head. B. at the feet. C. en route to the hospital. D. in the ambulance.
B
Which of the following statements regarding age-related changes in the nervous system is correct? Choose one answer. A. Because of a decrease in the number of brain cells, a person's level of intelligence decreases with age. B. Interconnections between brain cells often prevent a loss of knowledge or skill, despite a loss of neurons. C. The metabolic rate in the brain increases with age, but the consumption of oxygen decreases significantly. D. Generally speaking, the brain increases in size by 10% to 20% by the time a person reaches 80 years of age.
B
Which of the following statements regarding communications with the elderly is correct?Choose one answer. A. The majority of elderly patients are hearing or visually impaired. B. Older patients have difficulty understanding when they are stressed. C. Explain the justification for a procedure after it has been completed. D. Attempt to calm the elderly patient by using his or her first name.
B
Which of the following statements regarding toddlers and preschoolers is correct?Choose one answer. A. The normal respiratory rate in toddlers and preschoolers is between 12 and 20 breaths/min. B. Toddlers and preschoolers commonly experience upper respiratory infections because of a loss of passive immunity. C. Toddlers and preschoolers have well-developed lung musculature, even though they have less lung tissue. D. Muscle mass and bone density decrease in toddlers and preschoolers because of increased physical activity.
B
Which statement made by the EMT indicates that he understands the relationship between seizures and pregnancy? Choose one answer. a. "A short seizure in the pregnant female with a seizure history generally does not require transport." b. "Prolonged seizures can easily cause the mother and baby to become hypoxic." c. "If the pregnant patient is seizing, the EMT must quickly make a decision to administer or withhold her anti-seizure medications." d. "Seizure activity in the pregnant female is typically not life-threatening unless the patient has had seizures in the past."
B
You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is not moving and does not appear to be conscious or breathing. You should: Choose one answer. A. begin immediate rescue breathing. B. stabilize his head and open his airway. C. assess for the presence of respirations. D. perform a head tilt-chin lift maneuver.
B
You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is not moving and does not appear to be conscious or breathing. You should: Choose one answer. A. perform a head tilt-chin lift maneuver. B. stabilize his head and open his airway. C. begin immediate rescue breathing. D. assess for the presence of respirations.
B
You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: Choose one answer. A. allowing the child to remain with her mother and applying a nasal cannula. B. administering blow-by oxygen and transporting the child with her mother. C. separating the child from her mother and providing ventilatory assistance. D. requesting a paramedic ambulance to insert an advanced airway device.
B
You are dispatched to an office complex for a patient in labor. You find a 26-year-old patient who states she is 9 months pregnant with her first child. She has been having contractions for the past few hours and they are getting closer together. She denies her water breaking. While preparing her for transport, she states she has to go to the restroom. Your best action in this situation would be to: Choose one answer. a. Tell the mother she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital. b. Advise the mother that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible. c. Advise the mother that this could be a sign of a serious complication, have her lie on her left side, apply high-flow oxygen and transport immediately. d. Allow her to use the bathroom as it will make transport, and also delivery, more comfortable.
B
You are examining your patient for crowning when you notice the umbilical cord is the presenting part. Your management of this prolapsed umbilical cord would include: Choose one answer. a. Placing the mother in a supine position with pillows under her shoulders. b. Placing the mother in a head-down position with pillows under her hips. c. Using your gloved hand to push the umbilical cord back up through the cervix. d. Immediately clamping the cord in two places and cut it between the clamps.
B
You have responded to the scene where a child has decreased respiratory rate, decreased chest rise with inspiration, and cyanosis. What is this respiratory condition called? Choose one answer. a. Orthopnea b. Respiratory failure c. Tachypnea d. Dyspnea
B
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: Choose one answer. A. apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment. B. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center. C. insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center. D. apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport.
B
Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: Choose one answer. A. gently pulling on the infant's leg in an attempt to facilitate delivery. B. placing the mother supine with her head down and pelvis elevated. C. carefully attempting to push the infant's leg off of the umbilical cord. D. placing the mother in a recumbent position and rapidly transporting.
B
A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Considering the fact that this patient is probably in shock, what is the MOST likely explanation for the absence of tachycardia? Choose one answer. A. failure of the parasympathetic nervous system B. deterioration of the cardiac conduction system C. the effects of her antihypertensive medication D. intrathoracic bleeding and cardiac compression
C
A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for: Choose one answer. A. acute appendicitis. B. myocardial infarction. C. an aortic aneurysm. D. a strangulated bowel.
C
A 9-year-old boy who has had difficulty breathing and wheezing for the past 24 hours is sitting up but appears tired and has audible wheezing. He has a blood pressure of 98/66 mm Hg, a pulse of 124 beats/min, and a respiratory rate of 32 breaths/min. Which assessment is the most important to include in the examination of the patient? Choose one answer. a. Ability to swallow b. Quality of pulses c. Work of breathing d. Oral temperature
C
A common cause of shock in an infant is: Choose one answer. A. a cardiac arrhythmia. B. cardiovascular disease. C. dehydration from vomiting and diarrhea. D. excessive tachycardia.
C
A service dog is easily identified by its:Choose one answer. A. color. B. size. C. harness. D. breed.
C
An elderly patient with a myocardial infarction is ________ than a younger counterpart. Choose one answer. a. equally likely to present with classic symptoms. b. less likely to have cardiac enzyme elevation when the hospital does a blood exam. c. less likely to present with classic symptoms. d. more likely to present with classic symptoms.
C
An infant's blood pressure typically increases with age because:Choose one answer. A. as the infant gets older, his or her blood vessels dilate. B. the infant's total blood volume decreases with age. C. blood pressure directly corresponds to body weight. D. his or her normal heart rate usually increases with age.
C
Assessment of a newborn indicates that his heart rate is 120 beats per minute. How many points would he be awarded according to the APGAR scoring system? Choose one answer. a. 0 b. 1 c. 2 d. 3
C
Based on your 30-second assessment of the newborn, you note no meconium staining, full-term delivery, good muscle tone, and peripheral cyanosis. What should be your next action? Choose one answer. a. chest compressions, 60/min for 30 seconds, reevaluate b. positive pressure ventilations, 60/min for 30 seconds, reevaluate c. dry, warm, position, stimulate, O2 prn, reevaluate d. chest compressions, 120/min for 30 seconds, reevaluate
C
Clouding of the lenses of the eyes is called:Choose one answer. A. glaucoma. B. conjunctivitis. C. cataracts. D. retinitis.
C
Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, EXCEPT:Choose one answer. A. increased stiffness of the thoracic cage. B. a loss of respiratory muscle mass. C. increased surface area available for air exchange. D. decreased residual volume.
C
In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:Choose one answer. A. will only activate if it detects rhythms such as ventricular fibrillation. B. is implanted under the skin in the left upper abdominal quadrant. C. regulates the patient's heart rate if it falls below a preset value. D. delivers a shock to the heart if the rate becomes exceedingly fast.
C
In late adults, the amount of air left in the lungs after expiration of the maximum amount of air:Choose one answer. A. decreases, resulting in widespread collapsing of the alveoli and impaired diffusion of gases. B. decreases, which increases diffusion in the lungs and causes an accumulation of carbon dioxide. C. increases, which hampers diffusion of gases because of stagnant air that remains in the alveoli. D. remains unchanged because the lungs have become accustomed to years of breathing pollution.
C
Osteoporosis is MOST accurately defined as: Choose one answer. A. an abnormality near the growth plate. B. increased flexibility of bone mass. C. a decrease in bone mass and density. D. decreased bone marrow production.
C
Postpartum care of the mother should include: Choose one answer. a. fluid resuscitation of the mother to compensate for blood loss. b. administering Pitocin to facilitate placenta delivery. c. massaging the fundus. d. immediately sitting the mother upright so the infant can suckle.
C
The pediatric patient that experiences fluid loss from any cause will: Choose one answer. a. be unable to keep up with the metabolic demands. b. slowly decompensate over a greater period of time. c. compensate well, but rapidly decompensate. d. all of the above.
C
The purpose of the pediatric assessment triangle (PAT) is to: Choose one answer. A. facilitate a rapid head-to-toe assessment of the child by visualization only. B. gather critical data by performing a rapid hands-on assessment of the child. C. allow you to rapidly and visually form a general impression of the child. D. determine if the child's vital signs are within the age-appropriate limits.
C
The son of an 88-year-old patient states that he told his mother to increase the amount of medication she was taking so she would "feel better faster." Why would this not be wise in the geriatric patient? Choose one answer. a. Decreased respiratory function b. Increased risk for stroke c. Decreased liver and kidney function d. Increased risk for cancer
C
Which of the following affects the lower airway? Choose one answer. a. Laryngitis b. Croup c. Pneumonia d. Epiglotitis
C
Which of the following findings would indicate SIDS? Choose one answer. a. gastric distention b. malnutrition c. frothy fluids in the mouth d. dehydration
C
Which of the following statements describing falls among the elderly is MOST accurate? Choose one answer. a. The elderly have the highest incidence of falls. b. Falls account for the highest percentage of emergency department visits among the elderly. c. Fall-related injuries represent the leading cause of accidental death among the elderly. d. A majority of falls are primarily related to infrapatellar bursitis.
C
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?Choose one answer. A. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. B. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition. C. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition. D. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness.
C
Which of the following statements regarding middle adults is correct?Choose one answer. A. Increased cholesterol levels in the middle adult age group often do not respond to exercise and diet. B. Women in the middle adult age group typically experience menopause in their late 50s or early 60s. C. Cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer. D. Significant impairments in hearing and vision begin to occur in persons between the ages of 41 and 44 years.
C
You are assessing a 5-year-old boy who is complaining of arm pain after falling down three steps. As you assess the patient, he tries to bite you when you lay hands on him. His mother is at his side. Which of the following statements is appropriate to make regarding the behavior of biting? Choose one answer. a. "Do you bite your mother? Why would you try to bite me?" b. "Mom, you need to stop him from trying to bite me." c. "I know that you do not feel good, but biting is not okay." d. "If you bite me, I will not help you feel better."
C
You are assessing a female patient who informs you that she has been pregnant two times and has delivered once. Which of the following would you document on the prehospital care report? Choose one answer. a. Para III; Gravida I b. Para II; Gravida I c. Gravida II; Para I d. Gravida III; Para I
C
You are dispatched to a private residence for a patient with back pain. Upon your arrival, the wife leads you into the family room where her husband is sitting in a chair. He is complaining of severe back pain. He states he was watching TV when he got up to get a drink. On his way to the kitchen, he felt a "tearing" pain in his abdomen. The pain then moved to his back. Your patient is most likely experiencing a(n): Choose one answer. a. Bowel obstruction. b. Gall bladder disease. c. Abdominal aortic aneurysm. d. Diverticulitis.
C
You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should: Choose one answer. A. inquire about a history of Alzheimer disease. B. obtain a complete list of the patient's medications. C. determine the patient's baseline mental status. D. ask an attendant for the patient's medical records.
C
You are treating a 4-year-old female patient who suddenly developed breathing difficult while playing with her friends. She is alert and responds appropriately for her age. You hear stridor upon auscultation. Her skin is warm and dry and she has a strong pulse. Your most appropriate treatment for this patient would be to: Choose one answer. a. Perform abdominal thrusts. b. Perform alternating back slaps and chest thrusts. c. Transport the child secured in a car seat. d. Attempt a finger sweep to remove any foreign body.
C
You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should: Choose one answer. A. clamp and cut the umbilical cord and keep him warm. B. begin chest compressions and reassess in 30 seconds. C. keep him warm and provide ventilatory assistance. D. assess his skin color and give free-flow oxygen as needed.
C
A "silent" heart attack occurs when: Choose one answer. A. a sudden dysrhythmia causes death. B. sweating is the only presentation. C. the patient minimizes the chest pain. D. the usual chest pain is not present.
D
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:Choose one answer. A. attempt to troubleshoot the ventilator problem. B. place a call to the home health agency treating this patient. C. reset the ventilator by unplugging it for 30 to 60 seconds. D. disconnect the ventilator and use a bag-mask device.
D
A 2-year-old boy is alert and crying, has multiple lacerations and a deformed forearm after he was struck by a car. Additional assessment reveals that he has warm, dry, pink skin and bruising on the lateral right lower chest. He has a blood pressure of 88/60 mm Hg, a pulse of 134 beats/min, and respirations of 32 breaths/min. To accurately assess the child's appearance, you should Choose one answer. a. remove his caregivers from the scene if they are anxious or upset. b. reassure him that you will not hurt him. c. tell him to lie quietly or you cannot take care of him. d. distract him with a penlight or stethoscope.
D
A 31-year-old female is in labor. After assuring her airway, breathing, and circulation, you assess her perineum. You observe the umbilical cord protruding from the vagina, but do not see the baby. Your immediate action would be to: Choose one answer. a. Gently pull the cord to assist in delivery. b. Prepare and apply high-flow oxygen to the mother. c. Place a saline-soaked dressing over the cord. d. Place the patient in a knee-chest position.
D
A coworker is telling you about a recent run in which he provided care to a preschooler. Based on this description, you know that age of the patient would have been: Choose one answer. a. 2 years. b. 6 years. c. 8 years. d. 4 years.
D
Airway maintenance in an unresponsive pediatric patient who is immobilized can be hampered by: Choose one answer. a. the larger tongue that occludes the nasopharynx. b. the decreased thoracic excursion from the chest strap of the backboard being applied. c. the inability to roll the patient to the side if vomiting occurs during immobilization. d. the larger occipital region, which promotes cervical flexion.
D
Airway management can be challenging in patients with Down syndrome because their:Choose one answer. A. occiput is round, which causes flexion of the neck. B. tongue is relatively small and falls back in the throat. C. mandible is large, which inhibits a mask-to-face seal. D. teeth are misaligned and they have a large tongue.
D
An Emergency Medical Responder asks you why you should not overextend the airway when performing a head tilt-chin lift on a infant. Your reply would be: Choose one answer. a. "The infants esophagus is very thick and will occlude the airway if the neck is hyperextended." b. "The infants cervical spine is delicate and can be injured if the neck is hyperextended." c. "The trachea of the infant is very short and can be injured by extension." d. "The cartilage of the trachea is very soft and can 'kink' if the neck is extended too far."
D
As the bag of waters breaks, you notice the presence of thick meconium. This alters your normal delivery process in that you must: Choose one answer. a. Check for fever before suctioning the infant. b. Nothing extra, this is normal. c. Vigorously rub the infant's back immediately upon delivery to stimulate breathing. d. Be prepared to suction the infant immediately before he takes a breath.
D
Breathing is often more labor intensive in older adults because the: Choose one answer. A. overall size of the airway decreases. B. surface area of the alveoli increases. C. diaphragm and intercostal muscles enlarge. D. elasticity of the lungs decreases.
D
Burns in children are commonly caused by all of the following, EXCEPT: Choose one answer. A. exposure to caustic chemicals. B. scalding water in a bathtub. C. hot items on a stovetop. D. entrapment in a structural fire.
D
Death caused by shaken baby syndrome is usually the result of: Choose one answer. A. intra-abdominal hemorrhage. B. fracture of the cervical spine. C. multiple open fractures. D. bleeding in the brain.
D
Despite positive pressure ventilation, a newborn's heart rate has fallen from 80 beats per minute to 40. He is breathing 40 times a minute and has a mottled appearance. The EMT would immediately: Choose one answer. a. Suction the airway. b. Continue positive pressure ventilation. c. Attach an AED. d. Start CPR.
D
Scenario: You arrive at the scene just as a 22-year-old has delivered her first child. She tells you that her due date is not for six weeks. Your initial assessment of the neonate reveals core and peripheral cyanosis, apnea, and an unobtainable pulse. Your first action will be to: Choose one answer. a. secure the scene for the coroner, this is a still birth. b. advise the mother that the age of viability is 38 weeks and apologize for her loss. c. suction the nose and mouth and flick the soles of the feet. d. start CPR.
D
Spina bifida is MOST accurately defined as:Choose one answer. A. a birth defect in which the child is born without spinal vertebrae. B. congenital inflammation of the spinal cord, usually in the neck. C. chronic pressure on the brain caused by excess cerebrospinal fluid. D. a birth defect caused by incomplete closure of the spinal column.
D
Syncope in the older patient is:Choose one answer. A. most commonly caused by a silent myocardial infarction. B. generally of no concern unless the patient was injured. C. rarely life threatening but should be evaluated by a physician. D. caused by an interruption of blood flow to the brain.
D
The decline in cardiac function that commonly occurs in late adulthood is MOST often related to:Choose one answer. A. medication use. B. kidney failure. C. hypotension. D. atherosclerosis.
D
The human body should be functioning at its optimal level between the ages of:Choose one answer. A. 18 and 22 years. B. 25 and 35 years. C. 21 and 30 years. D. 19 and 25 years.
D
The stooped posture of some older people, which gives them a humpback appearance, is called:Choose one answer. A. miosis. B. arthritis. C. scoliosis. D. kyphosis.
D
Under what circumstances is a left ventricular assist device used? Choose one answer. A. to reduce ventricular pumping force in patients with aortic aneurysms B. to permanently replace the function of one or both of the ventricles C. to ensure that the ventricles contract at an adequate and consistent rate D. as a bridge to heart transplantation while a donor heart is being located
D
When assessing a 78-year-old female who complains of shortness of breath, the EMT should:Choose one answer. A. give oxygen only if the patient has labored breathing. B. place the patient supine to see if the problem worsens. C. conclude that the patient is experiencing a heart attack. D. ask her how many pillows she uses when she sleeps.
D
Which of the following is a physical change that typically occurs in the adolescent age group?Choose one answer. A. The systolic blood pressure decreases. B. Muscle and bone growth both decrease. C. The normal pulse rate steadily increases. D. Secondary sexual development begins.
D
Which of the following is an anatomic difference between children and adults?Choose one answer. A. The trachea of an infant is proportionately longer than an adult's. B. The ribcage of an infant is less flexible than an adult's. C. An infant's head accounts for less body weight than an adult's. D. An infant's tongue is proportionately larger than an adult's.
D
Which of the following is an indication of imminent birth? Choose one answer. A. expulsion of the mucus plug from the vagina B. rupture of the amniotic sac C. irregular contractions lasting 10 minutes D. crowning of the baby's head
D
Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding? Choose one answer. a. Finding out if the patient is currently sexually active b. Obtaining a thorough gynecological history c. Preventing infection d. Monitoring for hypovolemic shock
D
Which of the following statements regarding the aging process is correct?Choose one answer. A. Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. B. Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. C. The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver. D. Aging is a linear process; the rate at which a person loses functions does not increase with age.
D
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: Choose one answer. A. notify the receiving facility and advise them of the patient's weight and status. B. ask a member of your team to locate the best route to move him to the ambulance. C. perform a secondary assessment, focusing on his respiratory system and back. D. avoid placing him in a supine position if possible and administer oxygen.
D
You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose level is 450 mg/dL. She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: Choose one answer. A. acute renal failure with associated hyperglycemia. B. diabetic ketoacidosis. C. hyperglycemia with moderate dehydration. D. hyperosmolar hyperglycemic nonketotic coma (HHNC).
D
You are assessing a patient in active labor. One of your first decisions is whether to transport or prepare for delivery. In which of the following situations should the patient be transported immediately? Choose one answer. a. The infant's arm is the presenting part b. The mother experiences a severe, tearing sensation in her abdomen during labor and the outline of the fetus can be felt through the abdominal wall c. Delivery is not imminent and there is about 500 cc of painless, bright red bleeding d. All of the above
D
You are assessing the pediatric patient with respiratory distress who is having labored breathing with accessory muscle use. You should remember that: Choose one answer. a. because they are young, the pediatric patient will compensate longer. b. oxygen delivery will be sufficient as they compensate. c. the patient will not need intubation until apneic. d. the muscles will tire more easily in the pediatric patient.
D
You are at a private residence assessing a 1-year-old patient. The mother states she called an ambulance because her daughter was having a seizure. The child has been ill for the past two days. The patient is very warm to the touch and is not responding appropriately for her age. Your treatment should include: Choose one answer. a. Sponging the child's back and arms with rubbing alcohol. b. Giving the patient ice chips to suck. c. Placing ice packs in the armpits, groin and around the head. d. Removing the child's clothing down to underpants or diaper.
D
You are caring for an 8-month-old boy who is unresponsive after choking on a piece of hard candy he managed to find. As you look into his mouth, you can see the candy in the back of his oropharynx. Your next action would be to: Choose one answer. a. Check the brachial pulse. b. Perform a blind finger sweep. c. Provide 5 abdominal thrusts. d. Attempt to retrieve and remove it.
D
You are dispatched to a private residence for a child who fell down some steps. Upon your arrival, you find the child crying in her mother's arms. Your physical exam reveals several contusions in various stages of healing and some red band-like marks on the patient's buttock and lower back. You should be suspicious that the: Choose one answer. a. House may have several hazards. b. Child may be very uncoordinated. c. Child is mentally impaired. d. Child may have been abused.
D
You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:Choose one answer. A. a family member regularly checks up on her. B. she takes medications for Alzheimer disease. C. she attempted to catch herself before falling. D. she became dizzy or fainted before falling.
D
You are on the scene of a possible SIDS patient. Though there is nothing you can do for this patient, the parents may be experiencing all of the following emotional states EXCEPT: Choose one answer. a. Anger. b. Denial. c. Guilt. d. Indifference.
D
You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next? Choose one answer. A. Clamp and cut the umbilical cord. B. Begin assisting the newborn's breathing. C. Allow the mother to hold her baby. D. Assess the brachial or umbilical pulse.
D
Your patient is a 5-year-old female who awoke with a harsh cough, sore throat, drooling, and high fever. She has shallow respirations of 40 and inspiratory stridor. She is completely focused on breathing, leaning forward on her outstretched arms. Which of the following is the best course of action? Choose one answer. a. Rapidly tranfer to the ambulance and begin to ventilate at a rate of 24 to 28 per minute. b. Inspect the hypopharynx for edema and be prepared for insertion of an OPA if airway obstruction is imminent. c. Provide high-flow oxygen by nonrebreathing mask and repeat a full set of vital signs every 5 minutes en route to the emergency department. d. Provide blow-by oxygen, humidified if possible; transport without delay and avoid procedures that might upset her.
D
