EMT Exam 2

The primary reason for applying a sterile dressing to an open injury is to: A) prevent contamination. B) control external bleeding. C) reduce the risk of infection. D) minimize any internal bleeding.

Answer: B Rationale: Although prevention of contamination is an important reason for applying a sterile dressing to an open injury, the primary reason is to control the external bleeding associated with it.

A 20-year-old man was kicked numerous times in the abdomen during an assault. His abdomen is rigid and tender, his heart rate is 120 beats/min, and his respirations are 30 breaths/min. You should treat this patient for: A) a lacerated liver. B) a ruptured spleen. C) respiratory failure. D) hypovolemic shock.

Answer: D Rationale: The patient may have a liver laceration or ruptured spleen—both of which can cause internal blood loss. However, it is far more important to recognize that the patient is in hypovolemic shock and to treat him accordingly.

Which of the following is NOT a component of the cardiovascular system? A) Heart B) Lungs C)Venules D) Plasma

B) Lungs

Which of the following sets of vital signs is LEAST indicative of internal bleeding? A) BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min B) BP, 100/50 mm Hg; pulse rate, 120 beats/min; respirations, 24 breaths/min C) BP, 98/60 mm Hg; pulse rate, 110 beats/min; respirations, 28 breaths/min D)BP, 102/48 mm Hg; pulse rate, 100 beats/min; respirations, 22 breaths/mi

A) BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min Rationale: Internal hemorrhage typically reveals vital signs that are consistent with shock: hypotension, tachycardia, and tachypnea. Hypertension, bradycardia, and bradypnea (choice "A") is consistent with a closed head injury, not internal bleeding

All of the following are potential causes of impaired tissue perfusion, EXCEPT: A) increased number of red blood cells. B) pump failure. C) low fluid volume. D) poor vessel function.

Answer: A Rationale: An increased number of red blood cells would allow adequate oxygen and nutrients to be delivered to the cells.

A 22-year-old male was attacked by a rival gang and has a large knife impaled in the center of his chest. Your assessment reveals that he is apneic and pulseless. You should: A) carefully remove the knife, control any bleeding, begin CPR, and transport. B) stabilize the knife in place, provide rescue breathing, and transport at once. C) remove the knife and control any bleeding, apply the AED, and analyze his rhythm. D) begin CPR, control any external bleeding, and transport rapidly to a trauma center.

Answer: A Rationale: As a rule, impaled objects should be stabilized in place. However, if they interfere with the patient's breathing or your ability to perform CPR, they should be removed. You cannot perform CPR on a patient if a knife is impaled in the center of the chest. Carefully remove the knife, control any bleeding, begin CPR, and transport at once. The AED is not indicated for patients with traumatic cardiac arrest; their arrest is usually caused by massive blood loss, not a primary cardiac dysrhythmia.

If an injury distracts an EMT from assessing a more serious underlying illness, the EMT has suffered from: A) tunnel vision. B) index of suspicion. C) virulence. D) a trauma emergency.

Answer: A Rationale: As an EMT, you should use the dispatch information to guide your initial response, but do not get locked into a preconceived idea of the patient's condition strictly from what the dispatcher tells you. Tunnel vision occurs when you become focused on one aspect of the patient's condition and exclude all others, which may cause you to miss an important injury or illness.

Bronchospasm is MOST often associated with: asthma. bronchitis. pneumonia. pneumothorax.

Answer: A Rationale: Asthma—a reactive airway disease—is caused by bronchospasm (sustained constriction of the bronchioles). Common triggers to an acute asthma attack include environmental allergens, stress, and temperature changes.

All of the following are common signs and symptoms of cardiac ischemia, EXCEPT: headache. chest pressure. shortness of breath. anxiety or restlessness.

Answer: A Rationale: Cardiac ischemia occurs when the heart's demand for oxygen exceeds the available supply. Common signs and symptoms of cardiac ischemia include chest pain or discomfort, shortness of breath (dyspnea), and anxiety or restlessness. Headache is not a common symptom of cardiac ischemia.

A 56-year-old man experienced a sudden, severe headache and then became unresponsive. He has a history of high blood pressure. The MOST likely cause of his condition is a(n): hemorrhagic stroke. acute ischemic stroke. severe migraine headache. transient ischemic attack

Answer: A Rationale: Hemorrhagic strokes are typically preceded by a sudden, severe headache (signals the rupture of a cerebral artery), after which the patient becomes unresponsive due to bleeding within the brain. Ischemic strokes and transient ischemic attacks generally do not cause a sudden, severe headache, and migraine headaches typically do not cause a loss of consciousness.

A 45-year-old convenience store clerk was shot in the right anterior chest during a robbery. Your assessment reveals that the wound has blood bubbling from it every time the patient breathes. Your MOST immediate action should be to: A) prevent air from entering the wound. B) cover the wound with a bulky dressing. C) assess the patient's back for an exit wound. D) transport the patient promptly to the closest trauma center.

Answer: A Rationale: Immediate treatment for a sucking chest wound (open pneumothorax) involves covering the wound with an occlusive dressing. This will prevent air from being drawn into the chest cavity. After covering the wound, assess for an exit wound, apply high-flow oxygen (if not already done), and transport promptly.

An unrestrained driver collided with a bridge pillar. Upon inspection of the interior of his vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you will MOST likely encounter: A) trauma to the pelvis. B) blunt abdominal trauma. C) a severe closed head injury. D) penetrating thoracic trauma.

Answer: A Rationale: Impact points are often obvious from a quick inspection of the vehicle's interior. During a frontal collision, the unrestrained occupant's knees often impact the lower dashboard. With this type of impact, energy is transferred from the knees to the femurs, and then to the pelvis or hip.

A 60-year-old woman presents with a BP of 80/60 mm Hg, a pulse rate of 110 beats/min, mottled skin, and a temperature of 103.9°F. She is MOST likely experiencing: A) septic shock. B) neurogenic shock. C) profound heart failure. D) a severe viral infection.

Answer: A Rationale: In septic shock, bacterial toxins damage the blood vessel walls, causing them to leak and rendering them unable to constrict. Widespread dilation of the vessels, in combination with plasma loss through the injured vessel walls, results in shock. A high fever commonly accompanies a bacterial infection.

Nitroglycerin is contraindicated in patients: with a systolic blood pressure less than 100 mm Hg. with chest pain of greater than 30 minutes duration. who are currently taking antibiotics for an infection. who are younger than 40 years of age and have diabetes.

Answer: A Rationale: Nitroglycerin is a vasodilator and may cause a drop in BP; therefore, it is contraindicated in patients with a systolic BP of less than 100 mm Hg and in patients who have taken erectile dysfunction (ED) drugs within the past 24 to 48 hours. ED drugs are also vasodilators; if given in combination with nitroglycerin, severe hypotension may occur.

Which of the following patients is the BEST candidate for oral glucose? A) Conscious patient who is showing signs of hypoglycemia B) Unconscious diabetic patient with a documented low blood sugar C) Conscious diabetic patient suspected of being hyperglycemic D) Semiconscious patient with signs and symptoms of low blood sugar

Answer: A Rationale: Oral glucose is given to diabetic patients with suspected or documented hypoglycemia (low blood sugar). It should not be given to unconscious patients or those who are otherwise unable to swallow because it may be aspirated into the lungs.

The process in which oxygen and carbon dioxide are exchanged in the lungs is called: a) respiration. b) ventilation. c) metabolism. d) inhalation.

Answer: A Rationale: Respiration is defined as the exchange of gases between the body and its environment. The exchange of oxygen and carbon dioxide in the lungs is called pulmonary (external) respiration. The exchange of oxygen and carbon dioxide at the cellular level is called cellular (internal) respiration.

A 70-year-old man is experiencing a severe nosebleed. When you arrive, you find him leaning over a basin, which contains an impressive amount of blood. He has a history of coronary artery disease, diabetes, and migraine headaches. His BP is 180/100 and his heart rate is 100 beats/min. Which of the following is the MOST likely contributing factor to his nosebleed? A) His blood pressure B) His history of diabetes C) The fact that he is elderly D) His heart rate of 100 beats/min

Answer: A Rationale: Several conditions can cause a nosebleed (epistaxis), including skull fractures, facial injuries, sinusitis (inflamed sinuses), high blood pressure, coagulation disorders (ie, hemophilia), and digital trauma (ie, nose picking). A BP of 180/100 indicates a significant amount of pressure on the arteries, which is no doubt the main contributing factor to this patient's nosebleed.

Your patient opens his eyes when you say his name, is making incomprehensible sounds, and withdraws when you pinch his earlobe. What is his GCS score? 9 8 11 12

Answer: A Rationale: The Glasgow Coma Scale gives a score of 3 to a patient who opens his or her eyes in response to speech. "Incomprehensible sounds" has a score of 2, and "withdraws to pain" has a score of 4. When added together, this patient's GCS score is 9.

When assessing a patient with an infectious disease, what is the first action you should perform? A) Size up the scene and take standard precautions. B) Obtain a SAMPLE history. C) Hand the patient off to a paramedic. D) Cover your mouth and nose with your hand

Answer: A Rationale: The assessment of a patient suspected to have an infectious disease should be approached much like any other medical patient. First, the scene must be sized up and standard precautions taken. Always show respect for the feelings of the patient, family members, and others at the scene.

A 41-year-old man presents with slow, irregular breathing; hypotension; and dilated pupils. These signs MOST likely indicate dysfunction of the: brain stem. hypothalamus. cerebrum. cerebellum.

Answer: A Rationale: The brain stem is responsible for functions such as breathing, blood pressure, and pupil constriction. Brain stem dysfunction would result in abnormal findings with these functions.

When administered to a patient, a metered-dose inhaler will: A) deliver the same dose each time it is administered. B) be ineffective when given to patients with asthma. C) deliver a different dose each time it is administered. D) be delivered to the lungs over a period of 6 to 8 hours.

Answer: A Rationale: The metered-dose inhaler (MDI) delivers the same dose of medication each time it is used. Drugs given via the MDI act very quickly and are commonly prescribed to patients with asthma, emphysema, and other airway diseases.

A 33-year-old woman presents with a generalized rash, facial swelling, and hypotension approximately 10 minutes after being stung by a hornet. Her BP is 70/50 mm Hg and her heart rate is 120 beats/min. In addition to high-flow oxygen, this patient is in MOST immediate need of: A) epinephrine. B) rapid transport. C) an antihistamine. D) IV fluids.

Answer: A Rationale: This patient is in anaphylactic shock—a life-threatening overexaggeration of the immune system that results in bronchoconstriction and hypotension. After ensuring adequate oxygenation and ventilation, the MOST important treatment for the patient is epinephrine, which dilates the bronchioles and constricts the vasculature, thus improving breathing and blood pressure, respectively.

Which of the following diseases is potentially drug resistant and is thought to be transmitted by coughing? Tuberculosis Croup Diphtheria Epiglottitis

Answer: A Rationale: Tuberculosis is a bacterial infection spread by cough. It is dangerous because many strains are resistant to antibiotics.

Anaphylactic shock is typically associated with: A) urticaria. B) bradycardia. C) localized welts. D) a severe headache.

Answer: A Rationale: Urticaria (hives) is typically associated with allergic reactions—mild, moderate, and severe. They are caused by the release of histamines from the immune system. In anaphylactic shock, urticaria is also accompanied by cool, clammy skin; tachycardia; severe respiratory distress; and hypotension.

Whiplash injuries are MOST common following _________ impacts. A rear-end B) rollover C) frontal D) lateral

Answer: A Rationale: Whiplash injuries of the neck are a common occurrence following rear-end collisions. As the vehicle is suddenly thrust forward, the occupant's head is thrust backward. Properly positioned headrests can minimize the severity of whiplash injuries.

A young male was struck in the forearm with a baseball and complains of pain to the area. Slight swelling and ecchymosis are present, but no external bleeding. Which type of injury does this describe? A) Abrasion B) Contusion C) Hematoma D) Avulsion

Answer: B Rationale: A contusion (bruise) is caused by direct blunt force trauma. The epidermis remains intact, but small blood vessels in the dermis are injured. The depth of the injury varies, depending on the amount of energy absorbed. Pain and swelling occur as fluid and blood leak into the damaged area. The buildup of blood produces a characteristic blue and black discoloration called ecchymosis.

Which of the following patients is breathing adequately? 36-year-old man with cyanosis around the lips and irregular respirations 29-year old woman with respirations of 20 breaths/min, who is conscious and alert 22-year-old man with labored respirations at a rate of 28 breaths/min and pale skin 59-year-old woman with difficulty breathing, whose respirations are rapid and shallow

Answer: B Rationale: Adequate breathing in the adult is characterized by a respiratory rate between 12 and 20 breaths/min, good chest rise (indicates adequate tidal volume), unlabored breathing effort, nonaltered mental status, and good perfusion to the skin (ie, pink, warm, dry).

A 59-year-old woman presents with chest pressure. She is conscious and alert, but her skin is cool, pale, and clammy. Your first step in providing care (treatment) should be: apply the AED. administer oxygen. ask her if she takes nitroglycerin. take a complete set of vital signs.

Answer: B Rationale: Any patient with suspected cardiac compromise should be given oxygen as soon as possible. Obtaining vital signs and inquiring about the use of nitroglycerin are appropriate; however, you should administer oxygen first. The AED is only applied to patients in cardiac arrest.

A 70-year-old man recently had a heart attack and now complains of severe difficulty breathing, especially when lying flat. He is coughing up pink, frothy secretions. This patient is MOST likely experiencing: acute right heart failure. severe left heart failure. an acute onset of bronchitis. an acute pulmonary embolism.

Answer: B Rationale: As a result of his recent heart attack, the left side of this patient's heart has been severely damaged. The left side of the heart is responsible for pumping oxygenated blood to the rest of the body. When it fails to do this, blood backs up into the lungs, resulting in pulmonary edema. Signs of pulmonary edema include dyspnea (especially when lying flat); rapid and shallow respirations; and, in severe cases, coughing up of pink, frothy sputum.

Which of the following respiratory diseases causes obstruction of the lower airway? Croup Asthma Epiglottitis Laryngitis

Answer: B Rationale: Asthma is a lower airway disease that causes the bronchioles in the lungs to constrict (bronchospasm), resulting in various degrees of obstruction. Croup, epiglottitis, and laryngitis cause swelling, inflammation, and varying degrees of obstruction of the upper airway.

Which of the following routes of medication administration has the fastest effect? Oral Intravenous Subcutaneous Intramuscular

Answer: B Rationale: Because its administration is directly into a vein, a drug given intravenously enters the body quickly. The intravenous route is the fastest acting of all the routes of medication administration.

A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of his vehicle, you would MOST likely find: A) deployed airbags. B) steering wheel deformity. C) starring of the windshield. D) a crushed instrument panel.

Answer: B Rationale: Blunt chest injuries during a motor vehicle crash typically occur when the chest impacts the steering wheel. Therefore, your inspection of the vehicle's interior will most likely reveal a deformed steering wheel.

Controlling internal bleeding requires: A) applying a tourniquet. B) surgery in a hospital. C) positioning the patient in the sitting position. D) providing slow and considerate transport.

Answer: B Rationale: Controlling internal bleeding usually requires surgery that must be done in the hospital. To care for the patient in the field, administer high-flow oxygen and assist ventilations, if needed; control all obvious external bleeding; monitor and record the vital signs every 5 minutes; place the nontrauma patient in a shock position; keep the patient warm; and provide immediate transport.

The quickest and MOST effective way to control external bleeding from an extremity is: A) a pressure bandage. B) direct pressure and elevation. C) a splint. D) a tourniquet.

Answer: B Rationale: Direct pressure is the quickest, most effective way to control external bleeding from an extremity. This will effectively control external bleeding in most cases.

All of the following are causes of acute dyspnea, EXCEPT: asthma. emphysema. pneumothorax. pulmonary embolism.

Answer: B Rationale: Emphysema—a form of COPD—is a chronic respiratory disease; therefore, it presents with progressively worsening dyspnea. Asthma, pulmonary embolism, and pneumothorax are all acute conditions; therefore, they typically present with an acute onset of dyspnea.

The MOST important reason for promptly transporting a stroke patient to the hospital is: a transient ischemic attack can be ruled out. medications may be given to reverse the stroke. the clot in the coronary artery may be dissolved. he or she needs close blood pressure monitoring.

Answer: B Rationale: Fibrinolytic medications (clot busters) have been shown to reverse the symptoms of a stroke by dissolving the clot that is blocking the cerebral artery. However, for the patient to be eligible for this therapy, it must be initiated within 3 hours after the onset of symptoms. For this reason, prompt transport of the stroke patient is critical.

What should you do if you are exposed to a patient who is found to have pulmonary tuberculosis? A) Get the BCG vaccine. B) Get a tuberculin skin test. C) Undergo serious therapy. D) No precautions need to be taken.

Answer: B Rationale: If you are exposed to a patient who is found to have pulmonary tuberculosis, you will be given a tuberculin skin test. This simple skin test determines whether a person has been infected with M. tuberculosis.

When applying a tourniquet to an amputated arm, the EMT should: A) use the narrowest bandage possible. B) avoid applying the tourniquet over a joint. C) cover the tourniquet with a sterile bandage. D) use rope to ensure that the tourniquet is tight.

Answer: B Rationale: If you must apply a tourniquet, never apply it directly over a joint. You should use the widest bandage possible and make sure it is secured tightly. Never use wire, rope, a belt, or any other narrow material, as it could cut the skin. The tourniquet should never be covered with a bandage. Leave it open and in full view.

Kinetic energy is a calculation of: A) weight and size. B) weight and speed. C) mass and weight. D) speed and force.

Answer: B Rationale: Kinetic energy is a calculation of mass (weight) and velocity (speed). Energy cannot be destroyed, only converted.

When caring for a patient with severe epistaxis, the MOST effective way to prevent aspiration of blood is to: A) insert a nasopharyngeal airway and lean the patient back. B) tilt the patient's head forward while he or she is leaning forward. C) place the patient supine with his or her head in the flexed position. D) tilt the patient's head forward while he or she is leaning backward.

Answer: B Rationale: Leaning forward, with the head tilted forward, will stop blood from trickling down the throat. This decreases the risk that the patient will swallow the blood, which may cause vomiting, or aspirating the blood into the lungs.

You are managing a 62-year-old woman who complains of crushing chest pain. Her blood pressure is 84/64 mm Hg and her heart rate is 110 beats/min. Medical control advises you to assist her in taking her prescribed nitroglycerin. After receiving this order, you should: A) reassess the patient's heart rate and then assist with the nitroglycerin. B) repeat the patient's blood pressure to the physician and confirm the order. C) wait 10 minutes, reassess the blood pressure, and then give the nitroglycerin. D) administer the nitroglycerin to the patient and then reassess her blood pressure.

Answer: B Rationale: Nitroglycerin is a vasodilator and lowers blood pressure (BP); therefore, it should not be given to patients with a systolic BP less than 100 mm Hg. If you receive an order to give nitroglycerin to a patient with a systolic BP less than 100 mm Hg, you should ensure that the physician is aware of the patient's BP, then reconfirm the order

Your patient is having respiratory difficulty and is not responding to your treatment. What is the best method of transport? A) Without lights and sirens, to the closest hospital B) With lights and sirens, to the closest hospital C) Air transport, to a special facility located 30 miles away D) The patient does not need to be transported

Answer: B Rationale: Patients with respiratory difficulty generally require high-priority transport, especially if they do not respond to your initial treatment. If a life-threatening condition exists, the transportation should include lights and sirens. In this case, it is appropriate to select the closest hospital with an emergency department as your destination.

Pharmacology is defined as the: A) study of cells and tissues. B) study of drugs and medications. C) effects of medications in the lungs. D) distribution of drugs to the body's tissues.

Answer: B Rationale: Pharmacology is the field of science that deals with the study of drugs and medications.

Unlike an ischemic stroke, a transient ischemic attack is characterized by all of the following, EXCEPT: symptoms that resolve within 24 hours. symptoms that persist for longer than 24 hours. weakness or paralysis to one side of the body. an acute onset of confusion and slurred speech.

Answer: B Rationale: Signs and symptoms of a transient ischemic attack (TIA) are usually identical to those of an acute ischemic stroke (eg, hemiparesis, slurred speech, confusion, facial droop). Unlike the ischemic stroke, however, the symptoms of a TIA usually resolve within 24 hours.

A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition? Coronary veins Coronary arteries Pulmonary veins Pulmonary arteries

Answer: B Rationale: The coronary arteries, which branch off the aorta, supply the myocardium (heart muscle) with oxygen-rich blood. Occlusion of one or more of these arteries results in a cessation of oxygenated blood beyond the area of occlusion and results in acute myocardial infarction (AMI).

Epinephrine is given to patients with anaphylactic shock because of its effects of: A) bronchodilation and vasodilation. B) bronchodilation and vasoconstriction. C) vasodilation and bronchoconstriction. D) bronchoconstriction and vasoconstriction.

Answer: B Rationale: The two major complications associated with anaphylactic shock are bronchoconstriction, which impairs air move-ment in and out of the lungs, and vasodilation, which causes a drop in blood pressure. Epinephrine reverses these processes by causing bronchodilation and vasoconstriction, thereby improving breathing and increasing the blood pressure, respectively.

A 5-year-old boy was burned when he pulled a barbecue grill over on himself. He has partial- and full-thickness burns to his anterior chest and circumferentially on both arms. What percentage of his body surface area has been burned? A) 18% B) 27% C) 36% D) 45%

Answer: B Rationale: Using the pediatric rules of nines, the anterior chest accounts for 9% of the BSA (the entire anterior trunk, which includes the chest and abdomen, accounts for 18% of the BSA), and each arm accounts for 9% of the BSA. Therefore, this child has experienced 27% BSA burns.

The term "shock" is MOST accurately defined as: A) a decreased supply of oxygen to the brain. B) cardiovascular collapse leading to inadequate perfusion. C) decreased circulation of blood within the venous circulation. D) decreased function of the respiratory system leading to hypoxia.

Answer: B Response: Shock, or hypoperfusion, refers to a state of collapse and failure of the cardiovascular system, or any one of its components (eg, heart, vasculature, blood volume), which leads to inadequate perfusion of the body's cells and tissues.

Potential causes of cardiogenic shock include all of the following, EXCEPT: A) inadequate heart function. B) disease of muscle tissue. C) severe bacterial infection. D) impaired electrical system.

Answer: C Rationale: Cardiogenic shock is caused by inadequate function of the heart, or pump failure. Within certain limits, the heart can adapt to these problems. If too much muscular damage occurs, however, as sometimes happens after a heart attack, the heart no longer functions well. Other causes include disease, injury, and an impaired electrical system.

Your patient believes he has hepatitis and is now exhibiting signs of cirrhosis of the liver. He most likely has: A) hepatitis A. B) hepatitis B. C) hepatitis C. D) hepatitis D.

Answer: C Rationale: Cirrhosis of the liver develops in 50% of patients with chronic hepatitis C.

When treating a trauma patient who is in shock, LOWEST priority should be given to: A) spinal protection. B) thermal management. C) splinting fractures. D) notifying the hospital.

Answer: C Rationale: Critical interventions for a trauma patient in shock include spinal precautions, high-flow oxygen (or assisted ventilation), thermal management, rapid transport, and early notification of a trauma center. Splinting fractures should not be performed at the scene if the patient is critically injured; it takes too long and only delays transport.

Which of the following statements regarding chemical burns is FALSE? A) Most chemical burns are caused by strong acids or alkalis. B) Fumes of strong chemicals can cause burns to the respiratory tract. C) Prior to removing a dry chemical, you should flush the area with sterile water. D) You should not attempt to neutralize an acid burn with an alkaline chemical.

Answer: C Rationale: Dry chemicals should be brushed off the patient before irrigating the wound with sterile water or saline. Failure to do so may increase the burning process and cause further tissue damage.

Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is most often associated with which type of motorcycle impact? A) Head-on collision B) Angular collision C) Ejection D) Controlled crash

Answer: C Rationale: During an ejection, the rider will travel at high speed until stopped by a stationary object, another vehicle, or road drag. Severe abrasion injuries (road rash) down to bone can occur with drag.

An acute bacterial infection that results in swelling of the flap that covers the larynx during swallowing is called: croup. laryngitis. epiglottitis. diphtheria.

Answer: C Rationale: Epiglottitis—a potentially life-threatening illness—is an acute bacterial infection that causes swelling of the epiglottis (the flap the covers the larynx during swallowing). It is characterized by a sudden onset of high fever, difficulty breathing, stridor, drooling, and varying degrees of hypoxemia.

A patient with neurogenic shock would be LEAST likely to present with: A) tachypnea. B) hypotension. C) tachycardia. D) altered mentation.

Answer: C Rationale: In neurogenic shock, the nerves that control the sympathetic nervous system are compromised. The nervous system is responsible for secreting the hormones epinephrine and norepinephrine, which increase the patient's heart rate, constrict the peripheral vasculature, and shunt blood to the body's vital organs. Without the release of these hormones, the compensatory effects of tachycardia and peripheral vasoconstriction are absent.

A seizure patient is having what kind of medical emergency? A) Respiratory B) Cardiovascular C) Neurologic D) Immunologic

Answer: C Rationale: Neurologic emergencies involve the brain and may be caused by a seizure, stroke, or fainting (syncope).

A 40-year-old man was standing near a building when it exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury was MOST likely caused by ___________ blast injuries. A) primary B) secondary C) tertiary D) quaternary

Answer: C Rationale: Primary blast injuries are caused by the pressure wave and include ruptured eardrums and hollow organ rupture. Secondary blast injuries are caused by flying debris and include impaled objects and shrapnel injuries. Tertiary blast injuries occur when the victim is thrown into a solid object, resulting in blunt trauma to virtually any part of the body. Quaternary blast injuries include other miscellaneous injuries.

A sudden onset of difficulty breathing, sharp chest pain, and cyanosis that persists despite supplemental oxygen is MOST consistent with: severe pneumonia. myocardial infarction. a pulmonary embolism. a spontaneous pneumothorax

Answer: C Rationale: Signs of an acute pulmonary embolism include a sudden onset of difficulty breathing, sharp (pleuritic) chest pain, and cyanosis that persists despite the administration of high-flow oxygen. Patients who are immobile for prolonged periods of time (eg, confined to a hospital bed) are prone to a pulmonary embolism.

A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if: CPR is initiated within 10 minutes. oxygen and rapid transport are provided. defibrillation is provided within 2 minutes. paramedics arrive at the scene within 5 minutes.

Answer: C Rationale: Survival from cardiac arrest secondary to ventricular fibrillation is highest if CPR is provided immediately and defibrillation is provided within 2 minutes of the patient's cardiac arrest. Early high-quality CPR and defibrillation are the two most important factors that influence survival from cardiac arrest.

A 20-year-old man has major open facial injuries after his vehicle struck a tree head-on. Which of the following findings within the car would MOST likely explain his injury pattern? A) Deployed airbag B) Bent steering wheel C) Nonintact windshield D) Crushed instrument panel

Answer: C Rationale: The mechanism of injury and condition of the vehicle's interior suggest likely areas of injury. Head and neck injuries are likely to result when the head and face impact the windshield.

Which of the following are components of the Cincinnati Prehospital Stroke Scale? Arm drift, blood pressure, speech Speech, pupil response, arm drift Facial symmetry, speech, arm drift Pupil response, facial droop, speech

Answer: C Rationale: The three components of the Cincinnati Prehospital Stroke Scale are facial symmetry, speech, and arm drift. Both sides of the patient's face should move symmetrically (equally) when he or she smiles. The patient's speech should be easily understandable and without slurring. The patient should be able to hold both arms out in front of his or her body—with eyes closed and palms up—without one arm drifting down to his or her side.

The MOST appropriate way to dress and bandage an open abdominal wound with a loop of bowel protruding from it is to: A) cover the wound with a dry, sterile dressing and apply firm pressure. B) apply a moist, sterile dressing to the wound and apply firm pressure. C) apply a moist, sterile dressing to the wound and secure with an occlusive dressing. D) carefully replace the protruding bowel into the abdomen and cover the wound.

Answer: C Rationale: Treatment for an abdominal evisceration includes applying a moist, sterile dressing to the wound and covering the moist dressing with an occlusive dressing. Do not replace a protruding bowel back into the wound or apply firm pressure, which may force the bowel back into the wound; these actions increase the risk of infection.

If a patient complains of a severe migraine, how should she be transported? In a brightly lit ambulance so she can see while her vision is impaired With loud sirens so she can get to the hospital as soon as possible Without lights and sirens This patient should not be transported.

Answer: C Rationale: Treatment of a migraine headache is supportive; however, you should always assess the patient for other signs and symptoms that might indicate a more serious condition. Applying high-flow oxygen, if tolerated, may help ease the patient's condition. When possible, provide a darkened and quiet environment because patients are sensitive to light and sound. Do not use lights and sirens during transport.

If a "frequent flier" calls 9-1-1 because of a suspected head injury, you should NEVER: A) take the call seriously; don't waste your time or resources on such a caller. B) perform a primary assessment; he called for a head injury last week, and it wasn't serious. C) assume you know what the problem is; every case is different, and you don't want to miss a potentially serious problem. D) treat the patient with respect; he is probably lying.

Answer: C Rationale: You are obligated as a medical professional to refrain from labeling patients and displaying personal biases. Never assume that you know what the problem is, even when you are treating patients who frequently call for EMS. This attitude could result in missing a serious condition.

Albuterol, a beta-2 agonist, is the generic name for: Alupent. Metaprel. Brethine. Ventolin.

Answer: D Rationale: Albuterol is the generic name for Ventolin (Proventil). Albuterol is a beta-agonist, which dilates the bronchioles, and is commonly used to treat patients with asthma and other reactive airway diseases.

While palpating the radial pulse of a 56-year-old man with chest pain, you note that the pulse rate is 86 beats/min and irregular. This indicates: pain. fear. anxiety. dysrhythmia

Answer: D Rationale: An irregular pulse in a patient with a cardiac problem suggests dysrhythmia — an abnormality in the heart's electrical conduction system. Patients with signs of cardiac compromise, who have an irregular pulse, must be monitored closely for cardiac arrest.

What effects will the application of an ice have on a hematoma? A) Vasodilation and increased pain B) Vasodilation and decreased bleeding C) Vasoconstriction and increased swelling D) Vasoconstriction and decreased bleeding

Answer: D Rationale: Applying an ice pack to a closed wound, such as a hematoma, will decrease bleeding, pain, and swelling by causing constriction of the blood vessels

A compression injury that is severe enough to cut off blood flow below the injury is called: A) a contusion. B) a hematoma. C) a local thrombus. D) compartment syndrome.

Answer: D Rationale: Compartment syndrome can occur when a part of the body has been compressed for a prolonged period of time—usually greater than 4 hours. The injured tissue begins to swell, which can impede arterial blood flow and venous return. As a result, the part of the body distal to the compression site becomes hypoxic and metabolic waste products (ie, lactic acid) begin to accumulate.

Which of the following would MOST likely result from the third collision in the "three-collision" effect that occurs during a high-speed, frontal impact motor vehicle crash? A) Extensive damage to the automobile B) Flail chest and lower extremity fractures C) Massive external trauma with severe bleeding D) Aortic rupture or compression injury to the brain

Answer: D Rationale: During the third collision, the body's internal organs collide with the inside of the body. These injuries are usually not as obvious, but are often the most life-threatening. Injuries that may result from this include internal injuries of the brain (compression injuries) and aortic tears, resulting in massive internal bleeding.

A patient with a suspected stroke presents with slurred speech that is difficult for you to understand. This is referred to as: aphasia. dysphasia. dysphagia. dysarthria.

Answer: D Rationale: Dysarthria is defined as slurred, poorly articulated speech; it is common in stroke patients. Dysphasia is defined as difficulty speaking; the patient's speech may or may not be slurred. Aphasia is the inability to speak. Dysphagia is defined as difficulty swallowing.

All of the following are factors that increase the risk for developing MRSA, EXCEPT: A) antibiotic therapy. B) prolonged hospital stays. C) exposure to an infected patient. D) close contact with wild birds.

Answer: D Rationale: Factors that increase the risk for developing MRSA include antibiotic therapy, prolonged hospital stays, a stay in intensive care or a burn unit, and exposure to an infected patient. Close contact with wild birds is a factor that may increase the risk of acquiring avian flu.

A type of seizure that is characterized by severe twitching of all the body's muscles and lasts for several minutes or longer is called a(n): partial seizure. absence seizure. tonic-clonic seizure. generalized seizure.

Answer: D Rationale: Generalized seizures are characterized by generalized severe twitching of all of the body's muscles; they often last for several minutes or longer. An absence seizure is characterized by a blank stare; generalized muscle twitching is absent.

Signs of compensated shock include all of the following, EXCEPT: A) restlessness or anxiety. B) pale, cool, clammy skin. C) a feeling of impending doom. D) weak or absent peripheral pulses.

Answer: D Rationale: In compensated shock, the body is able to maintain perfusion to the vital organs of the body via the autonomic nervous system. Signs include pale, cool, clammy skin; restlessness or anxiety; a feeling of impending doom; and tachycardia. When the body's compensatory mechanism fails, the patient's blood pressure falls; weak or absent peripheral pulses indicates this.

If your medical patient is not in critical condition, how long should you spend on scene? A) 10 minutes or less B) 30 minutes C) 2 hours D) However long it takes to gather as much information as possible

Answer: D Rationale: In many cases, the time on scene may be longer for medical patients than for trauma patients. If the patient is not in critical condition, you should gather as much information as possible from the scene so that you can transmit that information to the physician at the emergency department.

Your patient is complaining of fever, headache, stiffness of the neck, and red blotches on his skin. He most likely has: A) tuberculosis. B) hepatitis B. C) SARS. D) meningitis.

Answer: D Rationale: Patients with meningitis will have signs and symptoms such as fever, headache, stiff neck, and altered mental status. Patients with meningococcal meningitis often have red blotches on their skin; however, many patients with forms of meningitis that are not contagious also have red blotches.

Death from a rollover motor vehicle crash is MOST often secondary to: A) crushing injuries. B) airbag-related trauma. C) multiple collisions to the interior of the car. D) ejection of the patient from the motor vehicle.

Answer: D Rationale: Rollover crashes are the most unpredictable with regard to injuries sustained by the patient. An unrestrained passenger may have struck multiple points within the vehicle. However, the most life-threatening event in a rollover is ejection or partial ejection of the patient from the vehicle.

Which of the following is considered a severe burn? A) Any full-thickness burn B) 20% partial-thickness burn C) 10% full-thickness burn with abrasions D) 5% full-thickness burn with a fracture

Answer: D Rationale: Severe burns include the following: full-thickness burns involving the hands, feet, face, airway, or genitalia; full-thickness burns covering more than 10% of the body's total surface area (BSA); partial-thickness burns covering more than 30% of the BSA; burns involving the respiratory tract (eg, smoke inhalation); burns complicated by fractures; and burns on patients younger than 5 years or older than 55 years that would otherwise be classified as "moderate" burns on younger adults.

An acute ischemic stroke is caused by: a ruptured cerebral artery. increased intracranial pressure. an acute rise in a person's blood pressure. a blocked cerebral artery.

Answer: D Rationale: There are two types of stroke—hemorrhagic and ischemic. A hemorrhagic stroke is caused by a ruptured cerebral artery (aneurysm), which causes bleeding within the brain and increased intracranial pressure. An ischemic stroke is caused by a blocked cerebral artery—either from a clot that grows locally (thrombus) or that travels to the brain from another part of the body (embolus).

When assessing a stab wound, it is important for the EMT to remember that: A) stabbings to an extremity are rarely associated with an exit wound. B) the majority of the internal trauma will be near the path of the knife. C) most stabbings are unintentional and cause less severe internal injury. D) more internal damage may be present than the external wound suggests.

Answer: D Rationale: With low-velocity penetrations, injuries are caused by sharp edges of the object moving through the body and are therefore close to the object's path. Weapons such as knives, however, may have been deliberately moved around internally, causing more internal damage than the external wound suggests.

Perfusion is MOST accurately defined as: A) the removal of adequate amounts of carbon dioxide during exhalation. B) the intake of adequate amounts of oxygen during the inhalation phase. C)circulation of blood within an organ with sufficient amounts of oxygen. D) the production of carbon dioxide, which accumulates at the cellular level.

C) circulation of blood within an organ with sufficient amounts of oxygen.

A man involved in a motorcycle crash has multiple abrasions and lacerations. Which of the following injuries has the HIGHEST treatment priority? A) Widespread abrasions to the back with pinkish ooze B) 3" laceration to the forehead with dark red, flowing blood C) Laceration to the forearm with obvious debris in the wound D) 1" laceration to the thigh with spurting, bright red blood

D) 1" laceration to the thigh with spurting, bright red blood

When caring for a patient with internal bleeding, the EMT must first: A) ensure a patent airway. B) obtain baseline vital signs. C) control any external bleeding. D) take appropriate standard precautions.

D) take appropriate standard precautions.