EMT Final Exam

The secondary assessment of a medical patient:

Is not practical is critically ill or your transport time is short.

What is a true statement regarding drowning?

Laryngospasm following submersion in water makes rescue breathing difficult

When pulling a patient, you should extend your arms no more than _______ in front of your torso.

15" to 20"

External bleeding from a vein is relatively easy to control because:

Veins are under a lower pressure

Law enforcement has summoned you to a nightclub, where a 22 year old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. What should you do?

Assist ventilations, perform a rapid exam, and prepare for immediate transport.

A 20 year old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. What should you do?

Assume that the arrow injured an internal organ

What situation requires you to notify the appropriate authorities?

Attempted suicide

The poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center is what?

Aware of the substance that is involved.

Pale skin in a child indicates what?

Blood vessels near the skin are constricted

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:

Checking the radial pulse and noting the color, temperature, and condition of his or her skin.

The most distal four spinal vertebrae, which are fused together, form what?

Coccyx

The chief component of connective tissues and bones that deteriorates as people age is called what?

Collagen

What would be an example of a primary prevention strategy?

Community awareness programs that emphasize the dangers of drinking and driving.

In contrast to a behavioral crisis, a psychiatric emergency occurs when a person does what?

Demonstrates agitation or violence or become a threat to himself, herself, or to others.

A common cause of depression in the elderly is due to an acute onset of dementia. True or False?

False

In what situation would external bleeding be most difficult to control?

Femoral artery laceration and a blood pressure of 140/90 mm Hg.

Peritonitis may result in shock because:

Fluid shifts from the blood stream into body tissues

What medication form does oral glucose come in?

Gel

During your primary assessment of a semiconscious 30 year old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in line stabilization of her head, you should do what?

Instruct him to assist her ventilations while you perform a rapid assessment.

Bleeding from the nose following head trauma is what?

It is a sign of a skull fracture and should not be stopped

What would be a correct statement regarding the IV administration set?

It moves fluid from the IV bag into the patients vascular system

A 43 year old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:

Pinching the patients nostrils and having him lean forward.

Shortly after assisting a 65 year old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. What should you do?

Place her supine and elevate her legs.

A 50 year old male presents with an altered mental status. His wife tells you that he had a "small stroke" 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should do what

Prepare for immediate transport.

When assessing a patient who experienced a blast injury, it is important to remember what?

Primary blast injuries are the most easily overlooked

CPR will NOT be effective if the patient is:

Prone

When removing a critically injured patient from his or her vehicle, you should do what?

Protect the cervical spine (c-spine) during the entire process

The ultimate goal in treating a patient who is experiencing an ST-segment elevation myocardial infarction (STEMI) is to:

Rapidly restore perfusion to the coronary arteries

A 6 year old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of the neck and facial cyanosis. In addition to the appropriate airway management, the intervention the will most likely improve her chance of survival is what?

Rapidly transporting her to the hospital

When assessing a patient with a hemothorax, you will MOST likely find:

Signs and symptoms of shock

What organs can tolerate inadequate perfusion for up to 2 hours?

Skeletal Muscle

As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden sharp pain in your lower back. What should you do?

Stop the move and request additional lifting assisstance

Hypovolemic shock occurs when:

The body cannot compensate for rapid blood loss.

What would most likely provide clues regarding the source of a patients allergic reaction?

The environment in which the patient was found

You arrive at the home of a 50 year old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

The patient is at risk for vomiting and aspiration.

The type and severity of wounds sustained from incendiary and explosive devices primarily depend on what?

The patients distance from the epicenter of the explosion

What is a correct statement regarding secondary assessment?

The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

Basic life support (BLS) is defined as:

noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.

An infectious disease is MOST accurately described as:

A medical condition caused by growth and spread of small harmful organisms within the body.

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called what?

A shunt

The cervical spine is composed of ____ vertebrae.

7

The average pulse rate of individuals between 19 and 60 years of age is typically:

70 beats/min

What MOST accurately portrays emergency medical services (EMS)?

A team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means what the patient has:

Abnormal breath sounds.

Clinical signs of compensated shock include all of the following except:

Absent peripheral pulses.

Elderly patients with abdominal problems may not exhibit the same pain response as younger patients because of:

Age related deterioration of their sensory systems

In what area of the lungs does respiration occur?

Alveoli

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. What should you do?

Apply direct pressure above and below the wound

If gastric distention is interfering with your ability to adequately ventilate a patient, you may have to:

Apply manual pressure to the abdomen.

With regard to musculoskeletal injuries, the zone of injury is defined as what?

Area of soft tissue damage surrounding the injury

Poor peripheral circulation will cause the skin to appear:

Ashen

A 38 year old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thread pulse. She has a red rash on her entire body and her face is very swollen. What should you do?

Assist her ventilations with 100% oxygen.

You are dispatched to a local nursery for a 39 year old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include what?

Assisted ventilation with a bag mask

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the most appropriate treatment for this patient includes:

Assisted ventilation, thermal management, and elevation of the lower extremities

When relaying patient information via radio, communications should be:

Brief and easily understood

What best describes septic shock?

Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation.

When assessing a patient with signs and symptoms of shock, it is most important to remember that:

Blood pressure may be the last measureable factor to change in shock.

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:

Carbon dioxide

The 5 sections of the spinal column, in descending order, are the:

Cervical, thoracic, lumbar, sacral, and coccygeal.

A 39 year old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. What should you do?

Control the bleeding with direct pressure.

The myocardium receives oxygenated blood from the____, which originates from the ______.

Coronary arteries, aorta

A burn that is characterized by redness and pain is classified as what?

First degree burn

Putrefaction is defined as what?

Decomposition of the body's tissues

After the patients airway is intubated during two-rescuer CPR, what should you do?

Deliver one rescue breath every 6 to 8 seconds.

What is a true statement regarding anaphylactic shock?

Each subsequent exposure following sensitization often produces a more severe reaction.

Breathing is often more labor intensive in older adults because the:

Elasticity of the lungs decreases

Communicating with hearing impaired patients can be facilitated by doing all of the following, EXCEPT:

Elevating the tone of your voice and exaggerating word pronunciation.

Prior to defibrillating a patient with an AED, it is most important that you:

Ensure that no one is touching the patient.

As the first arriving senior EMT at the scene of an incident, you should perform a scene size up and then what?

Establish command

In contrast to the assessment of a trauma patient, assessment of a medical patient is what?

Focused on the nature of illness (NOI), the patients chief complaint, and his or her symptoms.

You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher what?

If there is law enforcement at the scene

You respond to a residence for a 40 year old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, what should you do?

Immediately request ALS support

A tight fitting motorcycle helmet should be left in place unless what?

It interferes with your assessment of the airway

A 40 year old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. What should you suspect?

Liver dysfunction

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patients vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patients presentation, you should suspect what?

Lyme disease

When assessing the interior of a crashed motor vehicle for damage, you are gathering information regarding what?

Mechanism of injury

Each cell of the body combines nutrients an oxygen and produces energy and waste products through a process called what?

Metabolism

After establishing that an adult patient is unresponsive, you should do what?

Open the airway

In order for efficient pulmonary gas exchange to occur:

Oxygen and carbon dioxide must be able to freely diffuse across the alveolar capillary membrane.

A 60 year old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. What treatment modalities is most appropriate for this patient?

Oxygen via nonrebreathing mask and a focused secondary assessment.

Burns to pediatric patients are generally considered more serious than burns to adults, why?

Pediatric patients have more surface are relative to total body mass

When arriving at the scene of an overturned tractor-trailer rig, you not that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but is bleeding profusely from the head. After notifying the hazardous materials team, you should do what?

Position the ambulance upwind

A palpable pulse is created by what?

Pressure waves through the arteries caused by cardiac contraction.

In MOST cases, cardiopulmonary arrest in infants and children is caused by:

Respiratory arrest

A 38 year old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his home. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things. He has several lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to do what?

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

What structure does not contain smooth muscle?

Skeletal system

The primary route of exposure of vesicant agents is what?

Skin

When immobilizing an injured child in a pediatric immobilization device, you should do what?

Secure the torso before the head

During your rapid secondary assessment of a 30 year old male who fell 25', you note crepitus when palpating his pelvis. Your partner advises you that the patients blood pressure is 80/50 mm Hg and his heart rate is 120 beats/min and weak. After completing your assessment, what should you do?

Stabilize the pelvis with a pelvic binder and protect the spine

What clinical sign is MOST suggestive of a ruptured cerebral artery?

Sudden, severe headache

A 42 year old male is found unresponsive on his couch by his neighbor. During your assessment, you find no signs of trauma and the patients blood glucose level is 75 mg/dL. His blood pressure is 168/98mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states that he has hemophilia. What should you do?

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

Insulin shock will most likely develop if a patient does what?

Takes too much of his/her prescribed insulin

The reference used as a base for your initial actions at a HazMat incident is/are what?

The Emergency Response Guidebook

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer, can be what?

They may be relatively painless

When a patients respirations are shallow:

Tidal volume is markedly reduced

You receive a call to a residence for a apneic 2 month old male. When you arrive at the scene, the infants mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and adequate tidal depth. His oxygen saturation reads 98% on room air. What should you do?

Transport the infant to the hospital and bring the apnea monitor with you.

True or False. Painful urination is a common sign of gonorrhea in men and women.

True

The reasons for rescue failure can be referred to by the mnemonic FAILURE. According to this mnemonic, the "u" stands for what?

Underestimating the logistics of the incident

The main objective of traffic control at the scene of a motor vehicle crash is to what?

Warn oncoming traffic and prevent another crash

The nasal cannula is MOST appropriately used in this prehospital setting:

When the patient cannot tolerate nonrebreathing mask