EMT FINAL PRACTICE TEST
Assessment of a newborn indicates that his heart rate is 120 beats per minute. How many points should he be awarded according to the Apgar scoring system? A. 2 B. 0 C. 3 D. 1
A. 2
A 19-year-old female patient with diabetes is unresponsive after drinking a large amount of alcohol and trying some "pills" that her friend provided. She has snoring respirations and an intact radial pulse. Emergency Medical Responders are maintaining her airway with a head-tilt, chin-lift maneuver, which has eliminated the snoring respirations. Vital signs are pulse, 116; respirations, 14 breaths/min; minimal chest wall motion with absent breath sounds in the bases; and SpO2, 92%. Advanced life support has been contacted for assistance. Your next action would be to: A. Administer oxygen through positive pressure ventilation B. Identify the pills that the patient took C. Attempt to contact the parents for permission to treat D. Determine the patient's blood glucose level
A. Administer oxygen through positive pressure ventilation
A 19-year-old female patient with diabetes is unresponsive after drinking a large amount of alcohol and trying some "pills" that her friend provided. She has snoring respirations and an intact radial pulse. Emergency Medical Responders are maintaining her airway with a head-tilt, chin-lift maneuver, which has eliminated the snoring respirations. Vital signs are pulse, 116; respirations, 14 breaths/min; minimal chest wall motion with absent breath sounds in the bases; and SpO2, 92%. Advanced life support has been contacted for assistance. Your next action would be to: A. Administer oxygen through positive pressure ventilation B. Identify the pills that the patient took C. Determine the patient's blood glucose level D. Attempt to contact the parents for permission to treat
A. Administer oxygen through positive pressure ventilation
The mother of a 5-year-old female patient states that her daughter has been "sick" with a sore throat and fever for several days. The mother became concerned tonight and called 911 because the child was "making funny noises" and could not breathe well. Your assessment reveals a lethargic, well-developed child sitting upright and with high-pitched tracheal noises when she breathes in. What should be the priority action for the EMT? A. Administering supplemental oxygen if indicated B. Placing an oropharyngeal airway C. Inspecting the airway with a tongue depressor D. Performing abdominal thrusts
A. Administering supplemental oxygen if indicated
You are called to a residence for a 19-year-old woman who had a grand mal seizure and is now postictal with sonorous respirations. Which of the following devices should you utilize FIRST if all of them could be inserted? A. An oropharyngeal airway B. A bite block C. A rigid-tip suction catheter D. A rescue airway such as the King or ETC
A. An oropharyngeal airway
While working to build a house, a construction worker was hit in the head by a 2-inch × 4-inch plank that slid from the roof and fell to the ground below. The patient has a sizable laceration to the left side of his face and is spitting and coughing blood. He also lost several teeth, two of which he is holding. Your initial action when caring for this patient would be to: A. Apply supplemental oxygen B. Apply an occlusive dressing to the laceration and preserve the teeth C. Obtain and preserve the teeth in a cup of saline, or wrapped in saline-soaked gauze D. Assess the ability of the patient to maintain his own airway
A. Apply supplemental oxygen
Which of these patients should the EMT recognize as having a potential occlusion of the upper airway? A. A 3-year-old male with a fever and swelling of the larynx B. A 45-year-old female with spasm of the bronchioles C. A 78-year-old female with a large mucus plug in her bronchi D. A 61-year-old male with a piece of fruit stuck in his trachea
A. A 3-year-old male with a fever and swelling of the larynx
You are by the side of an alert and oriented 56-year-old male patient who complains of generalized weakness and a pounding headache. His pulse is 104, respirations are 18 breaths/min, and blood pressure is 218/110 mmHg. He has a history of high blood pressure, for which he takes lisinopril. He states that he has not taken the Lisinopril for 2 weeks and hands you a container with the medication inside. You would: A. Continue treatment and transport the patient to the hospital B. Assist the patient in taking the lisinopril C. Ensure that it is the patient's medication and then administer it D. Contact medical direction to request an order for lisinopril administration by you
A. Continue treatment and transport the patient to the hospital
You are treating a 32-year-old male patient who struck a large tree with his car. On your arrival, law enforcement tells you that the patient was wandering around the accident scene. You locate the patient sitting on the ground next to his car, conscious and alert. He is unable to speak because of an avulsion of his left cheek, leaving a full-thickness section that was severed and is heavily bleeding, just below his zygomatic arch, flipped down onto his lower jaw. You also note that he is missing several of his now exposed teeth. Your partner immediately begins control of the patient's cervical spine, and you note that his respirations are 16 and easy and his radial pulse is 92. After the airway has been secured, what is your NEXT priority? A. Controlling the bleeding B. Immobilizing the spine C. Locating the missing teeth D. Applying high-flow oxygen
A. Controlling the bleeding
You are on the scene of a shooting. Your assessment reveals a 23-year-old male who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is actively bleeding. The second wound is to the left lateral chest and bubbles every time the patient exhales. What would your immediate and best action be? A. Cover the chest wound with a gloved hand B. Place direct pressure over the abdominal gunshot wound C. Place the patient on high-concentration oxygen with a nonrebreather face mask D. Obtain a sterile dressing and cover the chest wound
A. Cover the chest wound with a gloved hand
A patient fell 20 feet from a ladder, and is now confused and anxious. Which of these signs/symptoms suggests that the patient is in shock? A. Heart rate of 110 beats/min B. Deformity to the left arm C. Contusion to his head D. Constricted pupils
A. Heart rate of 110 beats/min
You are assisting a paramedic in the transport of a patient from a community hospital emergency department to a large medical center. The patient was diagnosed with an acute myocardial infarction and received fibrinolytic therapy in the ED. Currently, you are transporting the patient with the fibrinolytic medication infusing through an IV. In regard to the fibrinolytic therapy, you know that during this transport, you will need to closely monitor the patient for which complication? A. Internal bleeding B. Hypertension C. Hypoglycemia D. Respiratory arrest
A. Internal bleeding
Which of these is considered an early sign of inadequate breathing in children? A. Nasal flaring B. Barrel chest C. Crying D. Blue-gray skin
A. Nasal flaring
You have arrived on the scene of a 64-year-old patient with diabetes. He is supine in bed and exhibits snoring respirations. Family members state that they just tested his blood sugar and it is 25 mg/dL. What should be your immediate action? A. Open the airway with a manual technique B. Have the family recheck the blood sugar C. Determine what the patient has eaten D. Prepare and administer oral glucose
A. Open the airway with a manual technique
You have arrived on the scene of a 64-year-old patient with diabetes. He is supine in bed and exhibits snoring respirations. Family members state that they just tested his blood sugar and it is 25 mg/dL. What should be your immediate action? A. Open the airway with a manual technique B. Prepare and administer oral glucose C. Determine what the patient has eaten D. Have the family recheck the blood sugar
A. Open the airway with a manual technique
Which of these sequences best describes the path that oxygen must travel to get into the cells of the body? A. Oropharynx, larynx, trachea, carina, bronchioles B. Nasopharynx, oropharynx, carina, trachea, alveoli C. Pharynx, larynx, trachea, alveoli, bronchioles D. Nose, pharynx, esophagus, bronchi, alveoli
A. Oropharynx, larynx, trachea, carina, bronchioles
When monitoring a patient receiving oxygen through a nasal cannula, which of these observations warrants immediate intervention? A. Oxygen flow rate of 15 liters per minute B. Tubing positioned over the ears and under the chin C. Breathing normally with the nasal cannula in place D. Prongs in the nostrils curving posteriorly into the nose
A. Oxygen flow rate of 15 liters per minute
Assessment of a young girl who was hit by a car while riding her bike reveals her to be responsive to painful stimuli with flexion of the extremities; she is also in respiratory distress. There is marked deformity to her thoracic spine and bruising noted to her anterior chest and abdomen. She does not move her legs when a noxious stimulus is applied to the lower extremities. Manual cervical spine motion restriction is being maintained and a cervical collar has been applied by fire department EMRs. Given the critical nature of this patient, which action is most appropriate for her care? A. Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital B. Wait for family members to arrive and give consent for treatment prior to moving her to the stretcher for immediate transport C. Rapidly transfer her to the stretcher and secure her to the long board while en route to the hospital D. Transfer her to the long board already placed on the stretcher and secure with straps en route to the hospital
A. Quickly but carefully provide full spine motion restriction precautions on scene prior to rapid transport to the hospital
A 4-year-old female patient is having great difficulty breathing. She is responsive to verbal stimuli and has an open airway. Her respiratory rate is 40 breaths/min, and she has an SpO2 reading of 88%, which has dropped from 90% despite high-concentration oxygen through a pediatric nonrebreather mask. Her pulse is rapid, and her skin cool to the touch. As a knowledgeable EMT, you would recognize these findings as associated with which condition? A. Respiratory failure B. Respiratory distress C. Respiratory arrest D. Cardiopulmonary arrest
A. Respiratory failure
Which sign or symptom would reinforce the EMT's suspicion that a patient with a history of pancreatitis is having an exacerbation of the disease? A. Upper abdominal pain that radiates to the back B. Decreased heart rate and elevated blood pressure C. Right upper quadrant pain with referral to the right shoulder D. Nausea, vomiting, and diarrhea
A. Upper abdominal pain that radiates to the back
You are by the side of an unresponsive 6-month-old with a history of congenital heart disease. The patient's airway is patent, but he is not breathing. A heart rate of 24 beats per minute is noted, and cardiac compromise is witnessed. At this time, it is essential that you: A. start cardiopulmonary resuscitation. (Ventilation and Compressions) B. apply the AED with pediatric pads. C. place the patient on the stretcher for immediate and emergent transport. D. start positive pressure ventilation with high-concentration oxygen.
A. start cardiopulmonary resuscitation. (Ventilation and Compressions)
You have been called for a patient with a sickle cell crisis. In reviewing the pathophysiology of sickle cell anemia, you understand that the underlying problem is: A. there is abnormal hemoglobin formation and decreased ability to carry oxygen. B. there is a decreased amount of circulating RBCs that do not release O2. C. the number of white blood cells is abnormally elevated. D. the blood is thick and has difficulty circulating.
A. there is abnormal hemoglobin formation and decreased ability to carry oxygen.
The EMT shows she understands "Do Not Resuscitate" (DNR) orders and living wills when she states: A. "If the patient has a living will, it can legally be used as a substitute for a DNR order by the EMT as long as it is properly dated and signed." B. "A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart ceases to beat, whereas a living will pertains to long-term life support care and equipment." C. "If a patient has a valid DNR, the EMT should withhold all care and transport the patient to the hospital. If a living will is present, the EMT should do exactly what it says." D. "A living will is a form of DNR; only a living will states exactly how the patient wants to be resuscitated."
B. "A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart ceases to beat, whereas a living will pertains to long-term life support care and equipment."
The EMT shows that she understands the difference between classic angina and an acute myocardial infarction (MI) when she states: A. "Classic angina occurs when the heart rate becomes too fast; an acute MI is the result of coronary artery disease." B. "An acute myocardial infarction results in the death of cardiac tissue; classic angina does not." C. "Classic angina is not accompanied by other symptoms like shortness of breath; the chest pain with an acute MI is." D. "The pain in an acute MI is typically described as stabbing; the pain with classic angina is more pressure-like."
B. "An acute myocardial infarction results in the death of cardiac tissue; classic angina does not."
A construction worker complains of pain to both eyes after an extended period spent welding on a gas well. The light is bothering him, and he rates the pain as a 10/10. He states that this problem occurred once before and was caused by the intense light of his welding tool. The primary assessment reveals no deficits. The patient's vital signs are pulse, 80 beats/min; respirations, 14 breaths/min; blood pressure, 132/68 mmHg; and SpO2, 98%. Although the injury is very painful, his vision is not compromised. Which set of instructions indicates proper care of this patient? A. "We will need to flush the eyes with bicarbonate to stop the burning." B. "I do not think that we will need to provide supplemental oxygen." C. "Why don't we flush the eyes with the sterile saline on the ambulance?" D. "Applying direct pressure very gently to both eyes may provide pain relief."
B. "I do not think that we will need to provide supplemental oxygen."
A 44-year-old female patient states that she has a history of endometritis. The EMT would recognize that this patient has: A. Endometrial tissue that is growing outside of the uterus B. An infection of the endometrial lining C. Absence of a menstrual period D. An infection of the ovaries
B. An infection of the endometrial lining
A patient involved in a motor vehicle collision has critical injuries and must be removed from the car for care and transport to the hospital. Prior to removing the patient from the vehicle, what must be done? A. Completion of the primary assessment and vital signs B. Application of a cervical collar C. Application of a vest-type immobilization device D. Completion of the primary and secondary exam
B. Application of a cervical collar
You are assessing an elderly patient with a decreased level of consciousness. Your assessment reveals the patient to have a patent airway, labored respirations, and weak, rapid pulses. The skin is pale, cool, and cyanotic in the extremities. You also observe diaphoresis and a delayed capillary refill. Vital signs for this patient are heart rate, 136 beats/min; blood pressure, 66/40 mmHg; and respirations, 40 and shallow. Auscultation of the lungs reveals profound rales located throughout each lung. The patient's temperature is 99°F and there is obvious jugular vein distention and pedal edema. Additionally, family states that the patient has an extensive cardiac and diabetic history. Based on this information, you should suspect which kind of shock? A. Obstructive B. Cardiogenic C. Hypotensive D. Hypovolemic
B. Cardiogenic
A patient with a past medical history of angina is now complaining of chest discomfort. When assessing this patient, which sign or symptom should alert the EMT that the patient is probably experiencing an acute myocardial infarction and not an anginal attack? A. Pain radiates into the left arm B. Chest discomfort is not relieved by nitroglycerin C. The patient complains of mild shortness of breath D. The patient's skin is not diaphoretic
B. Chest discomfort is not relieved by nitroglycerin
You are on the scene of a shooting. Your assessment reveals a 23-year-old male who has been shot twice. The first wound is to the left lower quadrant of the abdomen and is actively bleeding. The second wound is to the left lateral chest and bubbles every time the patient exhales. What would your immediate and best action be? A. Place direct pressure over the abdominal gunshot wound B. Cover the chest wound with a gloved hand C. Place the patient on high-concentration oxygen with a nonrebreather face mask D. Obtain a sterile dressing and cover the chest wound
B. Cover the chest wound with a gloved hand
When administering albuterol to a patient with shortness of breath, the EMT realizes that the therapeutic effect of this medication is achieved by: A. Decreasing mucus production B. Dilating the small airways C. Opening the large airways D. Decreasing inflammation
B. Dilating the small airways
A 78-year-old male patient was found lying on his bathroom floor. Emergency Medical Responders report that the patient is unresponsive, with unequal pupils, and vital signs are as follows: pulse, 78; respirations, 20 breaths/min and snoring; blood pressure, 210/106 mmHg; SpO2, 99%. The EMRs have applied oxygen by nonrebreather mask, and also report that the patient has a hematoma on the back of his head. What should you do first? A. Lift the patient onto the stretcher for transport B. Ensure an open airway with a jaw-thrust maneuver C. Quickly apply a cervical collar D. Replace the nonrebreather mask with a nasal cannula
B. Ensure an open airway with a jaw-thrust maneuver
You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate front-end damage. The patient complains of some back pain, but is walking around after the crash and does not appear to be suffering from any neurologic deficits. Although he answers your questions appropriately, he keeps asking you, "What happened?" What is your initial action in caring for this patient? A. Obtain the patient's vital signs B. Initiate spine motion restriction precautions C. Look for injuries to the patient's head D. Perform the primary assessment
B. Initiate spine motion restriction precautions
When administering epinephrine to an infant or child, the EMT would place the injector at which site? A. Outer buttock B. Lateral thigh C. Hip muscle D. Upper arm
B. Lateral thigh
Which of the statements concerning trauma is most accurate? A. A "spider web" or "star" pattern of cracks on the windshield means the patient impacted the windshield with his head B. Multisystem trauma has a higher mortality rate than single-system injuries C. The mechanism of injury is the best predictor of patient outcome D. Falls are the leading cause of trauma deaths
B. Multisystem trauma has a higher mortality rate than single-system injuries
Which of these conditions would the EMT recognize as most likely signaling a neurologic deficit? A. Hypoglycemia B. Paralysis C. Constricted pupils D. Headache
B. Paralysis
You are securing a 4-year-old-boy on a long spine board during a spine motion restriction process. Which action would be appropriate when performing this intervention? A. Do not apply the chest strap across the thorax B. Place padding between his shoulders/back and the spine board C. Place a pillow or padding under the head to maintain normal spinal alignment D. Secure the chest and legs to the board after the head
B. Place padding between his shoulders/back and the spine board
What is a function of the skeletal system? A. Forming the vital organs of the body B. Producing blood cells C. Providing structure and points of attachment to blood vessels D. Protecting all of the abdominal organs
B. Producing blood cells
You have been called for a male patient experiencing a severe allergic reaction. The patient is very confused and having great difficulty breathing. He has an epinephrine auto-injector, but your service does not have protocols related to its use. Fortunately, in your EMT class, you learned about and passed a test on the use of an epinephrine auto-injector for allergic reactions. In this case, you should: A. Contact the physician prescribing the medication for permission to use the auto-injector B. Provide oxygen and respiratory support as needed, followed by immediate transport C. Assist the patient with his epinephrine using implied consent as justification D. Assist the patient with his epinephrine auto-injector and then contact medical control
B. Provide oxygen and respiratory support as needed, followed by immediate transport
A 61-year-old male fell off a roof. Your primary assessment findings include unresponsiveness, agonal breathing, and a slow and weak radial pulse. The patient's skin is cool and dry. Emergency Medical Responders are maintaining manual spine motion restriction procedures. What should you do immediately? A. Size and apply a cervical collar B. Start positive pressure ventilation C. Place the patient in the shock position D. Apply oxygen via a nonrebreather mask
B. Start positive pressure ventilation
You have been called to a long-term care facility for a 77-year-old female patient who was found unresponsive in her wheelchair by staff. The nurse reports that the patient complained of a headache earlier in the day and was given 600 mg of Motrin. Your assessment shows the patient to be unresponsive with a patent airway, slow and irregular respirations, and a weak radial pulse. Her lips are cyanotic, and your partner reports the following vital signs: pulse, 44; respirations, 6 breaths/min; and blood pressure, 228/116 mmHg. Which action should be your next priority? A. Attach the pulse oximeter to get a SpO2 reading B. Start positive pressure ventilation C. Perform a prehospital stroke screen D. Check the patient's blood glucose level
B. Start positive pressure ventilation
As you approach a patient who was involved in a motor vehicle crash, you note that he has dark, oozing blood coming from an open fracture to his lower left tibia. The patient was removed from the car by bystanders and is being held by a family member. What should you do immediately? A. Apply direct pressure to the bleeding B. Take manual in-line spine motion restriction C. Assess and open the airway D. Provide supplemental oxygen
B. Take manual in-line spine motion restriction
A durable power of attorney for health care is an: A. advance directive that, when presented, requires the EMT not to resuscitate a terminally ill patient. B. advance directive that identifies a person who can make decisions for the patient if he becomes incapacitated. C. advance directive that identifies a relative who can sue an insurance company for health benefits if needed. D. attorney who specializes in health care issues for the elderly, terminally ill, and mentally ill patient.
B. advance directive that identifies a person who can make decisions for the patient if he becomes incapacitated.
An imaginary line drawn vertically from the middle of the armpit to the ankle is called the: A. medial line. B. midaxillary line. C. posterior line. D. middorsal line.
B. midaxillary line.
The EMT would recognize that a hypothermic patient is deteriorating when he observes: A. painful extremities. B. slurred speech and AMS. C. vigorous shivering. D. term-70red-colored skin.
B. slurred speech and AMS.
An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals the child to be extremely irritable, crying weakly, and resistant to being touched by the EMT. Which description best describes this infant's mental status? A. Lethargic B. Verbal C. Alert D. Obtunded
C. Alert
A 59-year-old male patient has summoned EMS for crushing chest pain. He states that he needs his nitroglycerin, but it is in his car in a nearby parking lot. A friend of the patient explains that he also takes nitroglycerin and hands you his bottle of nitroglycerin. The patient appears very ill, and he says that this chest pain is the worst he's ever experienced. Given the patient's condition, your best action would be to: A. Administer the friend's nitroglycerin B. Have the patient retrieve his nitroglycerin from the car C. Ask the friend to get the patient's nitroglycerin from his car quickly D. Administer his friend's nitroglycerin now, but retrieve patient's nitroglycerin bottle from his car so you have proof and verification that this medication was appropriate to administer
C. Ask the friend to get the patient's nitroglycerin from his car quickly
A 68-year-old female patient complains of a headache and generalized weakness. Her husband informs you that she was with a friend yesterday and was involved in a motor vehicle collision. She did strike her face on the dashboard, but refused treatment on scene. Her past medical history includes a stroke with right arm weakness and high blood pressure, for which she takes medications. When assessing this patient, which finding should concern the EMT most? A. Contusion to her left cheek area B. Weakness to the right-hand grip C. Bruising behind her left ear D. Complaint of pain when she moves her jaw
C. Bruising behind her left ear
An unrestrained female driver hit a utility pole with her vehicle at a moderate rate of speed. During the impact, she struck the steering wheel with her chest. The patient's airway is open, and she states that it is painful to breathe. Her pulse is moderate in strength, irregular, and tachycardic. Breath sounds are equal bilaterally, and no jugular venous distention is noted. Assessment of her chest reveals bruising and instability to the sternum. When asked, she denies any past medical history. Based on this mechanism and the assessment findings, the EMT should be suspicious of which condition? A. Tension pneumothorax B. Pneumothorax C. Cardiac contusion D. Traumatic asphyxia
C. Cardiac contusion
You have been called for a patient with angina. On scene, the 67-year-old man reports that he has a history of angina and the pain started when he was moving firewood from the garage into his house. Unfortunately, the pain has yet to go away, despite three nitroglycerin tablets and 20 minutes of rest. Your next action should be to: A. Administer a nitroglycerin tablet and aspirin B. Provide supplemental oxygen via nonrebreather C. Check the patient's vital signs D. Attach the AED but do not turn it on
C. Check the patient's vital signs
You suspect that an unhelmeted male patient who was thrown from a motorcycle may have a basilar skull fracture. As you perform the secondary assessment, which finding would reinforce this suspicion? A. Blood coming from both the ears and the nose B. Paralysis of the left arm and leg C. Clear fluid coming from the right ear and the left nostril D. Dilation and sluggish response of the right pupil to light
C. Clear fluid coming from the right ear and the left nostril
A beta-2 medication benefits a patient by: A. Eliminating chest pain B. Diminishing the need for oxygen C. Dilating the small airways D. Slowing the respiratory and heart rate
C. Dilating the small airways
The family of an 87-year-old female has called 911. The patient is confused and exhibiting improper and out-of-character behavior. The family informs you that the patient has diabetes, but takes pills and not insulin. They also state that she has been complaining of dizziness and has been drinking water nonstop as well as urinating. Assessment reveals adequate breathing, skin that is cool, and a radial pulse that is rapid and weak. The glucometer is malfunctioning and not providing a glucose reading. Based on her history, you should be suspicious of and treat the patient for: A. Urinary tract infection B. Stroke or transient ischemic attack C. Elevated blood sugar D. Hypoglycemia
C. Elevated blood sugar
You have arrived on the scene of an assault in which several people were injured. You are directed to assist another crew with a patient who has been shot once. As you approach, you are told that the patient has slow and irregular breathing that is inadequate. You observe the patient being ventilated with a bag-valve mask while another EMT maintains her airway with the jaw-thrust maneuver. Based on your observation, where might you expect that this patient was shot? A. Chest B. Pelvis C. Head D. Lower abdomen
C. Head
A 48-year-old male patient is short of breath and confused. His airway is open, and his breathing is fast. A radial pulse is easily palpated. His skin is warm to cool and dry. Your partner reports the following vital signs: pulse, 124; respirations, 24 breaths/min; blood pressure, 158/86 mmHg; and SpO2, 89% on room air. The patient's lung sounds indicate slight wheezing. Based on this information, which of these conditions poses the most immediate threat to this patient's well-being? A. Possible infection B. Increased heart rate C. Hypoxia D. Elevated blood pressure
C. Hypoxia
Which portion of the heart, when weakened by a heart attack, is responsible for causing fluid to back up into the alveoli? A. Pulmonary vein B. Right atrium C. Left ventricle D. Right ventricle
C. Left ventricle
You are called for an elderly woman who has slipped on the ice. On arrival, you find her supine on an icy sidewalk and responsive to painful stimuli with decorticate posturing (flexion). She has blood coming from a laceration on the back of her head and is breathing agonally at 4 times a minute. What should you do immediately? A. Remove the patient to the warm ambulance B. Start positive pressure ventilation C. Perform the manual jaw-thrust maneuver D. Insert a nasal airway into the right nare
C. Perform the manual jaw-thrust maneuver
A patient with an unknown medical problem is responsive to painful stimuli and breathing poorly at a rate of 8 breaths/min. The airway is patent and the skin warm and moist. The patient's radial pulse is strong and irregular. Breath sounds are absent over the bases of the lungs. Vital signs are pulse, 84; blood pressure, 256/120 mmHg; and SpO2, 81%. The best treatment for this patient's breathing difficulty would be: A. 2 to 4 liters of oxygen through a nasal cannula B. Continuous positive airway pressure (CPAP) C. Positive pressure ventilation D. High-concentration oxygen through a nonrebreather mask
C. Positive pressure ventilation
Family members report that their 62-year-old mother complained of dizziness and right leg weakness just before falling down a flight of stairs. Your assessment indicates that the patient is responsive, but confused and talking with garbled speech. Her breathing is adequate and her radial pulse is strong. Vital signs are pulse 84 beats/min, respirations 18 breaths/min, blood pressure 188/110 mmHg, and SpO2 96%. There is an open fracture to her right forearm. When instructed to do so, the patient does not move the fingers of her right hand. When caring for this patient, which sequence of actions seems most appropriate? A. Make sure that a radial pulse is present, and splint the right arm prior to moving the patient to the stretcher and then the ambulance, where she can be placed on a long spine board and provided with other spine motion restriction interventions B. Splint the right arm in the position found and transfer the patient to the stretcher for immediate transport to the hospital without taking spinal motion restriction precautions C. Provide spine motion restriction precautions to include a cervical collar, long spine board, and straps before extricating her to the ambulance for immediate transport D. Provide spine motion restriction precautions to include securing her on a long spine board, and then place a splint on her right arm prior to beginning a lights and sirens transport
C. Provide spine motion restriction precautions to include a cervical collar, long spine board, and straps before extricating her to the ambulance for immediate transport
You arrive on the scene of a home birth to find a vigorous infant who is crying and in NO distress, and his 35-year-old mother, who experienced a sudden onset of sharp, localized chest pain, and shortness of breath. Her skin is mottled and cool, she is in severe respiratory distress, hypotensive, and tachycardic. With which condition is the mother's signs and symptoms MOST consistent? A. Uterine rupture B. Postpartum hemorrhage C. Pulmonary embolism D. Septic shock
C. Pulmonary embolism
On scene, you find a 2-year-old male patient in significant respiratory distress. He is responsive to painful stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths/min. His pulse is rapid. Assessment of the skin shows it to be cool and diaphoretic, with cyanosis to the extremities and around the mouth. What is the immediate priority for this patient? A. Apply oxygen through a pediatric nonrebreather mask B. Move the patient to the ambulance for immediate transport C. Start positive pressure ventilation D. Insert an oropharyngeal airway
C. Start positive pressure ventilation
You have arrived on the scene of an assault involving a knife. Assessment of the unresponsive 21-year-old male patient reveals him to have sustained multiple lacerations to the arms and abdomen, and a section of his intestine is now protruding through a large laceration in the area around the umbilicus. He has lost a significant amount of blood. His airway is open and he is breathing poorly at a rate of 28 breaths per minute. His radial pulse is weak, and his skin is cool and pale. What should the EMT do first? A. Secure the patient to a long spine board B. Cover the intestine with saline-soaked gauze C. Start positive pressure ventilation D. Check the blood pressure
C. Start positive pressure ventilation
You are approaching a victim of a motor vehicle accident still sitting in the car. The patient is carrying on a conversation with a bystander outside the window and appears conscious and well oriented. As you approach the open driver's door, you notice that the air bag never deployed, the steering wheel is bent, and there is a starburst on the windshield. What is the MOST important conclusion you can draw from this observation? A. You should immediately fit a cervical collar. B. The patient may have chest injuries he does not realize. C. The air bag may still deploy, injuring you or the patient. D. The patient may have a head injury.
C. The air bag may still deploy, injuring you or the patient.
A person is in a hot environment and his body is successfully compensating to off-load excess heat. Which assessment findings best illustrate this process? A. Warm skin, elevated heart rate, decreased respirations, and decreased blood pressure B. Diaphoretic skin, decreased heart rate, and decreased blood pressure C. Warm and diaphoretic skin, elevated heart rate, and increased respirations D. Cool and clammy skin, normal blood pressure, and slow respirations
C. Warm and diaphoretic skin, elevated heart rate, and increased respirations
A mother has called you for her 9-year-old daughter, who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be allergic, although she has never been stung before. Assessment of the patient reveals a red, painful, and swollen area on the back of the girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older daughter's epinephrine auto-injector. You would: A. Administer the epinephrine into the patient's thigh B. Ask the mother to administer the auto-injector into the patient's thigh C. Wash the patient's hand with soap and water D. Contact medical direction for permission to use the epinephrine auto-injector
C. Wash the patient's hand with soap and water
You have arrived on the scene of a large structure fire. Emergency Medical Responders (EMRs) are by the side of a patient who is responsive to verbal stimuli and has significant burns to his body. They report that the patient fell down a flight of stairs while trying to escape and was trapped for several minutes. Their assessment findings include partial- and full-thickness burns to his right arm, right leg, and right side of the face. The EMRs also report that the patient's unburned skin is cool, clammy, and pale, with a delayed capillary refill. His pulse is 144 beats/min, respirations are 22 breaths/min, and blood pressure is 88/50 mmHg. Which instructions would be most appropriate? A. "The patient is in burn shock; let's cool him by pouring cold water on him now and during transport." B. "The patient is in burn shock; let's soak a sterile burn sheet in water and wrap it around him." C. "Before cooling the patient with water, let's figure out the percentage of his body that is burned, along with the type of burn." D. "After reassessing the ABCs, let's do a secondary assessment and look for signs of injuries that are causing shock."
D. "After reassessing the ABCs, let's do a secondary assessment and look for signs of injuries that are causing shock."
A bleacher at a college has collapsed, and your crew is the first EMS unit to arrive on the scene. As you enter the gym, several patients are walking around with visible injuries. Which instruction is most appropriate for these ambulatory patients? A. "Sit down here so that I can do a quick assessment on you." B. "Put this yellow tag on your wrist and go outside to the red fire truck in the parking lot." C. "Leave this gym and wait outside. I will be out in a few minutes after I check others who cannot walk." D. "Go outside and wait by the red fire truck in the parking lot and stay there."
D. "Go outside and wait by the red fire truck in the parking lot and stay there."
A 28-year-old male patient was cutting limbs from a tree when he lost his footing and fell approximately 20 feet. He is unresponsive and has shallow breathing, with a rate of 28 breaths/min. His radial pulse is weak and thready, and his skin is cool to the touch. Emergency Medical Responders (EMRs) have placed him on a nonrebreather face mask and are holding manual spine motion restriction. His respirations are sonorous. Based on these assessment findings, which of these instructions would you next provide to the EMRs? A. "Do not cover the patient with a blanket, because that will cause his blood vessels to dilate and drop his BP." B. "The patient has snoring respirations, so let's go ahead and open the airway with the head-tilt, chin-lift maneuver." C. "Let's elevate the patient's legs 8 to 12 inches so more blood gets to his vital organs." D. "Let's take off the oxygen mask and try manually opening the airway."
D. "Let's take off the oxygen mask and try manually opening the airway."
You are sitting next to a 24-year-old female patient with diabetes who has altered mental status and a blood sugar reading of 31 mg/dL. Family members state that she took her normal amount of insulin this morning and ate her breakfast as usual. Which additional statement would the EMT recognize as contributing to her current condition? A. "She has been taking Motrin every 6 hours for ankle pain." B. "She did not eat anything sweet for breakfast this morning." C. "She did not take her nighttime insulin last night." D. "She likes to stay in shape and ran 4 miles after breakfast."
D. "She likes to stay in shape and ran 4 miles after breakfast."
Which of these statements made by the EMT indicates that he has appropriately initiated the first phase of patient assessment? A. "Blood pressure is 124/80 mmHg." B. "Can you tell me why you called the ambulance?" C. "I have placed an oral airway in the patient." D. "The scene appears to be free of hazards."
D. "The scene appears to be free of hazards."
The EMT shows that she understands how to use an oropharyngeal airway when she states: A. "Once this airway has been placed, the head-tilt, chin-lift maneuver is no longer needed." B. "I must remain alert for vomiting or spasm of the vocal cords even with proper insertion." C. "If this airway is too small, it could push the epiglottis over the opening of the trachea." D. "This airway protects the patient from aspirating vomit or other secretions."
D. "This airway protects the patient from aspirating vomit or other secretions."
The family of a 31-year-old female patient reports that she has taken an overdose of her father's diabetes medication. Assessment reveals her to be unresponsive, lying on the floor, with snoring respirations. Her pulse is rapid and her skin is cool to the touch. The patient has no history of diabetes but is allergic to penicillin. It is believed that she took the medication within the past hour. Your initial intervention in caring for this patient would be to: A. Induce vomiting B. Perform a jaw-thrust maneuver C. Administer glycogen or intranasal naloxone D. Administer activated charcoal
D. Administer activated charcoal
The wife of a 43-year-old male patient has called 911 because her husband was difficult to wake up and now is lethargic with garbled speech. She reports a history of diabetes, stroke, renal failure, and high blood pressure. The patient's airway is patent, respirations are tachypneic but adequate, and radial pulse is rapid. Your partner reports the following vital signs: pulse, 136; respirations, 22 breaths/min; blood pressure, 106/62 mmHg; SpO2, 92%; and blood glucose, 642 mg/dL. What would be the most appropriate action in the care of this patient? A. Administer oral glucose B. Encourage the patient to drink water C. Assist the patient with taking his insulin D. Administer supplemental oxygen
D. Administer supplemental oxygen
A patient complains of back pain and numbness to both legs after being thrown from a bicycle. When should the EMT first check the motor function, sensory function, and pulses in the legs of this patient? A. Immediately after applying a cervical collar B. During the primary assessment C. Immediately after taking manual spine motion restriction precautions D. As the secondary assessment is performed
D. As the secondary assessment is performed
You are reassessing a young female who sustained blunt trauma to the chest in a motor vehicle collision. Which of these assessment findings best indicates that she is deteriorating and in the decompensatory phase of shock? A. Heart rate of 100 beats/min B. Restless and confused mental status C. Blood continuing to ooze from an abdominal laceration D. Blood pressure of 88/50 mmHg
D. Blood pressure of 88/50 mmHg
A patient was trapped in a burning apartment before being rescued by firefighters. As you approach him, you note that his legs and arms are burned. The patient is screaming in pain and coughing, but no longer actively burning. Given this information, which intervention would you perform first? A. Estimate the percentage of the patient's body that has been burned B. Determine whether the patient has partial-thickness or deep partial-thickness burns C. Perform a secondary assessment to determine if nonburn injuries are present D. Decide whether to administer oxygen with a nasal cannula or nonrebreather mask
D. Decide whether to administer oxygen with a nasal cannula or nonrebreather mask
A 45-year-old female was at a family reunion and fell off a trampoline. She hit a picnic table with the left side of her lower rib cage. Now, she is very anxious and confused. Her airway is open and her breathing adequate. Her radial pulse is rapid and weak, and her skin is cool and diaphoretic. Vital signs are pulse, 132 beats/min; respirations, 20 breaths/min; blood pressure, 102/78 mmHg; and SpO2, 97% on ambient air. The patient has ecchymosis to the left lower rib area as well as tenderness and instability to the rib cage. She also has a superficial abrasion to her forehead. Given these findings, you would suspect and treat her for which condition? A. Hypoxia B. Spinal shock C. Closed head injury D. Hypovolemic shock
D. Hypovolemic shock
An alert and oriented young male fell 5 feet from a stage, impacting a metal railing with the right side of his chest, just under his armpit. The primary assessment is negative for life threats, although he does complain of very painful breathing and has remarkable tenderness and crepitus over the fifth rib laterally in this area. Throughout care, which action is essential to perform? A. Splint site with a bulky dressing B. Apply ice to area C. Administer aspirin for pain D. Monitor breath sounds
D. Monitor breath sounds
A middle-aged male has been stabbed once in the left anterior chest. His airway is patent, respirations tachypneic, pulse weak and rapid, and skin cool and diaphoretic. Breath sounds are clear and equal bilaterally. The vital signs are pulse, 140 breaths/min; respirations, 24 breaths/min; blood pressure, 100/78 mmHg; and SpO2, 96% on supplemental oxygen. JVD is present. Given this presentation, you would have a high index of suspicion for: A. Pericardial tamponade B. Fail segment C. Hemothorax D. Pneumothorax
D. Pneumothorax
After you applied the AED to a patient in cardiac arrest, it delivered a shock. Immediately after the shock, what should you do next? Question content area bottom Part 1 A. Check the patient for a pulse and reanalyze the rhythm if no pulse is present B. Check the patient for a pulse and start CPR if no pulse can be located C. Provide five cycles of single-rescuer CPR with a ratio of 15 compressions to 2 ventilations D. Provide 2 minutes of CPR, and then check the patient for a pulse
D. Provide 2 minutes of CPR, and then check the patient for a pulse
What is the name of the process that results in the movement of gases (oxygen and carbon dioxide) across cellular membranes in the lungs and in the peripheral tissues? A. Ventilation B. Perfusion C. Oxygenation D. Respiration
D. Respiration
You have been called to an alcoholic rehabilitation center for a 56-year-old male patient whose left arm suddenly began to shake uncontrollably. He is alert and oriented, and he is terrified that he cannot stop his arm from moving. Which type of seizure should you suspect? A. Psychomotor B. Complex partial C. Generalized D. Simple partial
D. Simple partial
You have arrived on the scene of an assault involving a knife. Assessment of the unresponsive 21-year-old male patient reveals him to have sustained multiple lacerations to the arms and abdomen, and a section of his intestine is now protruding through a large laceration in the area around the umbilicus. He has lost a significant amount of blood. His airway is open and he is breathing poorly at a rate of 28 breaths per minute. His radial pulse is weak, and his skin is cool and pale. What should the EMT do first? A. Cover the intestine with saline-soaked gauze B. Check the blood pressure C. Secure the patient to a long spine board D. Start positive pressure ventilation
D. Start positive pressure ventilation
A patient has sustained a large abdominal evisceration, such that a large portion of intestines are now exposed. After properly managing this injury, you are preparing the patient for transport. You ascertain that there is no evidence of spinal injury. How should you place the patient on the stretcher for transport? A. Lateral recumbent position with legs extended B. Prone position, to maintain pressure on the abdomen C. Semi-Fowler's position, to promote adequate breathing D. Supine position, with knees and hips flexed
D. Supine position, with knees and hips flexed
The EMT should recognize a possible spinal column injury with no spinal cord involvement when he discovers which assessment finding? A. Intact motor ability to all four extremities with loss of sensation to the legs B. Pain to the cervical spine with loss of sensation to the right arm and leg C. Intact sensation to all four extremities with loss of motor ability to the arms D. Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity
D. Tenderness to the thoracic spine with intact motor and sensory abilities to each extremity
When assessing a patient who has been exposed to a poisonous substance, it is essential to understand: A. The route of entry into the body will determine the signs and symptoms B. Vomiting indicates that the poison has not yet been absorbed into the body C. Absorption into the body has not occurred if the signs of illness are not apparent within 15 minutes D. The signs and symptoms of toxic exposure will vary depending on the specific poison
D. The signs and symptoms of toxic exposure will vary depending on the specific poison
You are by the side of a patient who complains of severe chest pain that radiates into his right arm and neck. He is alert and oriented, with an open airway and adequate breathing. His radial pulse is strong, and his skin is cool and diaphoretic. Your partner reports his pulse rate is 84, respirations are 18 breaths/min, blood pressure is 86/62 mmHg, and SpO2 is 98% on room air. You have obtained a medical history and performed the secondary assessment. The patient states that he has had two heart attacks in the past and is allergic to aspirin and sulfa medications. What should you do next? A. Administer oxygen and nitroglycerin, and then transport the patient B. Administer baby aspirin to the patient C. Assist the patient in taking a nitroglycerin tablet D. Transfer the patient to the stretcher and begin transport
D. Transfer the patient to the stretcher and begin transport
You are by the side of a patient who complains of severe chest pain that radiates into his right arm and neck. He is alert and oriented, with an open airway and adequate breathing. His radial pulse is strong, and his skin is cool and diaphoretic. Your partner reports his pulse rate is 84, respirations are 18 breaths/min, blood pressure is 86/62 mmHg, and SpO2 is 98% on room air. You have obtained a medical history and performed the secondary assessment. The patient states that he has had two heart attacks in the past and is allergic to aspirin and sulfa medications. What should you do next? A. Administer oxygen and nitroglycerin, and then transport the patient B. Assist the patient in taking a nitroglycerin tablet C. Administer baby aspirin to the patient D. Transfer the patient to the stretcher and begin transport
D. Transfer the patient to the stretcher and begin transport
Near the end of a workday, a construction worker fell 10 feet from scaffolding, landing on his head and left shoulder. He is found to be spontaneously alert, but confused. His airway is open and his breathing is adequate. Coworkers state that he was unresponsive for a period of 2 minutes following the fall and is on medications for depression and heart problems. Based on this information, the EMT should initially classify him as which kind of patient? A. Medical, trauma, and behavioral B. Medical and trauma C. Trauma and behavioral D. Trauma
D. Trauma
A listless and lethargic 84-year-old male responds to painful stimuli only. His respirations shallow as well as show poor effort and are rapid and labored with a room air SpO2 is 84%. Additionally, you cannot appreciate breath sounds in his right lung. The best form of oxygen therapy for this patient would be: A. continuous positive airway pressure (CPAP). B. high-concentration oxygen via a nonrebreather. C. 2 lpm via nasal cannula initially and increase liter flow as needed. D. positive pressure ventilation.
D. positive pressure ventilation.
You have documented on the PCR that the patient was complaining of nausea. This type of information is known as: A. summative. B. narrative. C. objective. D. subjective.
D. subjective.
