Exam review 1
a 77-year-old female resident of a nursing home complains of difficulty breathing. she has a history of mild dementia. the most appropriate way to evaluate the mental status of his patient would be to: a. ask staff members what her baseline mental status is b. ask her what day of the week it is c. ask her ho the president of the untied states is d. perform a cincinnati prehospital stroke examination
a. ask staff members what her baseline mental status is
you arrive first on scene of a car that has struck a tree. moderate damage has occurred. you ensure the scene safety, don appropriate personal protective equipment, and request additional resources. you note that the patient is not responding and you are unable to gain access through the front doors. what should you do next: a. attempt to open a rear door and enter the car b. break a window to access the patient c. use a hack saw to remove the front windshield d. use a crow bar to pry open the drivers door
a. attempt to open a rear door and enter the car
a 44-year old male tells you he is sucidal and plans to hang himself with the rope next to his bed. he does not wish to be transported to the hospital. you should: a. await law enforcement and transport the patient against his will b. attempt to restrain the patient and transport him to the hospital c. speak to the patient calmly about why he is suicidal d. allow the patient to refuse care
a. await law enforcement and transport the patient against his will
early signs of hypo perfusion in a pregnant female patient may be lost due to the physiological change caused by pregnancy. which of the following vital signs is one such example of this? a. blood pressure b. respiratory rate c. pulse oximeter d. heart rate
a. blood pressure
a 31-year-old female has been found unconscious by the side of the road. bystanders state that they do not know what happened. the patient does not appear to be breathing. after snoring scene safety, you should next: a. check her carotid pulse b. open her airway using a jaw thrust maneuver c. obtain a blood glucose level d. interview bystanders for further information
a. check her carotid pulse
a 21-year-old female states that she has been taken 25 Libruim capsules approximately 30 minutes aho. after completing a primary assessment and initiating transport, you should next: a. contact poison control b. induce vomiting c. administer activated charcoal d. complete a detailed assessment
a. contact poison control
a patient has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. in order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ? a. enhancing vasomotor tone b. decreasing after load on the left ventricle c. slowing of the heart rate d. increasing diuresis through the kidneys
a. enhancing vasomotor tone
what term is used to describe the exchange of respiratory gases between the alveoli and the pulmonary capillary bed? a. external respiration b. internal respiration c. cellular ventilation d. cellular metabolism
a. external respiration
you have been dispatched to a local college dormitory for an unresponsive male. bystanders on scene state hw was drinking alcohol heavily, passed out and fell to the floor. as you approach the patient you see large amounts of vomitus on his face and around his head. what clinical finding would you observe if you suspect the patient is aspirating the vomitus? a. gurgling sounds with each breath b. stridorous airway sounds during inhalation c. sonorous airway sounds while attempting to breathe d. no breath sounds
a. gurgling sounds with each breath
a 21-year-old patient collided with another player while playing soccer. bystanders note be briefly lost consciousness. he is awake, but cannot remember where he is. he states he does not wish to be transported to the hospital. which one of the following reasons best describes why this patient cannot refuse? a. his mental status is altered b. he previously lost conscious c. a parent is not on scene d. he is only 21 years old
a. his mental status is altered
an 18-year-old male diabetic patient has been sick for one week. his family states he has complained of nausea and vomiting, but has been taking his insulin properly. today they note he is "acting drunk". you note the patient is pale and diaphoretic and his vital signs: pulse 116, respiration 28, blood pressure 132/80. what is the most likely cause of his condition? a. hypoglycemia b. hyperglycemia c. sepsis d. dehydration
a. hypoglycemia
a 19-year-old patient has a traumatic injury and is unconscious. when laid supine, the patient stops breathing. this apnea is most likely caused by: a. poor airway muscle control b. swelling in the airway c. recreations building up in the airway d. foreign bodies present in the airway
a. poor airway muscle control
a 22-year-old female is having an asthma attack. she is 31 weeks pregnant. which one of the following reasons explains why asthma might affect this patient more profoundly than a non pregnant patient? a. pregnancy increases the consumption of oxygen b. pregnancy causes slowed gastric motility c. pregnancy creates high pressures in the cardiovascular system d. pregnancy causes an increased blood volume
a. pregnancy increases the consumption of oxygen
you are addressing a person who is angry at you because his wife was pronounced dead on scene and he thinks you should have started treatment and transport. you are trying to gather specific patient information from him so you can contact appropriate authorities. during this exchange, what patient communication strategy could you possibly employ? a. reflection b. clarification c. anger d. confrontation
a. reflection
you are called to a school for an eight-year-old with a nosebleed, which the school nurse is having trouble controlling. when packaging the patient for transport, what is the most appropriate way to position him? a. sitting up and leaning forward b. sitting up and leaning back c. prone with the head turned to the side d. prone and flexed forward
a. sitting up and leaning forward
a 21-year-old male has been involved in a serious motor vehicle crash. you begin your primary assessment in the vehicle as rescue crews prepare for medical extrication. after checking airway and breathing, you find spurting blood coming from a laceration on his leg. your jump kit is outside the car. you should: a. use your gloved hand to initiate direct pressure b. immediately apply the trouniquet you carry in your pocket c. wait for the patient to be extricated to initiate bleeding control d. wait for a crew member to bring you a sterile dressing
a. use your gloved hand to initiate direct pressure
you are caring for a baby that just delivered in the mothers home. after cutting the cord you complete your initial APGAR scoring. you find the baby displays a strong cry, has cyanotic hands and feet with a pink core, is actively moving, the heart rate is 140 per minute and the newborn grimaces and cries with stimulation. what is the calculated APGAR score? a. 5 b. 7 c. 9 d. 11
b. 7
your partner tells you that after years of working as an EMT, he has begun to have nightmares. you also notice that he is quite irritable. those findings most likely indicate: a. an additional stressor in this EMT's home life b. a cumulative stress reaction c. an acute stress reaction d. nothing, because this is normal for an experienced EMT
b. a cumulative stress reaction
a 17-year-old was slashed in the abdomen during a knife fight. when you arrive, you observe that part of the patients large intestine is eviscerated. which of the following is the most appropriate way to care for the protruding intestine? a. flush the wound with saline and then cover it with an occlusive dressing b. apply a moistened dressing and then an occlusive dressing c. wrap the protruding section with dry sterile gauze dressing d. replace the protruding intestine in the abdomen
b. apply a moistened dressing and then an occlusive dressing
of the following traumatized patients, which one would most likely suffer critical injuries and require transport to a trauma center based on a significant mechanism of injury? a. a stable adult who wrecked his car with no interior displacement b. child who fell 5 feet from a fence top who had a loss of consciousness c. adult who dropped a cement block on his foot and has severe pain d. child who fell while skateboarding, complaining of lower back pain
b. child who fell 5 feet from a fence top who had a loss of consciousness
given any type of cellular, digital, or radio communication between the EMS providers and dispatch, what is one consistent limitation across these technologies the EMT must be aware of and try to avoid in order to assure smooth communication occurs? a. language barriers b. dead spots c. high costs d. dead batteries
b. dead spots
you are called to evaluate a two-year old female who has fallen. on your appearance, the child begins to cry and refuses to speak to you. this behavior is: a. a sign of potential brain injury b. expected in a two-year-old and most likely indicates normal mental status c. a potential sign of shock d. unusual for a two-year-old and may indicate altered mental status
b. expected in a two-year-old and most likely indicates normal mental status
a mother states her seven week old infant has not been feeling well and may have had a fever over the last four days. the baby is listless, and when you examine his head, you notice its fontanels are sunken. what does this finding most likely indicate? a. meningitis b. hypovolemia c. rising intracranial pressure d. traumatic brain injury
b. hypovolemia
a 22-year-old, 38-week pregnant female requires transport to the hospital after a fall. there is no indication of spine injury. the most appropriate position to transport her in would be: a. supine b. left lateral recumbent c. semi-fowler's position d. knee-chest position
b. left lateral recumbent
a 31-year-old male jumped from a fourth-floor window and landed feet first onto the pavement below. based on this mechanism of injury, you should suspect which one of the following areas to sustain the most damage? a. cervical spine b. lumbar spine c. thoracic spine d. sacral spine
b. lumbar spine
while managing a patient with cardiac chest pain, you elect to assist them in the administration of their nitroglycerin. after two doses the chest pain is still not relieved. per your clinical protocols, you must contact medical control prior to the administration of a third nitro. this is an example of what type of medical authorization? a. patient based medical control b. on line medical control c. off line medical control d. continuation of care protocols
b. on line medical control
a 16-year-old male has been struck by a car. he is confused and complains of abdominal pain. his vital signs are pulse 120, respirations 30, blood pressure 100/72. a detailed assessment should be completed on this patient: a. only if there are obvious additional injuries b. only after transport has been initiated c. before administering high-flow oxygen d. immediately following the primary assessment
b. only after transport has been initiated
a four month old male is in respiratory arrest. before initiating positive pressure ventilations, you should: a. hyperextend his neck to open the airway b. pad behind his shoulders to account for his large occiput c. pad behind his occiput to place him in the sniffing position d. flex his neck to put him in the neutral position
b. pad behind his shoulders to account for his large occiput
while ventilating a patient with a bag valve mask, you squeeze the bag in order to ventilate the patient. now hat the lungs have been filled, by what process does the air (oxygen) leave the lungs before the next ventilation is provided? a. active b. passive c. contraction d. reactive
b. passive
you arrive at the scene of a reported domestic dispute near your station. due to the rapid response time you arrive before police. as you cautiously approach the front door you hear loud shouting and what sounds like glass breaking coming from within. what should you do in this instance? a. stand to the side of the door b. return to the ambulance and stage a few blocks away while awaiting police c. clear the scene, return to the station, and wait for distance to resend you to the address after the police arrive d. cautiously peer in the windows to see what is going on
b. return to the ambulance and stage a few blocks away while awaiting police
during a large-scale incident in your community where multiple people are injured, you have been designated by the incident commander to serve the role of EMS branch director. as you establish the units under your direction, which one will be responsible for organizing the positioning and flow of ground and air ambulances to and from the scene? a. triage unit leader b. staging unit leader c. transport unit leader d. treatment unit leader
b. staging unit leader
a 71-year-old female presents with a new onset of right-sided facial droop and lethargic mental status. as you load her onto a stair chair for extrication, she exhibits snoring respirations. you should: a. immediately suction the airway b. stop movement and reposition her airway c. tilt her head forward to stop the snoring d. continue extrication but move quickly
b. stop movement and reposition her airway
you are transporting a 67-year-old patient who is complaining of chest pain. your partner is driving in nonemergency mode while you are administering oxygen and monitoring vital signs. suddenly the patient stops breathing and goes into cardiac arrest. you should next: a. attach the AED and tell your partner to expedite transport b. stop the ambulance first and then attach the AED c. divert the ambulance to a rendezvous with the closest ALS d. attach the AED and continue to transport in nonemergency mod
b. stop the ambulance first and then attach the AED
you are attempting to remove vomitus from the airway of a 3 year old female hit by a car. if you are planning on using a suction machine, what do you know regarding the length of time you should suction the oral cavity? a. suctioning should not exceed 15 seconds b. suction less than 10 seconds c. do not suction pediatrics due to inherent dangers of oral trauma d. do not exceed 30 seconds
b. suction less than 10 seconds
you and your partner are completing your pre-shift ambulance inspection. you notice that the driver's seat belt is not functioning. you should: a. not worry about it because you do not really need a seat belt b. take the ambulance out of service and notify maintenance c. take the ambulance out and make a maintenance appointment later d. attach a nine-foot strap to the seat to replace the malfunctioning belt
b. take the ambulance out of service and notify maintenance
you and your partner are preparing to transport a 56-year-old mane with hand pain. the patient states he does not wish to sit on the stretcher and " i just want to sit on the bench". you're partner says " sure that's fine" you should: a. be sure the bench seat has seatbelts and transport the patient b. tell your partner you are uncomfortable with transporting a patient on the bench seat c. require the patient to lie flat on the bench seat and use multiple seat belts to secure him d. transport the patient on the bench seat and sinus your concerns with your partner later
b. tell your partner you are uncomfortable with transporting a patient on the bench seat
which one of the following best describes the pathophysiology of pericardial tamponade? a. the sac surrounding the heart is ruptured, allowing the release of lubricating fluid b. the sac surrounding the heart fills with blood and limits the heart's ability to fill c. the heart is compressed between the sternum and the spine leading to blunt-trauma injuries d. the heart is bruised, causing swelling of myocardial tissue
b. the sac surrounding the heart fills with blood and limits the heart's ability to fill
you respond to a serious motor-vehicle crash where it is apparent that a young women has been killed. her family arrives on scene. when speaking with them, you should tell them: a. everything will be okay b. their daughter has died c. you know how they feel d. crews are doing everything they can
b. their daughter has died
you and your partner are on a lunch break when you hear a scream from across the room " my child is choking" you immediately go to help. the mother quickly tells you she thinks the 10 month old swelled a coin. you note that the baby is cyanotic with no cough. what is the appropriate way to clear the obstruction? a. try to blind finger sweep to dislodge the coin b. use back slaps and chest thrusts c. immediately attempt artificial ventilation d. deliver abdominal thrusts and back blows
b. use back slaps and chest thrusts
after checking your ambulance, you notice your hands have been soiled by an unknown substance. the most effective way to protect yourself against disease would be to: a. clean your hands with an alcohol-based hand cleaner b. wash your hands with warm soapy water c. rinse off your hands with an ammonia solution d. wipe off your hands with a dry towel
b. wash your hands with warm soapy water
a 60-year-old male complains of chest pain. you decide to use the acronym OPQRST to better investigate the chief complaint. when referring to the "S" of OPQRST, which one of the questions below would be the most appropriate? a. is the pain sharp or dull? b. what is the severity on a 1-10 scale? c. does the pain cause you to be sweaty? d. is the pain sustained?
b. what is the severity on a 1-10 scale?
approaching the scene of a single-car crash, you observe smoke in the vicinity of the vehicle. you are concerned that there may be someone still inside. as the first emergency responder on scene, where should you position your vehicle? a. next to the crashed car for fast access to the patient b. 50 feet downwind from the vehicle c. 100 feet upwind from the vehicle d. leave the area until the fire department arrives
c. 100 feet upwind from the vehicle
while obtaining a SAMPLE history from a 58-year-old suspected cardiac patient with severe chest pain and diaphoresis, you are informed that the patient had open-heart surgery three years ago. under which "letter" of the acronym SAMPLE should this information be placed? a. S b. E c. P d. L
c. P
a 26-year-old, 36-week pregnant female has been involved in a car crash. she complains of tearing, steady abdominal pain and vaginal bleeding. she is alert and her vital signs are pulse 116, respiration 24, blood pressure 100,68. given this presentation, what is her most likely problem? a. placenta previa b. braxton hicks contractions c. abruptio placentae d. imminent delivery
c. abruptio placentae
a 20-year-old female has been involved in a minor motor-vehicle crash. she is ambulatory on arrival and complains of difficulty breathing. she is alert and vitals are pulse 110, respiration 40, blood pressure 122/80. her skin is flushed. considering her respiratory status, you should: a. ask her to breathe into a paper bag b. do nothing because her respiratory status is fine c. apply a non rebreather mask d. begin positive pressure ventilations
c. apply a non rebreather mask
a 59-year old male complains of acute onset chest pain. he is alert, and diaphoretic. his vitals are pulse 110, respiration 24, blood pressure 188/80. the patient states he has a history of heart problems and takes nitroglycerin occasionally. the only other medication he takes is viagra. you should: a. administer only aspiring and oxygen because this patient cannot take nitroglycerin b. assist the patient with his nitroglycerin c. determine weather he has taken his viagra before assisting with the nitroglycerin d. transport only
c. determine weather he has taken his viagra before assisting with the nitroglycerin
a 45 year old female is complaining of trouble breathing. the patient is sitting in a tripod position, has nasal flaring, rapid breathing, accessory muscle use, and diminished alveolar breath sounds. of these findings, which one is indicative more so of difficult breathing rather than heightened respiratory due to the pulmonary problem? a. accessory muscle use b. nasal flaring c. diminished alveolor sounds d. tripod position
c. diminished alveolor sounds
a 58-year-old male was found confused and stumbling by his family. which one of the following questions would be most important to ask as part of obtaining the patient's history? a. does the patient take any medication? b. does the patient have any allergies? c. does the patient have any past medical problems? d. when did the patient last eat?
c. does the patient have any past medical problems?
a 20-year-old female complains of severe headache and photophobia. she notes she has had a fever and a stiff neck for the last two days. to manage this patient you should first: a. complete a cincinnati prehospital stroke scale b. admisnter 324mg of aspirin c. don gloves and respiratory protection d. turn down the lights in the ambulance
c. don gloves and respiratory protection
you are caring for a 19 year old female who is complaining of an acute onset of abdominal pain with dizziness. you find the patient to be tachypneic, tachycardia, nervous and very scared. skin is pale and diaphoretic. she admits to being sexually active, but "always" uses some type of prophylactic. her last mentural cycle was 25 days previously. abdominal assessment is benign other than slight tenderness to palpation. the most likely reason for the patient's pain is: a. pelvic inflammatory disease b. sexually transmitted disease c. ectopic pregnancy d. menstrual cramps
c. ectopic pregnancy
upon turning a patient over to hospital staff a nurse advises you that your patient is a known injectable drug abuser. of the numerous work practice controls to keep you safe from cross contamination, which of the below is in best protecting your safety as an EMT? a. use of non-latex exam gloves b. donning a moisture resistant gown c. hand washing d. wearing protective eyewear
c. hand washing
an insulin-dependent diabetic has completed a large meal and afterwards reports that he is not feeling well. for the past few hours he has been extremely thirsty with frequent urination. you notice that he is breathing rapidly and has breath that smells like acetone. during the SAMPLE history, he tells you that he has taken his insulin regularly. what is this patient's most likely underlying problem? a. hypoglycemia b. myocardial infarcation c. hyperglycemia d. urinary tract infection
c. hyperglycemia
a 68-year-old female complains of abdominal pain and vertigo. she notes a three-day history of dark, black stools. she is pale, slightly diaphoretic, and get vital signs are: pulse 118, respiration 20, blood pressure 88,64. those findings indicate: a. pain caused by a GI infection b. diarrhea caused by food poisioning c. hypotensive shock caused by a GI bleed d. compensated shock cause by a bowel obstruction
c. hypotensive shock caused by a GI bleed
a 15-year-old male has been stabbed in the abdomen. as you examine the patient's abdomen, you see a small loop of intestine protruding from the wound. after completing your patient assessment, you should next: a. push the intestine back into the wound b. cover the exposed intestine with moistened sterile dressing c. initiate rapid transport d. apply an occlusive dressing over the wound
c. initiate rapid transport
a seven-year-old male has crashed his bicycle. he notes he was thrown over the handlebars and complains of only left shoulder pain. his vital signs are pulse 120, respiration 24, blood pressure 102/60. given this presentation, you should first rule out: a. soft-tissue damage in his shoulder b. a fractured left clavicle c. internal bleeding from a ruptured spleen d. internal bleeding from a gallbladder injury
c. internal bleeding from a ruptured spleen
a 35-year-old male police officer has been shot. his bulletproof vest stopped the bullet but, he now complains of pain in his left chest beneath where the bullet was stopped. you should suspect: a. only soft-tissue injuries because the bullet did not penetrate b. a potential second bullet that actually penetrated c. potential internal injuries from the blunt trauma d. myocardial infarction caused by the stress of the incident
c. potential internal injuries from the blunt trauma
a 55-year-old male dropped a container at work and was sprayed with dry powder that is burning him. the patient is now unconscious and you note that the powder still covers his chest and arms. his coworkers state that he complained of severe pain and burning before losing consciousness. you should: a. flush the wounds with copious amounts of water b. cover the wounds with moistened sterile dressings c. stage away from the patient until hazardous materials technician arrive d. brush away the powder and cover the wounds
c. stage away from the patient until hazardous materials technician arrive
a two-car-motor-vehicle crash has occurred at the bottom of a steep hill. as you approach the crash site, you can see the severely damaged vehicles, but the ambulance begins to slide on the ice. you should: a. leave your partner at the top of the hill to warn traffic b. continue on at a slower speed c. stop the ambulance and proceed on foot d. contact the highway department so they can de-ice the road.
c. stop the ambulance and proceed on foot
you are caring for an elderly female patient who has not been acting normal the past few hours. the family reports she has been acting confused, forgetful, and she has trouble walking. her medical history includes hypertension and thyroid problems. vitals are: heart rate 86/min, respirations 18/min, and a blood pressure of 168/78. the most likely medical problem to explain this presentation is: a. hypertensive crisis b. diabetic ketoacidosis c. stroke d. heart attack
c. stroke
which one of the following best describes the National Incident Management System? a. command system designed to improve span of control at a specific incident b. command system in which several agencies work independently but cooperatively c. system designed to be used by federal, state, and local governments to prepare for and manage emergencies in the united states d. predefined set of instructions for emergency responders to use during a specific major accident
c. system designed to be used by federal, state, and local governments to prepare for and manage emergencies in the united states
you respond to a severe motor-vehicle crash that requires technical extrication. rescue crews have begun readying to use power tools. a rescue team member asks you to climb in the car and hold manual immobilization while they extricate the patient. you do not have proper protective equipment on, you should: a. borrow a helmet and climb in the car b. ask for a protective blanket and climb in the car c. tell him you cannot enter because you are not properly equipped d. tell him to get one of their guys to climb in the car because you are not doing it
c. tell him you cannot enter because you are not properly equipped
a 66-year-old male patient with a stoma is found in respiratory arrest. which one of the following would be the most appropriate method for delivering positive pressure ventilations to this patient? a. use a traditional face mask to ventilate, leaving the stoma open b. seal the stoma and ventilate, using a traditional face mask c. use a pediatric mask to ventilate the stoma directly d. use a traditional face mask to ventilate the stoma directly
c. use a pediatric mask to ventilate the stoma directly
you and your partner are checking your ambulance prior to shift. which one of the following oxygen cylinder pressures would be the minimum safe residual pressure for operational use? a. 1000 psi b. 500 psi c. 2000 psi d. 200 psi
d. 200 psi
you are assisting in the management of 4 injured patients in a remote area of the country. you have at your disposal one helicopter capable of transporting one critical patient, and 2 more ground ambulances that that will handle the other three patients. please select the patient below that you would elect to receive transport by the helicopter. a. 42-year-old patient who just arrested due to traumatic injuries, resuscitation is ongoing b. 23-year-old patient with open demure fracture, bleeding controlled c. 24-year-old patient with penetrating lateral chest injury, breath sounds intact d. 39-year-old patient with head injury, and signs of herniation
d. 39-year-old patient with head injury, and signs of herniation
an adult patient who is extremely allergic to bee stings was attacked when he accidentally dislodged a beehive while cutting down a tree. he has multiple stings all over his body and currently presents with stridor, tachycardia, coarse bilateral wheezing, falling blood pressure, and unresponsiveness. given the pathophysiologic changes in an anaphylactic reaction, which of the below would be the greatest contributor to a rapid death of the patient? a. bilateral wheezing b. hypotension c. tachycardia d. airway closure
d. airway closure
a 48-year-old female was recently prescribed an antibiotic. upon taking her first pill. she noted watery eyes, itching and now complains of shortness of breath. she is alert, her skin is flushed, and you hear wheezes bilaterally. her vital signs are: pulse 110, respiration 30, blood pressure 112,74, you should first: a. conduct a detailed assessment b. contact poison control for further instructions c. identify the type of pill she took d. arrange for ALS to meet you en route to the hospital.
d. arrange for ALS to meet you en route to the hospital.
during the management of a patient with respiratory distress, you elect to assist in the administration of a metered dose inhaler (MDI). this drug causes smooth muscle relaxation at what level of the patient's respiratory tree? a. segmental bronchi b. alveoli c. bronchi d. bronchioles
d. bronchioles
a 55-year-old female complains of acute onset palpations and chest pain. she is alert, but pale and diaphoretic. her vitals are pulse 220, respiration 28, blood pressure 88/60. those findings most likely indicate: a. hypovolemic shock due to unknown internal bleeding b. septic shock due to an infection c. anaphylaxis due to an allergic reaction d. cariogenic shock secondary to a cardiac dysrhythmia
d. cariogenic shock secondary to a cardiac dysrhythmia
a 32-year-old male presents with an altered mental status. he is babbling and speaking incoherently. his family states he has a history of psychiatric problems. after snoring scene safety, you should next: a. contact the patients physicahtirst to obtain more information on this patient's particular problem b. request law enforcement transport because this is a psychiatric issue only c. explain to the family that there is nothing you can do for a purely psychiatric problem d. complete a primary and secondary assessment to rule out medical causes of altered mental status
d. complete a primary and secondary assessment to rule out medical causes of altered mental status
a seven-year-old female complains of difficulty swallowing and chills. you notice the child is sitting bolt upright and will not tolerate leaning back. you also note drooling. those findings most likely indicate: a. croup b. asthma c. bronchiolitis d. epiglottitis
d. epiglottitis
you are departing the scene of a 2 car MVC from which you are transporting a critical trauma patient. your partner is in the back and you are going to drive the ambulance to the hospital. as you conceptualize the route you wish to take to the hospital, which of the factors below is LEAST important to the actual route you'll take? a. traffic patterns b. road surface c. travel time d. freeway versus city road
d. freeway versus city road
you arrive on scene for a male patient in his mid 30''s who, according to family, is acting strangely. as you enter the house you find the patient standing with his face to the corner with tin foil wrapped around the top of his head to keep the "evil radio waves" from entering his head. the patient is not aggressive, allows you to complete your physical exam. of the following conditions, which is most likely NOT his problem? a. physicatric disorder b. stroke or tia c. hypoglycemic episode d. heart attack
d. heart attack
a four-year-old sustained an accidental impact to the chest and is conscious with some respiratory distress. while performing the physical assessment, you observe bruising on the chest. when palpating the chest bilaterally, no deformity is felt. auscultation identifies diminished sound on one side. based on the information from the assessment, which one of the following is most likely to have occurred? a. fractured ribs b. abdominal bleeding c. ruptured aorta d. hemothorax
d. hemothorax
you are caring for a 2 year old female patient with a recent history of bronchitis. the patient is being held by her mother, but you notice that the child seems very limp. the airway is patent, breathing is spontaneous but rapid and shallow. the pulse is rapid and shallow and the skin is ashen in color. breath sounds are markedly diminished with both inspiratory and expiratory wheezing bilaterally. given this situation, you should perform what intervention first? a. insert an NPA b. insert an OPA c. administer oxygen via NRB d. initiate PPV with oxygen supplementation
d. initiate PPV with oxygen supplementation
a patient is found in his apartment in a chair in the tripod position, manifesting noisy respirations, cyanosis around the lips, and restlessness. vital signs are: respirations 28 ( working to breathe), pulse 100 ( slightly irregular) and blood pressure 140/90. oxygen should be provided to this patient by way of: a. nasal cannula b. bag-valve mask c. oxygen-powered ventilation device d. non rebreather mask
d. non rebreather mask
a 17-year-old male complains of lower quadrant abdominal pain. how should you properly assess his abdomen? a. palpate only the affected area b. palpate every quadrant except the affected area c. first palpate the affected area and then the other three quadrants d. palpate four quadrants and the affected area last
d. palpate four quadrants and the affected area last
a patient has suffered significant blunt trauma to the chest, resulting in multiple rib fractures and a flail segment. beyond the impaired ventilation due to thoracic instability, what is a common secondary injury seen with blunt thoracic trauma that can severely hamper normal respiratory efficiency? a. ventricular rupture b. thoracic vertebral injury c. diaphragmatic hernia d. pulmonary contusion
d. pulmonary contusion
you are treating a 23-year-old male patient for burns sustained when the lawn mower he was working caught on fire due to a gas spill. the patient has reddened skin and blistering to both hands, his right arm, and anterior right thorax. given the type and percentage of body surface area burned, how would these burns be categorized? a. mild b. fatal c. moderate d. severe
d. severe
you are caring for a geriatric patient who is bedridden from a prior stroke and is being cared for by their family. upon assessment you note that the patient has bed sores, dirty underclothes and the bed smells of dried during. upon your arrival to the hospital, what should you report? a. that you personally witnessed the abuse b. that the patient is abused c. just the normal assessment findings d. the findings that are suggested of abuse
d. the findings that are suggested of abuse
a 12-year-old male is having an asthma attack. he appears tired and pale. during your primary assessment you note his respiratory rate to be over 40. however, you have difficulty hearing his lung sounds. what is the most likely reason for the difficulty hearing lung sounds? a. children require a different technique for lung-sound evaluation b. children always have quiet respirations c. fast breathing is difficult to hear d. there is little air moving
d. there is little air moving
during the management of a female trauma patient who is 8 months pregnant with her second child, you elect to immobilize her on a backboard for suspected spinal injury. when preparing for transport, what important treatment consideration must you provide regarding transport on a backboard? a. consider immobilizing the patient on her right side to improve fetal blood flow b. automatically provide positive pressure ventilation to assist in breathing while supine c. do not apply high flow oxygen as it may harm the fetus d. tilt the backboard to the left side to avoid potential hypotension
d. tilt the backboard to the left side to avoid potential hypotension
a 69-year-old female patient complains of difficulty speaking and an inability to move her right arm. she notes that the symptoms came on about 2 hours ago but have since subsided. she is most likely suffering from a(n): a. seizure b. syncopal stroke c. acute stroke d. transient ischemic event
d. transient ischemic event
a 43-year-old male patient has been shot in the abdomen during a bar fight. upon your arrival he appears alert and oriented. you observe a small puncture wound to the LUQ with minimal bleeding an no exit wound. the airway is patent, breathing is rapid but adequate, the peripheral perfusion is intact with good radial pulses. vitals are: heart rate 110, respirations 26/min, blood pressure 122,86. given these findings of thus far, how would you categorize his physiological status? a. stable, but not potentially unstable b. stable c. unstable d. potentially unstable
a. stable, but not potentially unstable
you are about to transport a pediatric cardiac arrest. a police officer ask you if you would like an escort: a. thank him but decline because an escort can cause a safety hazard b. accept the escort because it will shorten transport time c. ask him to follow the ambulance to help prevent tailgating d. accept the escort but tell him to make sure he maintains a good distance between the cruiser and the ambulance
a. thank him but decline because an escort can cause a safety hazard
a closed soft-tissue injury implies that: a. the soft tissue has not been broken or penetrated b. blood vessels beneath the skin are intact c. the bone beneath has not been broken d. a penetrating wound is no longer bleeding
a. the soft tissue has not been broken or penetrated
a 25-year-old male has been involved in a serious motor-vehicle crash. during your rapid trauma assessment, you note crepitus when evaluating the pelvis. the finding indicates: a. bruising of the skin b. a fracture of the pelvis c. a dislocation of the femur d. bleeding under the skin
b. a fracture of the pelvis
a 74-year-old COPD patient complains of difficulty breathing. she has an increased respiratory rate and you note cyanosis around her lips. after ensuring an open airway and adequate breathing, you should: a. assess her radial pulse b. administer high-concentration oxygen via nonrebreather mask c. conduct a focused assessment of her chest d. assess her mental status using the glasgow coma scale
b. administer high-concentration oxygen via nonrebreather mask
you are enroute to a MVC where you will back up an EMS unit already on scene. they advise you by radio that you will be picking up an unresponsive female patient with a head injury. they add that she is currently breathing spontaneously at 34/minute, pulses are present, all active bleeding has been managed, and vitals are stable. given this, what vital aspect of the primary survey did they not advise you of? a. SAMPLE history and OPQRST b. airway patency c. actual heart rate d. patients weight and ethnicity
b. airway patency
a patient has a gastrointestinal bleed that is resulting in a drop in his circulating blood volume. in order for the body to try and compensate for this volume loss while attempting to maintain adequate peripheral perfusion, what might the negative feedback systems of the body employ? a. increasing diuresis through the kidneys b. enchanting vasomotor tone c. decreasing after load on the left ventricle d. slowing of the heart rate
b. enchanting vasomotor tone
injury to which of the following skeletal structures carries with it the highest likelihood of fatal complications? a. tibia b. femur c. ulna d. humorous
b. femur
you should begin multi-casualty procedures when: a. you have fewer ambulances than patients to be transported b. the demands of the event overwhelms your available resources c. you have more than 10 patients d. you have more than 20 patients
b. the demands of the event overwhelms your available resources
while performing a scene size up for a report of workers overcome in a factory you see a diamond shaped placard on the building with four numbers. generally speaking, the higher the number in each quadrant, what can be inferred? a. number infer what the building is composed of b. the more dangerous the contents c. there is no relationship between the numbers and the substance inside d. the less dangerous the contents
b. the more dangerous the contents
a 32-year-old male has been stabbed in the upper right quadrant of his abdomen. the knife used was seven inches long. what is the organ most likely damaged by this wound? a. spleen b. bladder c. liver d. stomach
c. liver
as you enter an apartment, you observe an alert but anxious women in her 50s sitting in a chair working to breathe. you see accessory muscle use, shallow respirations, and pale skin. how would you classify the patients respiratory status? a. respiratory acidosis b. respiratory compromise c. respiratory distress d. respiratory failure
c. respiratory distress
you are called to assist another crew with lifting a heavy patient. after walking up the stairs to the patients second floor bedroom, you realize you do not have gloves. you should: a. not worry about gloves because you will not be providing care b. assist in the lift and be sure to wash your hands thoroughly after c. return to the ambulance to retrieve a pair of gloves d. be careful what you touch and assist in the lift
c. return to the ambulance to retrieve a pair of gloves
which one of the following medical-legal concepts would best apply to an EMT who chose to illegally perform a paramedic skill level? a. duty to act b. abandonment c. scope of practice d. libel
c. scope of practice
you are dispatched for a patient that has been assaulted. on arrival you note a crowd gathered around two men fighting. one of the men has blood on his shirt. you should: a. ask bystanders to help separate the combatants b. enter the crowd and attempt to stop the fight c. stage a safe distance away and await law enforcement d. return to the ambulance and leave the scene immediately
c. stage a safe distance away and await law enforcement
alveolar ventilation refers to the amount of: a. carbon dioxide transferred from the blood to the alveoli each minute b. oxygen transferred to the blood from the alveoli each minute c. air that does not reach the alveoli during normal inhalation d. air moved in and out of the alveoli per minute
d. air moved in and out of the alveoli per minute
a 17-year-old male has been stabbed in the groin. he presents with bright red, spurting blood. this bleeding is most likely from a(n): a. underlying organ b. capillary c. vein d. artery
d. artery
which one of the following best describes why activated charcoal is administered to treat an ingested toxin? a. it neutralizes acidic toxins b. it removes toxins from bloodstream c. it reverses the effects of many toxins d. it adsorbs toxins in the stomach
d. it adsorbs toxins in the stomach
