Final exam
Which one of the following statements made by a patient's family member would cause the EMT to suspect that a patient is suffering from hypovolemic shock? A. "He cannot stop throwing up." B. "He got up this morning and was having a hard time breathing." C. "He has had a rash for the past three days." D. "He has been taking an antibiotic for a chest cold."
A. "He cannot stop throwing up."
Two cars have collided head on. One car was traveling 55 mph and the other 35 mph. The total speed of impact would be: A. 90 mph B. 20 mph C. 35 mph D. 55 mph
A. 90 mph
Which portion of the heart is in failure when it can no longer effectively pump blood into the lungs? A. Right ventricle B. Left ventricle C. pulmonary vein D. Left atrium
A. Right ventricle
Which of the following is MOST clearly a HIPAA violation? A. You provide a personal injury attorney with a copy of a patient care report when the attorney stops by the station one day and asks for it. B. Your agency receives a subpoena authorizing the release of a copy of a patient care report to a plaintiff's attorney. C. You provide certain health information on the billing copy of the patient care report. Your answer is not correct. D. You provide a copy of the patient care report to a Paramedic who is assuming care of your patient at the scene.
A. You provide a personal injury attorney with a copy of the patient care report when the attorney stops by the station one day and asks for it.
When deciding whether or not to transport a patient to the hospital using lights and sirens to the hospital, what information carries the most weight in your decision? A. assessment findings B. index of suspicion C. mechanism of injury D. past medical history
A. assessment findings
You are assessing a 45-year-old female who was in severe respiratory distress. She has not responded to two bronchodilator treatments, she has an altered mental status, and her head is bobbing. What should you do NEXT for the patient? A. begin assisting her ventilations. B. sit her up, and reassess her vital signs. C. place her on the CPAP D. ask her to self-administer another bronchodilator treatment.
A. begin assisting her ventilations.
You are reassessing a young female who sustained blunt trauma to the chest in a motor vehicle collision. What assessment finding best indicates that she is deteriorating and in the decompensatory phase of shock? A. blood pressure of 88/50 mmHg B. anxiety C. heart rate 100 beats per minute D. blood continuing to ooze from an abdominal laceration
A. blood pressure 88/50 mmHg
Bystanders called 911 for a female patient who was screaming obscenities in a store parking lot. On arrival you find the patient to be sitting in the middle of the parking lot muttering incomprehensible phrases. After conducting the primary assessment and finding no immediate life-threatening conditions, you move her to the ambulance. Additional assessment findings include abrasions to her arm and urinary and fecal incontinence. She also has a bottle of Prozac in her pocket. You reference Prozac in your medication book and find it to be used to treat depression. With this information, how will you treat this patient? A. consider supplemental oxygen and transport on her left side. B. arrange for transport to the halfway home where she lives. C. assist her in taking one dose of Prozac. D. transport to the psychiatric hospital where she has been a patient
A. consider supplemental oxygen and transport on her left side
You are on the scene of a full arrest. You have begun resuscitation, inserted an airway, and are on your third round of CPR. A family member arrives to the home and presents you with a valid DNR order. You should: A. continue resuscitation while contacting medical control who will advise whether or not to stop or continue resuscitation. B. stop providing resuscitation immediately. C. complete two more rounds of CPR for a total of five rounds as per guidelines and then check for a pulse. If no pulse, then stop resuscitation. D. have your partner contact the communications center and have them send law enforcement to the scene as this is now a legal issue and the officer will make the decision.
A. continue resuscitation while contacting medical control who will advise whether or not to stop or continue resuscitation.
You are by the side of an alert and oriented 56-year-old male patient complaining of generalized weakness and a pounding headache. His pulse is 104, respirations 18, and blood pressure 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 two weeks and hands you a container with the medication inside. You would: A. continue treatment and transport to the hospital B. contact medical direction to request an order for the lisinopril C. ensure that it is the patient's medication and then administer it. D. assist the patient in taking the lisinopril.
A. continue treatment and transport to the hospital
A patient with chest pain and shortness of breath informs you that the last time he had a heart attack, he went into heart failure. When performing your secondary assessment, which one of the following signs or symptoms is most indicative that the patient is in heart failure again? A. crackles in the lungs B. hypertension C. shortness of breath D. flat neck veins
A. crackles in the lungs
Which one of the following actions taken by an EMT illustrates the best effort toward well-being in the field of EMS? A. Creating a healthy balance between work and family life B. Establishing a relationship with a mental health professional C. taking a body-building class D. avoiding all alcohol and fatty foods.
A. creating a healthy balance between work and family life.
The EMT knows that the cause underlying distributive shock is: A. dilation of the blood vessels B. loss of blood volume C. poor fluid intake D. damaged heart with poor contractility
A. dilation of the blood vessels
An elderly patient is being taken care of at home by family members and lies in a hospital-type bed in the living room. After providing necessary care, you prepare to move her from the bed to the stretcher. There is no mechanism that suggests a head, neck, or spinal injury. Which one of the following methods would be most appropriate in this situation? A. draw sheet method B. direct lift C. direct carry method D. extremity lift
A. draw sheet method
For negligence to be proven, which of the following must be present? A. Duty to act, injury, proximate cause B. Duty to act, breach of duty, battery C. harm to the patient, false imprisonment, duty to act D. Assault, breach of duty, damage
A. duty to act, injury, proximate cause.
A patient has been shot once in the left hand. After performing the primary assessment, the EMT quickly focuses his attention on the left hand and begins a specific assessment of the injury. What type of exam is the EMT performing? A. focused B. rapid C. specific D. extremity
A. focused
A patient in respiratory distress is exhibiting pursed lip breathing. You realize that he is doing this to: A. keep the small airways open B. prevent the loss of vapor with exhalation C. exhale increased amounts of CO2 D. inhale additional amounts of oxygen
A. keep the small airways open
Which assessment finding in a patient who is complaining of abdominal and back pain would the EMT be MOST concerned about? A. pulsating mass above the umbilicus B. history of gallbladder disease C. increased bowel sounds associated with diarrhea D. surgical scar in the right upper quadrant.
A. pulsating mass above the umbilicus.
A patient has been critically hurt in a nighttime motor vehicle collision. She was wearing a seat belt and hit a tree at 70 mph. the car she was driving weighed 2 tons and was equipped with air bags that did deploy. which of the following had the greatest impact on her being injured? A. speed of the vehicle at impact. B. nighttime conditions C. deployment of air bags D. weight of the vehicle
A. speed of the vehicle at impact.
On scene, you find a 2-year-old male in significant respiratory distress. He is responsive to verbal stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths per minute. 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. start positive pressure ventilation B. apply oxygen through a pediatric nonrebreather mask C. insert an oropharyngeal airway D. move to the ambulance for immediate transport
A. start positive pressure ventilation
A 67-year-old male who lives in an extremely "bad" neighborhood is experiencing chest pain. There are vacant homes throughout, including the homes to either side of his residence. Additionally, parked cars have forced you to park three houses away, making it necessary to walk and carry supplies to the residence. Which action is most appropriate as you approach and/or gain access to the patient's house? A. Walk single file with your partner behind you carrying the medical bag. B. stand in front of the door while knocking to make your presence known. C. walk on the sidewalk instead of the grass to ensure steadier footing. D. hold a lit flashlight in front of you to illuminate shrubbery and trash cans.
A. walk single file with your partner behind you carrying the medical bag.
Which of the following is best suited to remove large amounts of fluid from the oral airway? A. Yankauer catheter B. blind finger sweep C. soft-tip catheter D. French catheter
A. yankauer catheter
Which one of the following statements about PCRs is accurate? A. "The EMT should only document the direct care he or she provided and not the care by EMRs since their report will reflect this." B. "Aside from providing a record of the care given, the PCR also may be used for education and research." C. "The PCR is a public record that becomes part of the patient's permanent medical record." D. "National standards allow the EMT to complete the PCR up to three days after the call as long as a verbal report was given to the physician."
B. "Aside from providing a record of the care given, the PCR also may be used for education and research."
Which one of the following patients should receive supplemental oxygen with a nonrebreather mask or nasal cannula? A. 18-year-old who overdosed on a drug and is unresponsive and breathing 6 times a minute. B. 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute C. 39-year-old male with a sprained ankle and breathing 16 times per minute D. 61-year-old male who is unresponsive with a foreign body airway obstruction that cannot be removed with abdominal thrusts
B. 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute.
Most authorities agree that the modern-day EMS system evolved after the release of what document? A. The American Heart Association guidelines for Cardiac Resuscitation B. The White Paper "Accidental Death and Disability: The Neglected Disease of Modern Society." C. The Emergency Medical Services Act of 1973 D. The Emergency Medical Services: Agenda for the Future
B. The White Paper "Accidental death and Disability: The Neglected Disease of Modern Society."
You have been called to a local emergency department to transfer a 67-year-old male to another facility. At the hospital, the emergency physician informs you that the patient and his family have requested the transfer because his doctor is affiliated with the other hospital. At bedside, you see that the patient is receiving an antibiotic through an IV. Though your state does allow EMTs to perform non-emergent transports of patients receiving normal saline through an IV, it does not allow transport of patients receiving IV medications. When informed of this, the physician states that the antibiotic will be done in 10 minutes and that he will give written permission to start the transport while the medication is infusing. Which one of the following EMT actions would be most appropriate at this time? A. Stop the IV infusion and transport the patient. B. transfer the patient once all of the medication is infused. C. Recognize a HIPAA violation and refuse the transport? D. Follow the doctor's order as long as he writes and signs it.
B. Transfer the patient once all of the medication is infused.
A 48-year-old male is short of breath and confused. His airway is open, and his breathing accelerated. A radial pulse is easily palpated. His skin is warm to cool and dry. Your partner reports the following vital signs: pulse 124 beats per minute, respirations 24, blood pressure 158/86 mmHg, and an SpO2 at 89% on room air. His lung sounds indicate slight wheezing. Based on this information, the immediate threat to this patient's well-being is which one of the following conditions? A. infection B. hypoxia C. elevated blood pressure D. increased heart rate
B. hypoxia
While cleaning a gun, a 44-year-old patient accidentally shot himself in the abdomen. On arrival, you observe the patient on the floor lying on his side with his legs drawn to his chest. Blood is evident on his shirt and pants. Which one of the following indicates the correct sequence of events when caring for this patient? A. Transfer to the ambulance, perform the primary assessment and rapid secondary assessment, provide oxygen therapy, rapid transport B. Perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport C. Transfer to the ambulance, rapid transport, primary assessment and oxygen therapy performed en route to the hospital D. Perform primary and secondary assessments, move to the stretcher for immediate transport, start positive pressure ventilation en route to the hospital
B. perform the primary assessment, administer high-concentration oxygen, perform a rapid secondary assessment, transfer to the stretcher, rapid transport.
You have opened the airway using a head-tilt, chin-lift and are ready to ventilate an apnea patient with a potential mask. the first ventilation you attempt is unsuccessful. You should immediately: A. provide five abdominal thrusts B. reposition the head C. Use a jaw-thrust maneuver D. ventilate over 3 seconds
B. reposition the head
Which of the following signs related to breathing would be most concerning to the EMT? A. respiratory rate of 18, complaint of weakness. B. respiratory rate of 20, use of accessory muscles. C. respiratory rate of 10, speaking without difficulty. D. respiratory rate of 22, chest expansion of 1 inch.
B. respiratory rate of 20, use of accessory muscles.
Which patient description contains only vital signs: A. chief complaint of dizziness, skin cool and clammy, respiratory rate of 16. B. skin warm and dry, heart rate of 74, pupils equal and reactive. C. Chief complaint of dizziness, BP 110/76 mmHG, breath sounds clear and equal D. heart rate 88, respiratory rate 14, blood glucose level 98 mg/dL
B. skin warm and dry, heart rate of 74, pupils equal and reactive.
You notice that your partner routinely only takes one set of vitals when treating and transporting patients. When asked, he states that he only gets baseline vitals since they are most important as they provide information related to the patient's clinical status at the time of the EMS call. How would you respond? A. "You must get at least two sets of vital signs because that is what the national standard calls for." B. "You must at least get a pulse rate every 15 minutes since this is the most important vital sign." C. "Examining several sets of vital signs can indicate the effectiveness of your treatment." D. "Comparing several sets of vital signs is the only way you will know if the patient is improving or deteriorating."
C. "Examining several sets of vital signs can indicate the effectiveness of your treatment."
Which of the following statements best describes the relationship between the EMT and the program medical director? A. The medical director is required to be part of the hiring process, since the EMT works under his or her license. B. The EMT must contact the medical director before transporting any patient. C. The EMT operates as an extension of the medical director. D. The medical director is charged with establishing base pay for the EMT
C. The EMT operates as an extension of the medical director.
A 62-year-old female was struck by a car traveling approximately 45 miles per hour. After being struck, she was thrown 15 feet onto the sidewalk, impacting the pavement with her head and chest. The primary assessment has been completed and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, which of the following should the EMT perform first? A. obtain a full set of vital signs including a pulse oximeter reading. B. examine the head and chest for other life-threatening injuries C. Assess the patient from head to toe for additional injuries. D. inquire from family if the patient has any past medical history
C. assess the patient from head to toe for additional injuries.
Which of the following is true regarding s scene safety? A. Scene safety is assessed only once, immediately upon arrival. B. establishing scene safety is not your responsibility once law enforcement arrives. C. assessing scene safety is dynamic and ongoing D. Determination of scene safety is done prior to arrival
C. assessing scene safety is dynamic and ongoing.
Which statement would you agree with regarding both anaphylactic and anaphylactoid reactions? A. anaphylactoid reactions seldom involve the airway while anaphylaxis does. B. anaphylaxis is caused by medications; anaphylactoid reactions are not. C. both anaphylactoid and anaphylactic reactions are treated the same. D. administering epinephrine in an anaphylactoid reaction can be fatal.
C. both anaphylactoid and anaphylactic reactions are treated the same.
Your EMT partner is always reading the latest trade journals in EMS and discussing these readings with other colleagues and how these things could improve the care offered by the EMS service. This EMT has very strong: A. time management B. clinical judgment C. ethics D. morals
C. ethics
Many states require EMTs to report which of the following to law enforcement? A. Drug addiction and drug-related crimes. B. alcohol abuse and child abuse. C. physical and mental abuse D. refusal of EMS service
C. physical and mental abuse.
You arrive at a residence for a male patient who is unresponsive. As you enter the room, you observe an obese male lying on a recliner. His eyes are closed, and he has gurgling respirations. While your partner quickly performs a primary assessment, you should immediately prepare to: A. administer high-concentration oxygen B. insert an oropharyngeal airway C. suction the airway D. osculate breath sounds
C. suction the airway
The patient data section of the prehospital care report includes all of the following, EXCEPT: A. billing information B. the patient's age and sex. C. the ambulance service name D. mechanism of injury
C. the ambulance service name
A 40d-year-old man has been seriously injured in a car crash. He is unresponsive and has what you believe to be a collapsed lung. Additionally, his left leg is severely deformed and his vital signs are unstable. A passenger in the car informs you that the patient is a diabetic and has heart problems. Given this information, which one of the following is the best destination for this patient? A. cardiac center B. spine injury center C. trauma center D. stroke center
C. trauma center
While transmitting a patient to the emergency department, you should avoid: A. describing the patient's condition B. providing an ETA C. using personally identifiable information. D. informing the ED of the patient's medical history.
C. using personally identifiable information
While assessing a patient with acute abdominal pain, you note that his abdomen is very rigid. When asked to relax his stomach muscles, he does. The EMT would recognize: A. rebound guarding B. false guarding C. voluntary guarding D. involuntary guarding
C. voluntary guarding
Which one of the following patients should the EMT recognize as being mildly hypoxic? A. 44-year-old male breathing 22 times per minute who is confused and has an SpO2 at 97% B. 36-year-old female with asthma, breathing 22 times per minute with cyanosis to her fingertips C. 24-year-old female breathing 8 times per minute with cyanosis to her lips. D. 18-year-old male who is breathing shallowly at 16 times per minute with no cyanosis.
D. 18-year-old male who is restless and breathing at 16 times per minute with no cyanosis.
Which one of the following patients should benefit from the head-tilt, chin-lift manual airway maneuver? A. 45-year-old female who is alert and omitting blood B. 85-year-old female who hit her head on a tree limb and is now responsive to painful stimuli C. 67-year-old female who fell down a flight of stairs and is unresponsive. D. 39-year-old male who just had a seizure and has snoring respirations.
D. 39-year-old who just had a seizure and has snoring respirations.
Which of the following would be considered an appropriate position for transport? A. A hypotensive 48-year old male in a position of comfort. B. A 23-year old pregnant woman in a supine position. C. A critically injured 18-month old in a car seat. D. An alert 67-year-old female with nausea in a sitting position.
D. An alert 67-year-old female with nausea in a sitting position
When there are two rescuers to dedicate to the airway, the MOST appropriate device to use on a nonbreathing patient would be: A. a nonrebreather mask B. CPAP C. a partial-rebreather mask D. a bag-mask device
D. a bag-mask device
A tornado ripped through a small town, killing five and seriously injuring 21, including several young children. At a defusing session, which one of the following is most appropriate? A. provide information on stress reduction techniques. B. evaluate and critique the rescue effort. C. have a mental health processional talk with the rescuers D. allow the rescuers to vent their emotions
D. allow the rescuers to vent their emotions.
When caring for the victim of a motor vehicle collision, the EMT should suspect critical injuries if there was: A. more than one person injured. B. another passenger ejected. C. only a solo occupant. D. another occupant killed
D. another occupant killed
You are assessing a patient with an obvious left mid shaft femur fracture. The most immediate life threat to this patient's well-being is: A. pain B. Nerve damage C. infection. D. blood loss
D. blood loss
Jurisdiction over all EMS radio operations in the US is held by the: A. department of transportation B. Department of health and human services C. Federal emergency management agency D. federal communications commission.
D. federal communications commission.
You have arrived at the emergency department with a patient complaining of nausea. The department is extremely busy and you are waiting to give a verbal report to the nurse or doctor. While waiting, dispatch contacts you over the radio and states that you are needed for a critically injured child. Your best action would be to: A. provide the certified nurse's aide with a report of the patient's condition. B. take the call and come back to give the report at a later time. C. leave the patient in the emergency department and take the call. D. go to the nurse's station and provide the registered nurse with a quick report.
D. go to the nurse's station and provide the registered nurse with a quick report.
If an injured patient has lost all use of his diaphragm, the EMT should recognize that the patient: A. requires immediate cardiopulmonary resuscitation and frequent suctioning. B. is breathing adequately but most likely will be complaining of chest pain. C. requires supplemental oxygen with a nonrebreather face mask. D. has lost a major portion of his ability to breathe.
D. has lost a major portion of his ability to breathe.
You are teaching a group of firefighters who are in class to become Emergency Medical Responders. The topic is artificial ventilation with the bag-valve mask (BVM). Which one of the following points related to using the BVM should you emphasize? A. the BVM is useless unless it is hooked to supplemental oxygen. B. It is better to ventilate too quickly as opposed to too slowly. C. the bag must be fully squeezed in order to give the proper amount of volume with each breath D. maintaining a good man-to-face seal is difficult.
D. maintaining a good mask-to-face seal is difficult
Which of the following best describes the path that oxygen must travel to get into the capillaries? A. pharynx, larynx, trachea, alveoli, bronchioles B. nasopharynx, oropharynx, carina, trachea, alveoli C. nose, pharynx, esophagus, bronchi, alveoli D. oropharynx, larynx, trachea, carina, bronchioles
D. oropharynx, larynx, trachea, carina, bronchioles
What is the function of the respiratory system? A. transport oxygen throughout the body B. release oxygen from the body C. provide nutrients to the cells D. provide the body with oxygen
D. provide the body with oxygen.
In deterring the adequacy of ventilation, the two items that are considered include: A. SpO2 and method of oxygen delivery B. age and tidal volume C. patient age and BVM volume D. respiratory rate and quality.
D. respiratory rate and quality
Which of the following indicates your patient is maintaining adequate perfusion? A. The patient is warm. B. The patient is on high-flow oxygen. C. The patient is tachycardia. D. The patient has an adequate blood pressure.
D. the patient has an adequate blood pressure.
A distraught husband awoke to find his 26dash-yeardash-old wife not breathing and cold to the touch. You arrive on scene, and your assessment indicates that the woman has been dead for some time, so you contact medical direction for authorization to withhold emergency care. The medical director agrees, and the coroner is notified. At this time, your immediate responsibility is: A. deterring the cause of death B. establishing the time of death C. preparing for the next call D. to provide supportive care to the family present.
D. to provide supportive care to the family present.
A 67-year-old male with a history of diabetes and previous heart attack slipped and fell down three stairs. His chief complaint is pain and deformity to his right wrist. The EMT would classify the patient as a: A. medical and trauma patient B. special needs patient C. medical patient D. trauma patient
D. trauma patient
Which one of the following best explains the reason why emergency services communications are recorded? A. the Federal Communications Commission reviews all recordings for communication appropriateness. B. communications can become part of a legal record if need be C. the federal government requires that all communications be recorded. d. the state EMS agency will use the recording to determine if care was appropriate
b. Communications can become part of a legal record if need be.