NREMT EMT Test wrong answers

Your adult patient is apneic but has a pulse. Your partner pulls out the bag-valve mask (BVM) and portable oxygen to start ventilation. What is the ventilation rate?

1 breath every 5-6 seconds

You are on scene at a supermarket with an 83-year-old male who collapsed while shopping with his granddaughter. Your patient is unconscious and unresponsive with no obvious signs of trauma. You simultaneously check for breathing and a pulse. How long do you spend checking for the patient's pulse?

10 seconds

You have a 12-year-old female patient who was skateboarding at a local skate park. She fell off the board, striking her face on a concrete curb. Her two front teeth were avulsed, and her mother has them in her hand when you arrive. What is the recommended time frame from the time the patient received the trauma to the time of reimplantation?

20 - 60 minutes Reimplantation of an avulsed tooth is recommended within 20 minutes to 60 minutes after the trauma has occurred. This is the best timeframe for reimplantation to ensure the best possible prognosis. Necrosis of the tissues occurs after an avulsion injury, which can hinder the tooth from taking root during reimplantation

You are treating an 80-year-old female for shortness of breath. The patient has a history of COPD and pneumonia and has no known allergies. The patient takes bronchodilators and steroids and is on home oxygen. What percentage of the vital capacity do older adults over 75 years of age have compared to young adults?

50 percent

In general, which of the following is not a situation in which high-flow oxygen should be provided?

A patient with chronic obstructive pulmonary disease and an oxygen saturation of 95%

In which of the following situations would the administration of albuterol via a metered-dose inhaler (MDI) be the most beneficial?

An alert 16-year-old female with a history of asthma who has respirations of 24 breaths per minute and is wheezing Albuterol via a metered-dose inhaler (MDI) may be used for acute asthma or chronic obstructive pulmonary disease (COPD) exacerbation or bronchitis. The 16-year-old is likely suffering from an asthma exacerbation since she has a history of asthma, her respirations are elevated (above 20 breaths per minute), and she is wheezing. Contraindications to MDI use include a patient who is unable to help coordinate inhalation with depression of the trigger (i.e., confused, unconscious) or a patient who has already had the maximum prescribed dose. A patient with an active upper-respiratory infection (e.g., bronchitis) may not need albuterol via an MDI if no respiratory complaints are evident. An MDI may be used only if the "six rights," including the right patient, are assessed and accurate. Always follow local protocols for assisting with MDI use.

You are called to an 87-year-old female who fell while getting out of bed and hit her head on her bedside table. The patient is conscious, alert, and oriented when you arrive, with a hematoma and a 2" laceration to her forehead. While assessing her pupils, you notice they are uneven. Her family states that she was born with unequal pupils and that is normal for her. What is the medical term for someone who was born with unequal pupils?

Anisocoria is the term used for someone who is born with unequal pupils. People born with anisocoria do not typically have any underlying disorder, and it may be genetic. Even if a patient was born with unequal pupils, you should still be concerned if they have incurred any type of trauma.

Your patient is a 74-year-old female complaining of difficulty breathing with a history of chronic obstructive pulmonary disease (COPD). What are the early signs of hypoxia? Select the 2 answer options which are correct.

Anxiety Tachycardia

Your patient is a 34-year-old male who was ejected from his motorcycle at a high rate of speed. He was not wearing a helmet and is unresponsive with an irregular breathing pattern. His respirations are fast and deep, followed by a period of apnea. How would you describe your patient's respirations?

Cheyne-Stokes respirations are an irregular breathing pattern common in patients with a stroke or head injury, which is suspected in this patient. Cheyne-Stokes respirations present with an increasing rate and depth of respiration followed by a period of apnea. After the period of apnea, irregular respiration repeats itself.

What is the average length of the first stage of labor in a primigravida patient?

Correct answer: 12-18 hours The average length of the first stage of labor (the dilation of the cervix) in a primigravida patient is 12-18 hours. Typically, a patient in the first stage of labor, regardless of the number of prior pregnancies, will not deliver prior to transport.

Which of the following is the normal respiratory range for an infant patient at rest?

Correct answer: 30-60 breaths per minute Range of Respiration by Age: Ages 0 to 12 months: 30 to 60 breaths per minute Ages 1 to 3 years: 24 to 40 breaths per minute Ages 4 to 5 years: 22 to 34 breaths per minute Ages 6 to 12 years: 18 to 30 breaths per minute Ages 13 to 18 years: 12 to 16 breaths per minute Ages 18 and up: 12 to 20 breaths per minute

How long can the brain be deprived of oxygen before developing irreversible damage?

Correct answer: 4-6 minutes A normal, healthy adult patient may begin to experience permanent brain damage after 4-6 minutes without oxygenation. Simple acts, such as opening an airway, may restore normal breathing in unconscious patients. If spontaneous breathing is not restored by opening the airway, the patient may require assisted ventilation.

While driving an ambulance in emergency mode with lights and sirens, which steps should be taken to proceed through an intersection with a red light?

Correct answer: Come to a brief stop at the light, look for motorists and pedestrians before proceeding, and move forward when it is safe

An adult patient has a diabetic history. Which of the following findings would be expected for a patient suffering from hypoglycemia?

Correct answer: Diaphoresis A normal blood glucose level for an adult patient is between 80 and 120 mg/dL. Hypoglycemia will commonly cause a rapid onset of pale, cool, and moist skin (from sweating); a rapid, weak pulse; potential hypotension; shallow or ineffective breathing; and altered mental status if the blood glucose volume is too low. Oral glucose is the primary prehospital treatment for suspected hypoglycemia.

You are assessing a 56-year-old female with an altered level of consciousness. Family members stated she was eating breakfast and suddenly started asking strange questions and was not responding appropriately to their questions. Using the mnemonic AEIOU-TIPS to review the possible causes of altered mental status, what does the second "I" represent?

Correct answer: Infection Using the mnemonic AEIOU-TIPS is helpful to use when reviewing the possible causes of altered mental status. The second "I" represents infection. The rest of the mnemonic are as follows: A - Alcohol E - Epilepsy, electrolytes, endocrine I - Insulin O- Opiates and other drugs U - Uremia (kidney failure) T - Trauma, temperature I - Infection P - Poisoning, psychogenic causes S - Shock, stroke, seizure, syncope, space-occupying lesion, subarachnoid hemorrhage Insulin is the second "I" of the mnemonic. Ingestion would fall under "P" for poisoning. Ischemia is categorized under "S" for stroke.

An unconscious patient is found with blood and possibly broken teeth or debris in the upper airway. What is the best way to clear the patient's airway safely and effectively?

Correct answer: Log-roll the patient to the side and clear the mouth carefully with a gloved finger, clearing only visible foreign bodies Solid objects—teeth, foreign bodies, or food—may obstruct an otherwise patent airway. Suction is often not adequate to remove such objects. Log-rolling the patient to the side and removing visible objects is the most appropriate method. A blind finger sweep may push objects farther into the airway. Continuous ventilation, whether via a non-rebreather mask or a bag-valve mask, is inappropriate if particles are present within the airway.

You respond to a call for a 22-year-old female who is in active labor. Upon your arrival, you find the patient in the bathtub, and she tells you that she can feel part of the baby coming out. Upon your inspection, you see an arm presenting. How would you position your patient for transport?

Correct answer: On her back with her pelvis elevated When a patient has a limb presentation, you want to transport them on their back with their pelvis elevated. Transporting in this position uses gravity to lessen the pressure on the birth canal. Cover the limb with a sterile towel and transport the patient immediately. Patients who present with a limb presentation cannot be delivered in the field. Surgical intervention is needed. Usually, when transporting pregnant patients, you want to place them on their left side to reduce pressure on the inferior vena cava and improve oxygenation and blood return. However, when a limb is presenting, the patient needs to be placed on her back with the hips elevated. Pregnant patients with a limb presentation should not be positioned on their right side or flat on their back. The recommended position is on the back with the hips elevated.

A 32-year-old male is hypothermic after swimming in an icy river. Although he emerged from the river within a few minutes, he is showing a diminished level of consciousness. Which of the following is the appropriate next step?

Correct answer: Passive rewarming Passive rewarming is an appropriate first step when dealing with a patient who has mild hypothermia. Passive rewarming includes placing the patient in a warm environment (e.g., the patient compartment with the heat on); removing wet clothing; applying heat packs/hot water bottles to the groin, axillary, and cervical regions; placing dry blankets over and under the patient; and giving warm, humidified oxygen. Active rewarming is used for patients with severe hypothermia and is performed by ALS providers, with constant temperature monitoring. Patients should be discouraged from walking to avoid further damage to the feet. Massaging the extremities or handling the patient roughly is inappropriate.

Which is the preferred method to use when ventilating a patient with a tracheostomy tube?

Correct answer: Ventilate through the tube with a bag-valve mask (BVM) The preferred method for ventilating a patient with a tracheostomy tube is to ventilate through the tube using a BVM. The standard 15/22 mm adapter on the BVM will fit directly onto the tracheal stoma. With 100% oxygen attached to the BVM, the patient can easily be ventilated by one EMT. A non-rebreather mask alone does not provide ventilation, only oxygen. A child mask and BVM are used to ventilate a patient with a stoma in the absence of a tracheostomy tube. Neither the head tilt chin-lift maneuver nor the jaw-thrust is required to be performed on patients with a stoma.

During their careers, EMTs will typically see a written document called an advance directive. Which are examples of an advance directive? Select the 3 answer options which are correct.

DNR Living will a durable power of attorney

The GEMS diamond is an acronym for issues to be considered when assessing older patients. Which of the following make up the GEMS diamond? Select the 4 answer options which are correct.

GEMS: Geriatric Environmental assement Medical assesment Social assement

What are some complications of CPAP administration? Select the three answer options which are correct.

Gastric distention clausterphobia hypotension

If one part of the perfusion triangle is not working, a patient will go into shock. What parts make up the cardiovascular system and are referred to as the perfusion triangle? Select the 3 answer options which are correct.

Heart Blood Vessels Blood he cardiovascular system consists of three parts that are referred to as the perfusion triangle. These parts are the heart, blood vessels, and blood. The cardiovascular system can also be described as consisting of these three parts: a pump (the heart), a set of pipes (the blood vessels or arteries that act as a container), and the contents of the container (the blood). If one or more of these parts is not functioning, the patient will go into shock.

Which of the following mass-casualty victims would be tagged "yellow" or delayed using the START triage system? Select the two answer options which are correct.

In the START triage system, ambulatory patients are tagged as walking wounded or green. The START criteria for non-ambulatory patients assess respiration, pulse, and mental status. Those who have a respiratory rate of < 10 or > 30, a pulse of > 100, or altered mental status are tagged as immediate or red. Two of these patients meet the red criteria, not yellow. If their respiration, pulse, and mental status are within normal limits, the patient is tagged yellow or delayed.

Almost one-third of people who are killed immediately in a vehicle accident die from what type of chest injury?

In vehicle accidents, blunt trauma to the chest can result in many types of chest injuries. Almost one-third of people who are killed immediately in a vehicle accident die from traumatic rupture of the aorta. The aorta is the largest blood vessel in the body that transports oxygen-rich blood from the heart to the rest of the body. When the aorta is traumatically ruptured, it can quickly lead to hypovolemic shock and death.

Your patient's pulse oximeter reading is 92%. Which would you use to deliver up to 95-100% oxygen? Select the 2 answer options which are correct.

NON rebreathing mask with rewsevior BVM o deliver up to 95-100% oxygen, you would choose a nonrebreathing mask with a reservoir or a bag-valve mask with a reservoir. The nonrebreather delivers up to 95% oxygen at a flow rate of 10 to 15 liters per minute. The bag-valve mask delivers nearly 100% oxygen at a flow rate of 15 liters per minute. The mouth-to-mask device only delivers about 55% oxygen at a flow rate of 15 liters per minute. The Venturi mask allows you to vary the percentage of oxygen that is delivered to the patient by different attachments. The Venturi mask is a medium-flow device that delivers 24% to 40% oxygen, depending on the manufacturer. Reference:

Before being found guilty of negligence as an EMT, the determination of negligence is based on four factors. Which of the following are some of the factors in determining negligence? Select the 3 answer options which are correct.

Negligence is the failure to provide the same care that a person with similar training would provide in the same situation. The determination of negligence is based on the following four factors: Duty: The EMT has an obligation to provide care and do so in a manner that is consistent with the standard of care established by training and local protocols. Breach of duty: When the EMT does not act within an expected and reasonable standard of care. Damages: When a patient is physically or psychologically harmed in a noticeable way. Causation: There must be a reasonable cause and effect relationship between the breach of duty and the damage suffered by the patient.

Which is the most effective method of dislodging and forcing an object out of the airway of a conscious child or adult?

abdominal thrusts

While making dinner at your station, you hear a knock on the door. You open the door to find a father holding his two-year-old son who has a seal-bark cough and difficulty breathing. The father says his son has had a low-grade fever for two days and was given children's Tylenol. What is the best treatment you can provide for your patient?

administer humidified oxy Croup is an airway infection below the vocal cords, typically caused by a virus. It is common in children between the ages of six months and three years and presents with the classic seal-bark cough. Patients with croup often respond well to humidified oxygen. The cool air aids in reducing the swelling in the airway and helps with their breathing. Bronchodilators are contraindicated for croup and can make the patient's condition worse. Administering children's cough syrup is not typically in an EMT's scope of practice

There are intrinsic and extrinsic factors that affect pulmonary ventilation. Which are considered intrinsic factors that cause challenges with maintaining an open airway? Select the 3 answer options which are correct.

allergic reactions airway obstructions from the tongue infections Intrinsic factors come from within a person's body, while extrinsic factors arise externally. Intrinsic factors that cause challenges with maintaining an open airway include allergic reactions and infections that cause swelling of the airways and the tongue obstructing the airway in an unresponsive patient

Some patients have the right to refuse treatment or withdraw from treatment at any time. Which patients have the right to refuse treatment? Select the 3 answer options which are correct.

an emancipated minor an adult who is alert and orientated an alert adult who understands they may die without treatment Patients who have the right to refuse care or withdraw from treatment at any time are adults who are conscious, alert, and appear to have the capacity to make decisions. This holds true for alert adults who are told that they may die or be seriously injured if medical care is not provided. If an adult is impaired, they cannot make rational decisions. Medical control or law enforcement would need to be called to assist with this refusal. Follow your county protocols for patient refusal of an impaired adult.

Several conditions are associated with acute coronary syndrome (ACS). Which of the following is associated with ACS? Select the 2 answer options which are correct.

angina pectoris TIA AMI

You are dispatched to the side of the freeway where a patrol officer has stopped a couple for speeding. The officer reports assisting the mother with delivering her baby in the front seat of the car and requesting EMS. Upon your arrival, the mother seems to be doing fine, so you take the newborn from her to perform your assessment. How would you proceed if the newborn's heart rate was greater than 100 beats per minute (BPM)? Select the 3 answer options which are correct.

assess newborn continuously keep baby warm transport the newborn with her mother A newborn's heart rate at more than 100 beats per minute is within normal limits. Anything fewer than 100 BPM is considered bradycardia, and resuscitative measures should be taken. Because the heart rate is greater than 100 BPM, you should keep the newborn warm and transport with the mother while assessing the newborn continuously. You would begin assisted ventilation with a BVM and 100% oxygen if the heart rate was less than 60 beats per minute. If the heart rate was between 60 to 100 BPM, you would begin assisted ventilation with a BVM and room air. If the heart rate was less than 100 BPM, you would assess the newborn every 90 seconds. In this scenario, the newborn and mother are doing fine, so ALS backup would not be needed

Most often, low blood flow to the heart is caused by coronary artery atherosclerosis. What makes plaque inside the walls of blood vessels, resulting in atherosclerosis? Select the 2 answer options which are correct.

cholestrol calcium Calcium and cholesterol, which are a fatty material, build up and form a plaque inside the walls of the blood vessels, obstructing flow and interfering with the vessel's ability to dilate or contract. Over time, atherosclerosis can cause complete occlusion of a coronary artery and can involve other arteries of the body. Typically, the cholesterol is first deposited on the walls of an artery. As the cholesterol deposits grow, calcium deposits can form as well.

You are dispatched to a solo motorcycle accident with unknown injuries. A witness heard a crash and saw a rider and a motorcycle lying in the street in front of her house. What are the four types of motorcycle impacts that are outlined in the EMT textbook that a rider can experience? Select the 4 answer options which are correct.

controlled crash angular head on ejection

You are dispatched to a solo motorcycle accident with unknown injuries. A witness heard a crash and saw a rider and a motorcycle lying in the street in front of her house. What are the four types of motorcycle impacts that are outlined in the EMT textbook that a rider can experience? Select the 4 answer options which are correct.

controlled crash ejection head on crash angular crash The four types of motorcycle impacts are head-on crash, angular crash, ejection, and controlled crash.

You are called by search and rescue to transport a patient who was found after a two-day search in blizzard conditions. The patient had been camping and had a sleeping bag and warm clothes but still sustained frostbite to his nose and all his fingers and toes. How would you treat the frostbitten areas? Select the 3 answer options which are correct.

cover the injury with a dry sterile dressing splint the frost bitten extremity remove Jewlery from an injured part Frostbite is a deep cold injury that requires delicate handling of the injured part. Frostbite is the most serious cold injury because the tissues are actually frozen, which permanently damages cells. Appropriate treatment includes carefully removing jewelry from the injured part; covering the affected areas with a dry, sterile dressing; and splinting the frostbitten extremities to prevent secondary injuries by limiting use. You never want to rub or massage the affected area, apply direct heat or heat packs, or cover the injured part with a wet dressing. Rewarming of the injured parts is best done in a hospital. When the frostbitten parts are warmed, further chemical changes occur in the cells, causing permanent damage or cell death, which is called gangrene or necrosis. If gangrene occurs, the necrotic tissue needs to be surgically removed, sometimes by amputation.

what is the third stage of labor

delivery of placenta The third stage of labor begins with the birth of the newborn and ends with the delivery of the placenta. During the third stage of labor, the placenta will separate from the uterine wall. Contractions will continue, which assist the separation process and the clamping and closing down of the blood vessels that connect the placenta to the lining of the uterus. This can take up to 30 minutes.

You have a 12-year-old female patient who was skateboarding at a local skate park. She fell off the board, striking her face on a concrete curb. Her two front teeth were avulsed, and her mother has them in her hand when you arrive. What is the recommended time frame from the time the patient received the trauma to the time of reimplantation?

eimplantation of an avulsed tooth is recommended within 20 minutes to 60 minutes after the trauma has occurred. This is the best timeframe for reimplantation to ensure the best possible prognosis. Necrosis of the tissues occurs after an avulsion injury, which can hinder the tooth from taking root during reimplantation

Which of the following provides the most EMS support?

governmental fire emergencies

You have delivered a newborn and notice a portion of the spinal cord protruding outside of the body in the lumbar area. Which of the following is the proper treatment for the patient? Select the 3 answer options which are correct.

have someone hold the newborn against there body cover the opening with a moist sterile dressing cover the opening with a occlusive dressing

You and your partner are doing a standby at a charity t-ball tournament when a fly ball goes into the stands, striking a young girl in the face. You grab your medical bag and hurry over to assist. The patient is 13 years old, with blood pouring from her nose. She says the ball hit the tip of her nose, and you do not notice any deformity. How would you treat the patient's epistaxis (nosebleed)? Select the 3 answer options which are correct.

have the patient lean forward while sitting apply direct pressure pinching the fleshy part of the nose apply an ice pack to nose

You and your partner are doing a standby at a charity t-ball tournament when a fly ball goes into the stands, striking a young girl in the face. You grab your medical bag and hurry over to assist. The patient is 13 years old, with blood pouring from her nose. She says the ball hit the tip of her nose, and you do not notice any deformity. How would you treat the patient's epistaxis (nosebleed)? Select the 3 answer options which are correct.

have the pt lean forward pinch the fleshy part of nostrils apply an ice pack to the nose

The Occupational and Safety Health Administration (OSHA) requires employers to offer which type of hepatitis vaccine to their employees who may come into contact with blood?

hepatitis B The Occupational and Safety Health Administration (OSHA) requires employers to offer the hepatitis B vaccine to their employees who may come into contact with blood or other infectious material. This vaccine is voluntary, and employees can decline the vaccine after signing a waiver. Hepatitis B is a virus that is transmitted through blood and causes a serious infection of the liver, and the vaccine is recognized as an effective defense against contracting the virus. Currently, there is no vaccine for hepatitis C or D. There is a vaccine for hepatitis A, but it is not mandatory for employers to offer the vaccine because it is commonly spread through contaminated food and water, not through blood.

You have assisted in the delivery of a newborn without complications. The placenta has not yet been delivered. What are proper procedures for the delivery and transport of the placenta in this scenario? Select the 2 answer options which are correct.

if plecenta delivers enroute wrap the cord and plecenta in a bag and towell start transport without waiting for placenta

There are intrinsic and extrinsic factors that affect pulmonary ventilation. Which are considered intrinsic factors that cause challenges with maintaining an open airway? Select the 3 answer options which are correct.

infection FBAO Allergic reactions

You are transporting a 3-year-old male with suspected epiglottitis. His mother states he suddenly developed a sore throat and a high fever, and you find him in the tripod position and drooling. How would you treat and transport this patient? Select the 3 answer options which are correct.

keep them in postion comfort administer highflow o2 transport rapidly but limit use of siren

Crush syndrome can develop when an area of the body is trapped for some time, compromising arterial blood flow. How long does the area of the body need to be trapped for crush syndrome to develop?

longer then 4 hours A crushing injury occurs when significant force is applied to the body. The extent of damage a patient will have depends on the length of time the force is applied and how much force is applied. Continued compression of the soft tissues causes soft tissue damage and reduced circulation, resulting in further destruction of the tissues. When an area of the body is trapped for longer than four hours, arterial blood flow is compromised and crush syndrome can develop. When the patient's tissues are crushed beyond repair, the muscle cells die and release harmful toxins into the surrounding tissues. Once the object is removed from the patient, the toxins are released into the bloodstream, which can result in cardiac arrest and renal failure. With any crushing injury, especially one where the patient has been crushed for a length of time, ALS should be called to assist. Patients need IV fluids before the object is removed.

To effectively suction a patient when using a fixed suction unit, what vacuum pressure is needed when the tubing is clamped?

more then 300mmhg

You are assessing an unconscious 42-year-old male who hit a tree at a high rate of speed. The patient was not seatbelted, and there were no airbags in his older vehicle. You notice bruising to his chest, and the steering wheel is bent. After taking his vital signs, you suspect cardiac tamponade based on the Beck triad. What signs and symptoms of cardiac tamponade are referred to as the Beck triad? Select the 3 answer options which are correct.

narrowing pulse pressure muffled heart tones the presence of JVD The signs and symptoms of cardiac tamponade are referred to as the Beck triad, which is the presence of jugular vein distention, muffled heart sounds, and narrowing pulse pressure. Cardiac tamponade is a life-threatening condition caused by blunt or penetrating trauma, which results in hemorrhaging around the heart. Blood leaks into the pericardial sac, causing the outer walls of the heart to become compressed. Because the pericardium has little room to stretch, the accumulated fluid and blood exerts back pressure on the outer walls of the heart, preventing the heart from completely refilling with blood. This results in the Beck triad. Increased heart rate and rapid, shallow respirations are not signs and symptoms of the Beck Triad. They are signs and symptoms of a tension pneumothorax when a lung or chest wall injury allows air into the pleural space without release. Tracheal deviation is a late sign of a tension pneumothorax

You are assessing an unconscious 42-year-old male who hit a tree at a high rate of speed. The patient was not seatbelted, and there were no airbags in his older vehicle. You notice bruising to his chest, and the steering wheel is bent. After taking his vital signs, you suspect cardiac tamponade based on the Beck triad. What signs and symptoms of cardiac tamponade are referred to as the Beck triad? Select the 3 answer options which are correct.

narrowing pulse pressure the absence of jugluar vein distention muffled heart tones The signs and symptoms of cardiac tamponade are referred to as the Beck triad, which is the presence of jugular vein distention, muffled heart sounds, and narrowing pulse pressure.

An appropriately trained EMT did not provide adequate ventilation during resuscitation, and a patient died as a result. Which of the following has occurred?

negligence

Which of the following is the leading cause of death in adolescents?

nintentional injuries are the leading cause of death in adolescents, as well as in all patients ages one to 44 years. Suicide is the third-leading cause of death in adolescents. Congenital abnormalities are the leading cause of death in infants. Cancer is the leading cause of death in patients from 45 to 60 years old.

You are part of the first team at the scene of a motor vehicle crash (MVC). Which of the following directions are correct in regard to parking the ambulance? Select the 3 answer options which are correct.

park wheels turned away from the scene park in fend off location park 100 feet away if possible

There are three concepts of energy associated with traumatic injuries. Which of the following is not one of the concepts of energy?

partial energy

You are dispatched to a construction site for a 33-year-old male roofer who fell 20 feet off the roof, striking his head on a concrete pad. Upon arrival, the patient is unconscious and unresponsive with a weak pulse and agonal respirations. As you are assessing and treating the patient, you suspect the patient has received a traumatic brain injury (TBI). What are the two broad categories that classify traumatic brain injuries? Select the 2 answer options which are correct.

primary secondary

EMS Operations You arrive at a private residence for an unconscious male with a history of terminal cancer. Which are considered presumptive signs of death? Select the 3 answer options which are correct.

profound cyanosis absent of chest rise and fall unresponsive to painful stimuli

You arrive at a private residence for an unconscious male with a history of terminal cancer. Which are considered presumptive signs of death? Select the 3 answer options which are correct.

profound cynaosis absent of chest rise and fall unresponsive to painful stimuli

What guidelines does the National Highway Traffic Safety Administration (NHTSA) provide for emergency medical services (EMS)?

provides guidelines for ems education standards

You are called to a residential living facility where you find an 80-year-old female pulseless and apneic. The staff performs compressions while you manage the airway. Before placing the oropharyngeal airway, you notice the patient has dentures that are firmly intact. How would you proceed?

remove dentures

A 16-year-old male was sitting in the stands watching a baseball game when a baseball struck him at high speed, hitting him in the head. While assessing your patient, he repeatedly asks you what happened. He remembers everything but the events leading up to the injury. What is your patient most likely suffering from?

retrograde amnesia

Your patient is a 63-year-old female with a history of hypertension with a blood pressure of 200/120 and a complaint of the worst headache she has ever felt. You suspect the patient might be having a hypertensive emergency. What other signs and symptoms would indicate a hypertensive emergency? Select the 3 answer options which are correct.

ringing in the ears nausea and vomiting Altered mental status A hypertensive emergency typically occurs with a systolic pressure greater than 180 or a rapid rise in systolic pressure. One of the most common complaints is having the most severe headache they have ever felt. Other signs and symptoms related to a hypertensive emergency include ringing in the ears, nausea and vomiting, and an altered mental status. Additionally, patients may have a strong, bounding pulse, dizziness, warm skin (dry or moist), nosebleeds, and sudden onset of pulmonary edema.

Which of the following is the term used to describe the care an EMT is legally able to provide for a patient?

scope of practice

You are dispatched to an unknown medical emergency. Upon arrival, you find a 64-year-old male with a history of sickle cell disease. What is the most common chief complaint in patients with sickle cell disease?

severe pain Patients with sickle cell disease most often call 911 due to substantial or severe pain. Sickle cell patients have red blood cells that are shaped like a sickle. These sharp and misshapen cells cause dysfunction in oxygen binding, leading to clot formation. These clots may result in a blockage known as a vasoocclusive crisis. When a patient is having a crisis, their cells and tissues are not receiving adequate oxygen. The blockages that result from sickle cell crises or vasoocclusive crises can cause substantial to severe pain and organ damage.

You are called to a private residence for a 24-year-old female who is 32 weeks pregnant and having contractions two minutes apart. Upon arrival, the patient has delivered the newborn with the assistance of her husband. You notice empty beer and whiskey bottles around the house, and the female patient smells of alcohol. Which of the following would you expect to find in a newborn with fetal alcohol syndrome? Select the 3 answer options which are correct.

severe respiratory distress low birth weight the newborn is premature Because the mother most likely abused alcohol during her pregnancy and did not have prenatal care, high birth weight and longer than normal pregnancy are not typically seen in fetal alcohol syndrome.

The airway is made up of the upper and lower airways. What is considered the lower airway? Select the 3 answer options which are correct.

the broncioles the main bronchus the trachea The lower airway is comprised of the trachea, bronchioles, and main bronchus within the lungs. The trachea, also known as the windpipe, is the conduit for air entering the lungs. The trachea consists of c-shaped rings made of cartilage. The trachea begins below the cricoid cartilage and descends down the midline of the neck into the thoracic cavity. Inside the thoracic cavity, the trachea divides into the right and left mainstem bronchus. The bronchioles are inside the lungs with the bronchi and alveoli. The bronchioles are hollow tubes made of smooth muscle, which allows the bronchioles to dilate or constrict in response to various stimuli. The larynx is found in the upper airway. It is a cartilaginous structure located above the trachea and is the dividing point between the upper and lower airways.

You are off duty at a local coffee shop and decide to use the restroom before you leave. When you walk in, you notice a person on the ground in a stall who appears to be unresponsive. As you are trying to gain access, another person walks in. You ask them to call 911. You are able to pull the person out from under the stall and find them pulseless and apneic. You realize they are wearing an external defibrillator vest and find blue gel under the defibrillator pads when you start CPR. What does the blue gel represent?

the device has already delivered

A patient can experience chest pain when they have angina pectoris and acute myocardial infarction (AMI), but the cause of pain is for different reasons. Why is the patient with AMI experiencing chest pain?

the pain that occurs from an ami signals the death of a cells in the heart muscle When a patient has an acute myocardial infarction, the pain is caused by the death of cells in the heart muscle. Infarction means the death of tissue, which leads to severe diminishment of the heart to pump. An AMI occurs when a blood clot restricts or prevents blood flow to an area of the heart muscle. If left untreated, the heart tissue will die.

You are treating a 16-year-old female who had a seizure while sitting in her classroom. Her teacher placed her on the floor and she is uninjured. Your patient is unconscious with a clear airway and normal breathing. Which position would you place the patient to maintain a patent airway?

the recovery position.

Almost one-third of people who are killed immediately in a vehicle accident die from what type of chest injury?

traumatic ruputre of aorta In vehicle accidents, blunt trauma to the chest can result in many types of chest injuries. Almost one-third of people who are killed immediately in a vehicle accident die from traumatic rupture of the aorta. The aorta is the largest blood vessel in the body that transports oxygen-rich blood from the heart to the rest of the body. When the aorta is traumatically ruptured, it can quickly lead to hypovolemic shock and death.

You are preparing to package and transport a 78-year-old female complaining of left hip pain after she tripped and fell over her dog, landing on a concrete sidewalk. Upon assessment, you find shortening and rotation of her left leg and pain and tenderness upon palpation. What is the preferred method to immobilize the patient's hip for transport?

use a scoop strecher with pillows

What is done first in a primary assessment?

Assess level of consciousness After completing a scene size-up, the primary assessment is initiated. First, EMS providers should form a general impression of the patient. Next, assess the level of consciousness. According to the AVPU scale, a patient is considered awake and alert if their eyes open spontaneously and they are responsive to the environment. A patient is considered responsive to verbal stimuli if (a) their eyes do not open spontaneously but open in response to speech or (b) the patient is able to respond in some meaningful way. A patient is responsive to pain if they do not respond to questions but move or cry out in response to painful stimuli. Appropriate painful stimuli include gently but firmly pinching the earlobe, pressing on the bone above the eye, or gently but firmly pinching the muscles of the neck. If none of the above elicits a response, the patient is considered unresponsive. After the level of consciousness is assessed, the patient's airway, breathing, and circulation are assessed, and life-threatening problems are treated. Reference:

The cardiac muscle cells have a unique characteristic that is not found in any other types of muscle cells. What is this unique characteristic called?

Automaticity is the unique characteristic that is found only in the cardiac muscle cells. Automaticity allows a cardiac muscle cell to spontaneously contract without stimuli from a nerve source. The sinoatrial node sends normal impulses to myocardial cells, which will then contract when the impulses reach them. However, if no impulse arrives at the myocardial cells, they are capable, through automaticity, of creating their own impulse to stimulate a contraction of the heart. When this happens, the heart rate will generally be slower.

Which of the following is a system of internal and external reviews and audits of all aspects of an EMS system?

CQI Continuous quality improvement is a system of internal and external reviews and audits of all aspects of an EMS system. Periodic run-review meetings are held with those involved in patient care to review reports and discuss areas of care that may need changes or improvements. Quality control is the assurance that the appropriate medical care standards are met on each call; this is the responsibility of the medical director. Medical control is the instructions given by a physician via radio or cell phone, as well as standing protocols and guidelines authorized by the medical director of the service program. Primary prevention consists of any effort to prevent an injury or illness from occurring.

Which types of shock are related to pump failure? Select the 2 answer options which are correct.

Cardiogenic shock and obstructive shock are related to pump failure. Cardiogenic shock is caused by inadequate functioning of the heart or pump failure. Cardiogenic shock develops when the heart cannot maintain sufficient cardiac output to meet the body's needs. Many diseases or injuries can cause damage or inflammation to the heart muscle. Obstructive shock occurs when there is a mechanical obstruction that prevents an adequate volume of blood to fill the chambers of the heart. Common examples of obstructive shock are tension pneumothorax, cardiac tamponade, and pulmonary embolism

An unconscious adult patient has an active gag reflex and snoring respirations. Which of the following is most appropriate?

Open the patient's airway using the head-tilt/chin-lift maneuver and insert a nasopharyngeal airway A nasopharyngeal airway is used for a patient who is semiconscious or has an intact gag reflex or a patient who will not otherwise tolerate an oropharyngeal airway. Severe head injury with blood draining from the nose and a history of a fractured nasal bone are contraindications for use. An oropharyngeal airway is contraindicated in patients who are conscious or have an intact gag reflex. The main purpose of the oropharyngeal airway is to prevent the tongue of an unconscious patient, without a gag reflex, from blocking the upper airway. A laryngeal mask airway is a supraglottic airway. It is reserved for cases where intubation with an endotracheal tube fails. Generally, ALS will perform intubation. Intubation is indicated for patients who cannot otherwise maintain a patent airway with another airway device. There is no indication that the patient requires assisted ventilation at this time (i.e., the patient lacks apnea or respiratory distress/failure). A non-rebreather mask should be attempted prior to a bag-valve mask, as assisted ventilation may increase the risk of gastric distension or induce vomiting.

A nasopharyngeal airway is contraindicated in which of the following situations?

PT with eccoymosis behind his ear

A non-ambulatory, 150-kg patient requires transport from a fourth-floor apartment. The elevator is too narrow to accommodate this patient on a stretcher. Which of the following is the most appropriate next step?

Request lifting assistance from dispatch and stand by until their arrival Lifting and moving bariatric patients can pose a challenge for EMS crews. If transport is required, plan early for extra help; additional providers and/or specialized equipment may be necessary. Do not risk dropping the patient or injuring a team member by lifting too much weight. Using a stair chair may allow the patient to fit in the elevator but will not address the weight each member has to lift to transport the patient. A scoop stretcher is not likely to fit in the elevator. It would be inappropriate to ask a family member to assist in lifting the patient; this may injure the family member if they are not familiar with appropriate body mechanics.

Which of the following is the term used to describe the care an EMT is legally able to provide for a patient?

Scope of practice is the term used to describe the care an EMT is legally able to provide for a patient. The scope of practice is typically defined by state law, and the medical director further defines the scope of practice by developing protocols and standing orders. With these protocols and standing orders in place, the EMT has legal authorization to provide patient care through online or offline communication.

What is one contraindication to inserting a nasopharyngeal airway?

Severe head injury with blood draining from the nose

After the 20th week of gestation, pregnant patients can develop preeclampsia. Which signs and symptoms are characteristic of preeclampsia? Select the 3 answer options which are correct.

Severe hypotension, a dull headache, and increased thirst are not signs and symptoms of preeclampsia.

Several conditions are associated with acute coronary syndrome (ACS). Which of the following is associated with ACS? Select the 2 answer options which are correct.

TIA AMI

The 5 major functional areas of the Incident Command System (ICS) include which of these?

The Incident Command System (ICS) comprises five major functional areas: command, operations, planning, logistics, and finance/administration. Medical or EMS would be a branch or division under the major function of operations.

You are dispatched to a liquor store for an older adult male with an altered level of consciousness. When you arrive, the cashier tells you that he called because an older gentleman was acting irrationally. You approach the patient, who smells strongly of alcohol and has facial drooping on his right side. The patient has an altered level of consciousness and struggles with you when you attempt to place him on the gurney. What law principle allows EMTs to treat a patient with an altered level of consciousness during an emergency?

The emergency doctrine th an altered level of consciousness during an emergency is called the emergency doctrine. The doctrine is the principle of implied consent. The law states that if a person is unconscious or otherwise incapable of making rational decisions, the patient can be treated and transported by EMS personnel. The emergency doctrine applies to this scenario because the patient has an altered level of consciousness, is possibly intoxicated, and presents with stroke-like symptoms.

Asystole and pulseless electrical activity (PEA) are two rhythms that are not shockable when analyzed by an automated external defibrillator (AED). How is pulseless electrical activity defined?

The patient is in cardiac arrest, but there is still an organized electrical complex.

You have assisted in the delivery of a newborn and clamp and cut the umbilical cord. What is the other end of the umbilical cord attached to?

The placenta The placenta is a disk-shaped structure that is attached to the uterine wall, providing nourishment to the developing fetus. The placenta develops while attached to the inner lining of the uterus and is connected to the fetus by the umbilical cord.

How does deoxygenated blood from the body enter the right atrium of the heart?

Through the vena cava Deoxygenated blood from the body enters the right atrium of the heart through the vena cava.

After starting CPR on a patient, you must continue until one of four events occurs. The mnemonic STOP identifies these four events. Using the STOP mnemonic, what does the "T" represent?

Transferred Working as an EMT, you must continue CPR once you start until one of four events occurs. The mnemonic STOP identifies these four events: S-Starts, T-Transferred, O-Out of strength, and P-Physician. You can stop CPR if a patient starts breathing and has a pulse or if the patient is transferred to another healthcare provider who has an equal or higher level of training. If you are too tired to continue CPR and you are out of strength, you may discontinue CPR. Or, if a physician is present or providing medical direction online or by phone, they can assume responsibility for the patient and give directions to discontinue resuscitative efforts

Your EMS unit is responding to a private residence for a patient who is vomiting blood. Dispatch advises the patient has hemophilia and is conscious and alert. What is your main concern with a hemophiliac patient?

Uncontrolled bleeding Hemophiliacs have a clotting issue, but that does not affect the amount of oxygen that is transported in their blood.

When a patient receives injuries from a primary blast (explosion), which organs are most susceptible to damage from pressure changes? Select the 3 answer options which are correct.

When a patient is exposed to a primary blast, organs that are hollow and contain air, such as the lungs, middle ear, and gastrointestinal tract, are most susceptible to damage from pressure changes. The junction between tissues of different densities and exposed areas such as head and neck tissues are prone to injury as well.

To be protected by the Good Samaritan law, there are four conditions that need to be met. Which of the following conditions needs to be met? Select the 3 answer options which are correct.

You acted in good faith when rendering care. You rendered care without expecting compensation. You acted within the scope of your training. You did not act in a grossly negligent manner (willful or reckless disregard for a duty or standard of care).