NREMT Review

The amount of dead air space present in the lungs of an average adult is approximately:

150 ml

Eye Glasgow Coma Scale

3 is the score for eye opening to voice. 4 is spontaneously, 2 is in response to pain and 1 is no eye opening.

A D cylinder of oxygen contains approximately how many liters when full?

A D cylinder holds approximately 425 liters when full.

The difference between a contusion and a hematoma is the

A hematoma is a deeper injury than a contusion and results in greater blood loss.

A local emergency department has called for a critical patient transfer to a larger trauma center. You obtain a report from the physician, learning that the patient has cardiac tamponade. Your assessment of this patient would reveal distended neck veins, a weak pulse and:

A significant sign of a cardiac tamponade is hypotension. The pulse pressure would narrow, not widen.

Which of the following condition would likely cause a loss of vascular tone in the body?

Anaphylaxis

Shock from anaphylaxis is best described by which mechanism?

Anaphylaxis causes distributive shock by loss of vascular tone.

A 29-year-old female has been ejected from a vehicle during a high-speed motor-vehicle crash. She is found unconscious, and you note an unstable pelvis. Her vitals are pulse 130, respiration 38, blood pressure 60/44. What is the most appropriate method to splint her pelvis?

Apply and inflate the pneumatic anti-shock garment (PASG).

A patient has sustained a suspected spinal injury. When backboarding this patient, which is the correct order for performing each task after manual stabilization of the head and neck?

Apply collar, place on board, secure torso than head

Epinephrine is a medication administered to a patient who is experiencing an acute allergic reaction due to its alpha and beta effects. One side effect is cardiac irritability and tachycardia. What property of epinephrine is responsible for this?

Beta 1

Levels of carbon dioxide in the blood are sensed by

Chemoreceptors

What is orthopnea?

Difficulty breathing while lying supine.

If vascular tone is lost, a blood vessel will

Dilate

Bilateral Fractures

Fractures on Both Sides

A 19-year-old male complains of fever, sweating, and persistent cough for one week. He is currently not coughing. While treating this patient, which one of the following would be the most appropriate level of personal protection?

HEPA mask

Which one of the following reasons explains why you might have a higher index of suspicion for spine injury in a pregnant female compared to a nonpregnant female?

Hormones released during pregnancy cause ligaments to stretch.

A person who has paraparesis has:

Inability to feel or move and arm and leg on the same side of the body

You respond to a city park for a 15 year old stung by a bee. The assessment of the patient finds altered mental status, respiratory distress, hives, swelling of the face, hoarseness and pale, clammy skin. When taking vital signs what do you expect to find?

Increased heart rate and decreased blood pressure

Which one of the following reasons best indicates the importance of suctioning the nose of an infant in respiratory distress?

Infants rely more upon their nose to breathe than do adults

Which one of the following uses negative pressure to move air?

Inhalation

Which of the following is a sign of right sided heart failure?

Jugular venous distention

The division between the upper and lower airway is at the

Larynx

You are caring for a pediatric trauma patient who was not properly belted into their car seat and was thrown from the vehicle when it exited the road and rolled multiple times. Given what is known about pediatric trauma and pediatric arrest situations, if this patient does go into cardiopulmonary arrest, what is the most likely cause of this?

Loss of airway patency

What is ataxia?

Loss of coordination

During the insertion of an OPA in a patient with sonorous airway sounds, you witness your partner not properly size the device before insertion. Should the OPA inserted be too large, what would the likely complication to airway patency be?

Occlusion of the airway

A 90-year-old female is complaining of sharp, steady abdominal pain. When you palpate her abdomen, you feel a pulsating mass in the lower left quadrant. This finding most likely indicates a(n):

Pain and a pulsating mass indicate an aortic aneurism. A bowel obstruction typically presents with waxing and waning pain. An ulcer can cause pain, but does not typically cause a mass. An enlarged spleen might cause a mass, but would not typically be able to be palpated.

Why does tension pneumothorax lead to shock?

Pressure built up in the pleural space compresses the heart.

What type of molecules pull water into the bloodstream in plasma oncotic pressure?

Proteins

Which one of the following is a sign of left-sided heart failure?

Pulmonary edema

You are caring for a neonate who you suspect is severely depressed and in need of aggressive resuscitation. Which of the below clinical findings would support your suspicion?

Respiratory rate 64/minute

A bedridden patient has congestive heart failure. Fluid is likely to accumulate in the

Sacral area

A pregnant women goes through a number of stages of labor. The stage of labor that involves the baby entering the birth canal is referred to as which stage?

Second stage

The blood ejected from the heart in one beat is called the

Stroke volume

A patient may develop hypoglycemia by all of the following EXCEPT:

Taking too little insulin

Which one of the following would be an injury limited to medium- and high-velocity penetrating trauma?

Temporary cavity

A patient has suffered a penetrating chest injury following an explosion at a construction site. You have applied an occlusive dressing to the wound and initiated PPV for ventilatory insufficiency. Shortly thereafter the patient's heart rate continues to climb, he becomes cyanotic and the pulse ox drops. The patient is now totally unresponsive, and he is difficult to ventilate. What is the most likely reason for this patient's acute deterioration?

Tension pneumothorax Due to the proximity of the lung tissue to the thoracic wall, a penetration injury through the thorax will also commonly perforate the lung. During ventilations, airflow can exit the damaged lung and start to occupy space within the pleural cavity. With the occlusive dressing applied externally there is no way for the air to escape, so the patient' s pulmonary function continues to deteriorate. Atelectasis is when you have alveolar or lung collapse (but not necessarily a tension pneumothorax), cardiac tamponade will not result in difficulty in ventilating the patient, and a flail segment is commonly from blunt trauma and not penetration injuries.

You are caring for a patient who was ejected off a motorcycle when it struck a car. The patient was not wearing a helmet. Currently the patient has a GCS of 10, a spontaneous respiratory rate of 28/minute, the systolic blood pressure is 96 mmHg, and the heart rate is 110. Based on this information, the patient's computed Revised Trauma Score would be

The Revised Trauma Score (RTS) is based on the patient's systolic blood pressure, spontaneous respiratory rate, and Glasgow Coma Scale. A score of 0 - 4 may be given for each of the three areas. Total scores may range from 0 - 12. In this case: Respiratory rate of 28/min = 4 Systolic blood pressure of 96 mmHg = 4 GCS of 10 = 3 The patient has a RTS of 11.

If you wanted to auscultate the bases of the lungs you should listen

The bases of the lungs are largely posterior and are auscultated there. Auscultate over the ribs (about the 8th rib) posteriorly.

The NFPA 704 placard system

The blue area identifies the health hazard. Red is for the fire hazard, yellow is information on reactivity, and white is for specific hazards.

All of the following statements in reference to the larynx are true EXCEPT:

The epiglottis sits above the larynx (not distally) and protects the glottic opening.

An elderly male is complaining of fatigue, malaise, nausea, shortness of breath, and significant swelling of the ankles. All of these, he states, have developed over the past 12-24 hours. He has a history of MI, hypertension, diabetes, and prostate cancer. He takes blood pressure medication and aspirin daily. After oxygen therapy, what other medication may the EMT wish to administer? MDI

The patient with diabetes is not likely to experience chest pain from a heart attack because of nerve damage from his diabetes. As such, the EMT will have to rely on other associated findings indicative of a coronary event such as dyspnea, weakness, and edema. The patient, meeting protocols and following approval from medical control, may have a nitroglycerin tablet administered. The use of MDI or activated charcoal are not warranted for this presentation, and if the patient already takes aspirin daily, it is typically not re-administered by the EMT.

Which one of the following best describes why blind finger sweeps should be avoided in pediatric obstructed airway procedures?

The upper part of the trachea is funnel shaped.

If you were to auscultate the lungs at the mid-axillary line, you would be auscultating

Under the arm pit

A pulseless condition in which the heart's electrical impulses are disorganized, preventing the heart muscle from contracting normally is called?

Ventricular fibrillation

Pleuritic chest pain refers to pain

Which changes with breathing

An 81-year-old diabetic female presents with altered mental status. She is conversational, but confused as to where she is. She is pale and diaphoretic and her blood glucose is 62 mg/dL. You should first:

administer a tube of oral glucose.

A 70-year-old female complains of acute onset pressure in her jaw. She denies pain but notes the discomfort radiates into her neck. She is alert and her vital signs are pulse 90, respiration 20, blood pressure 160/68. You should:

administer aspirin and initiate transport.

A 31-year-old male is being arrested by police. As you arrive, police officers are attempting to restrain the patient in order to place him in handcuffs. The patient is extremely combative and is fighting with great force. As the struggle continues, one of the officers says, "I don't think he is breathing." A respiratory arrest in this type of situation is most likely associated with:

agitated delerium.

A six-year-old male patient is ventilated through a home respirator. You were called today because the patient's oxygen saturations have been low. As you assess the patient, you notice many secretions in the tracheostomy tube and gurgling on inhalation. You should:

ask the patient's parents to assist you with suctioning the tracheostomy tube.

The primary difference between distributive and hypovolemic shock is that

blood volume remains constant in distributive shock.

A one-year-old male has had a fever for three days and now has developed wheezing and severe respiratory distress. You notice his skin is hot and cyanotic around the lips. The patient suddenly begins to seize. The most likely cause of the seizure in this patient would be:

hypoxia

During your pre-shift ambulance inspection, you notice that one of the box warning flashers has burnt out. You should:

immediately take the ambulance out of service and notify maintenance.

A 26-year-old male is unconscious after a motor-vehicle crash. His airway is patent but he is breathing very rapidly. His respiratory rate is 58, and you notice he is slightly cyanotic. In this case the most important reason to initiate positive pressure ventilation is to:

increase tidal volume.

A 29-year-old male has been involved in a motorcycle crash. He has a large abrasion on his left thigh and lower leg. The most significant threat from this type of injury would be:

infection

An 18-year-old female tells you that she has ingested 48 amitriptyline pills. She notes she was trying to harm herself and took the pills about 20 minutes ago. She is alert and her vital signs are pulse 120, respiration 20, blood pressure 100/60. You should first:

initiate transport immediately.

A 64-year-old male complains of steady abdominal pain radiating across both upper quadrants. He also complains of nausea. His vital signs are: pulse 100, respiration 20, blood pressure 158/90. Given his presentation, you should first:

initiate transport to rule out acute myocardial infarction

The appropriate technique for splinting a midshaft tibia/fibula fracture is to immobilize the:

joint above and below the facture.

Disruption of upper airway patency in severe anaphylaxis is most likely caused by:

laryngeal edema.

The pulmonary artery delivers blood to the

lungs

The most important benefit of a unified command would be:

preventing more than one set of tactics at a single incident.

What is oliguria?

scant urine output

You may see a slight increase in diastolic blood pressure early in shock because

there is an increase in vascular tone