Week 3

Your ambulance service director has given you permission to replace an old fully automated AED with a new semi-automated AED produced by a different manufacturer. Before making the purchase, you must receive authorization to do so from the:

EMS system's medical director

You are transporting a patient in cardiac arrest. The AED is being used and a shock has been advised. Prior to administering the shock, what should you do?

Ensure that no rescuer is touching the stretcher

Which of these actions would be most important when administering aspirin to a patient with chest pain?

Ensuring that the patient can follow directions and has an intact gag reflex

is a medication for anaphylaxis that may be administered by the EMT through the intramuscular injection route.

Epinephrine

Which of the following is not a part of the scene size-up?

Establishing an airway

The last step in the primary assessment is .

Establishing patient priorities

You are assessing a confused dark-skinned patient who complains of a headache. When checking his skin color, you should:

Evaluate the palms of his hands or conjunctiva

You are transporting a depressed patient who states that she is thinking of killing herself by taking a "whole bunch of pills." After providing this information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. How often should vital signs be reassessed?

Every 15 minutes

At a nursing home, you find an elderly patient extremely short of breath. To best determine whether this patient is cyanotic, you should:

Examine the lining of the lips and mouth

The purpose of the OPQRST mnemonic is to guide the EMT in:

Exploring the patient's chief complaint

Which of the following is not normally considered a significant mechanism of injury in adult patients?

Fall from a height of 10 feet

Cardiac output multiplied by stroke volume equals blood pressure.

False

Cardiogenic shock is caused by massive bleeding from the heart.

False

Decreased blood volume increases afterload.

False

Norepinephrine only stimulates beta cells.

False

You are assisting a patient with her metered-dose inhaler (MDI). In an effort to determine the exact name of the medication, it would be best for the EMT to:

Find the medication name on the label of the MDI

To test a pediatric patient's capillary refill, the EMT will:

Firmly compress and then release pressure on the nail bed

Which of these statements made by an EMT student shows he correctly understands capillary refill?

For a capillary refill test to be normal for a child, it must be assessed at room temperature and be less than 2 seconds."

A patient with liver cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition as:

Jaundice

At crime scenes in which guns might be involved, EMTs should position the emergency vehicle outside the [ANSWER1] zone.

Killing

You have been called to a bar full of intoxicated patrons for a 46-year-old man who fell off his stool, injuring his left arm. As you assess his arm, the patient screams in pain. Several of the patrons get angry and yell for you to give him something for pain. Someone in the back throws a bottle in your direction. What should you do next?

Leave the scene and return only when police have made it safe to do so

After administering oral glucose to a patient with altered mental status, which of these findings best indicates a positive therapeutic effect or response to the medication?

Mental status that is now alert and oriented

The three phases that the body goes through following cardiac arrest are the electrical phase, the circulatory phase, and the __________ phase.

Metabolic

A patient with chest pain informs you that the pain is greater when he takes a deep breath. The EMT is using the active listening technique of "facilitation" and "clarification" when he responds by saying:

"I see. Can you describe what the pain feels like?"

You are interviewing a prospective candidate for an EMT position with your service. During the interview, you ask the applicant to describe the purpose of the primary assessment. Which of these statements best describes that purpose?

"Identify and treat life-threatening conditions."

Sudden death is defined as a patient who dies within how many hours of the onset of symptoms?

1

Which of these condition(s) is (are) as the most probable cause of cardiogenic shock?

Myocardial infarction

Which information can likely be collected from the patient, family members, or bystanders?

Nature of illness/mechanism of injury

To stabilize the cervical spine of a trauma patient while simultaneously opening the airway, how should you position her head?

Neutral and in-line

The rapid trauma assessment should take about:

2-2½ minutes

An adult patient's breathing is considered to outside of normal rates when respirations are greater than __________ breaths per minute or less than _______ breaths per minute

20; 12

When should the EMT transport the patient with cardiac arrest?

After three "no shock advised" messages are received

Once the patient's level of consciousness has been determined during the primary assessment, you would move on to assess the ______________.

Airway

If the assessment reveals tracheal tugging, you should suspect

Airway obstruction

A 44-year-old male patient has been shot in the abdomen. Which assessment findings would lead you to believe that the patient is in compensated shock?

Alert and anxious, pulse 102, BP 114/88 mmHg, pale and cool skin

You have been called for an adult patient who suffered a seizure. He is sitting on the floor, and looks at you as you enter the room. When questioned, he knows his name but cannot remember the date, what happened, or where he is. This patient's mental status can best be described as:

Alert but confused

You arrive on the scene at an extended care facility where you see the facility employees removing the residents via wheelchairs and hospital beds. As you exit the ambulance, an employee walks up to you and identifies herself as the night-shift charge nurse. She states that the facility had a furnace malfunction and the carbon monoxide alarms are sounding. There are probably 30 residents already in the parking lot a safe distance away, and there are reportedly 15 more inside who are unresponsive. Given the number of patient overall, the EMT should:

Alert dispatch of the need for additional resources

You have been dispatched to an apartment for an elderly male complaining of shortness of breath. When do you start the process of forming a general impression about this patient?

As you and your partner approach him

You believe that a young male patient, who has been shot in the lower abdomen, is bleeding internally and is in the early stage of shock. Which of these descriptions includes appropriate prehospital care of this patient?

Oxygen therapy and rapid transport to the hospital

During the rapid trauma assessment, you would check all extremities for

PMS.

In addition to checking nail beds, oral mucosa, and conjunctiva, you would assess the skin color of infants, children, and dark-skinned patients on the _____and _______

Palms; soles

You are performing a secondary assessment and are assessing the patient's chest. Which of these findings would you associate most with fracture of the ribs?

Paradoxical chest wall motion

You are transporting a 31-year-old male patient who was severely injured in a motor vehicle collision. He is unresponsive and being ventilated by your partner with a bag-valve mask. How will you conduct the rapid secondary assessment on this patient?

Perform a head-to-toe exam

A 43-year-old female has accidentally taken too much of her antidepressant medication and is now confused. Emergency Medical Responders are on scene and providing the patient with high-concentration oxygen. As you arrive at the patient's side, your first action should be to:

Perform a primary assessment

A 62-year-old female patient 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, spine motion restriction precautions have been provided, and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, what should the EMT do first?

Perform a rapid head-to-toe physical assessment

To assess a patient's level of orientation, you would ask specific questions about ______, _____, and _______

Person, place and time

The study of drugs is called

Pharmacology

What is the most reliable source of information about a medication?

Physician's Desk Reference (PDR)

The EMT should recognize normal skin color in a healthy patient as:

Pink

At the scene of a motor vehicle collision involving two vehicles on a narrow two-lane road, which actions would be most appropriate to ensure rescuer and patient safety?

Place flares in each direction from the collision scene

A young male patient was playing hockey on an ice-covered pond and became injured; he remains on the ice. As you arrive on scene, a park ranger informs you that the ice is 12 inches thick and poses no danger of collapse. In this situation, which action would be most appropriate to help keep you safe while accessing and extricating the patient?

Place tarps on the ice to walk over to the injured player

When assessing an adult trauma patient's circulation status during the primary assessment, the EMT's assessment should include:

Radial and/or carotid pulse, skin characteristics, and presence of external bleeding

For determination of vital signs, an EMT is concerned with two respiratory factors: _______and ______ .

Rate; volume

When a 52-year-old male patient collapsed on his front porch, his family dialed 911. When you arrive, the daughter informs you that the patient has been down for approximately 8 minutes. Assessment reveals him to be in cardiac arrest. What should you do immediately?

Start CPR while the AED is applied and readied for use

Information concerning the extent of injury can be related to findings of the complete head-to-toe exam by:

Utilizing the body system approach

Neurogenic shock is commonly referred to as ________ shock.

Vasogenic

A patient has just gone into cardiac arrest. His heart is most likely in which rhythm?

Ventricular fibrillation

The most frequent initial rhythm in cardiac arrest is

Ventricular fibrillation

Which cardiac arrest rhythm is the AED designed to shock?

Ventricular fibrillation

The outward signs of what is going on inside a patient's body are the

Vital signs

A 67-year-old male patient who lives in an extremely "bad" neighborhood is experiencing chest pain. There are vacant homes throughout the area, including the homes to either side of his residence. Additionally, parked/abandoned 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?

Walk single file with your partner behind you carrying the medical bag

Which of these statements about the heart rhythm of ventricular fibrillation is true?

When a patient's heart is in ventricular fibrillation, it is unable to pump blood throughout the body

When would an EMT enter the scene of a crime to provide care to the patient?

When all hazards have been addressed

Mechanical external compression devices are recommended:

When high-quality manual compressions are not possible

You arrive on the scene of an "unknown medical emergency." The local fire department EMRs arrive simultaneously, so you now have five providers at the scene to help. The on-scene police officer tells you the patient is an elderly man who has attempted suicide by shooting himself in the head. As you enter the patient's room, you see the male patient with an extensive skull injury. A large portion of his right temporal and parietal skull is gone, and there are blood splatter and brain tissue on the wall behind him. Given this information, what should you do?

Withhold resuscitation

Shock is simply defined as inadequate

tissue perfusion.

Medications administered sublingually are

dissolved under the tongue.

A drug or other substance that is used as a remedy for illness is called a(n)

medication.

Drugs meeting the requirements of the U.S. Pharmacopoeia or National Formulary are given a(n)

official name.

During the scene size-up at a multiple-vehicle crash, it is important to determine the number of patients because

on-scene resources may be inadequate.

A detailed secondary exam should be performed

only after all life-threatening injuries and conditions have been managed.

medications may be administered to patients who can swallow.

oral

The skin color that indicates anemia or emotional distress is

pale.

Taking blood pressure by use of the fingertips is known as

palpation

An EMT is permitted, with medical direction, to administer, or assist the patient in administering, all the following medications except

penicillin.

The study of drugs is referred to as

pharmacology.

Medications have specific ______ effects on the cells, organs, or body systems

physiological

In assessing potential injuries from a fall during scene size-up, determine

the surface on which the patient landed.

During assessment of a responsive medical patient, you gather a medical history using the memory aid SAMPLE. To obtain information related to the "M" component, which question should you ask?

"Are you currently taking any medications?"

Your partner is having a difficult time determining normal and abnormal blood pressures for a child. Which of these statements will help him most?

"A minimally acceptable systolic pressure can be estimated by doubling the child's age and adding it to 70."

After you assist a patient with use of his metered-dose inhaler, the patient's son asks why his father cannot take the medication in the form of a pill. Which of these responses would be most appropriate?

"By giving the medication into the lungs, the medicine goes directly to where it's needed."

Which of these statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient?

"Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescents or adults."

Which of these questions would the EMT ask when using the OPQRST mnemonic?

"Does the pain feel dull or sharp?"

At a continuing education seminar on shock, the presenter asks if there is a point where someone cannot recover from shock. Which statement made by an EMT is correct?

"Even with treatment, if shock has reached the final stage when multiple organs start to fail, death will result."

You notice that your partner routinely takes only one set of vital signs when treating and transporting patients. When asked, he states that he gets just baseline vital signs because 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?

"Examining several sets of vital signs can also indicate the effectiveness of your treatment."

On scene, you find a 91-year-old female patient who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respirations. Which instruction should you immediately give your partner after manual spinal motion restriction is applied?

"Get the suction out and clear out her airway."

At a continuing education seminar being taught by your medical director, the instructor asks the group for one reason why the secondary assessment is beneficial to perform on the trauma patient. Which of these responses is most appropriate?

"It is useful in finding additional injuries and guiding additional care."

When you are applying the pulse oximeter sensor to a patient's finger, he asks you what this device is for. Your response would be:

"It measures the amount of oxygen being carried by your blood cells."

You are transporting an unresponsive 31-year-old female patient who suffered cardiac arrest. On scene, Emergency Medical Responders (EMRs) shocked the patient once with the AED and she regained a pulse. She remains unresponsive and has shallow respirations. Ventilation is being provided with a bag-valve mask. An EMR has agreed to ride to the hospital with you to provide assistance in caring for the patient. Which set of instructions given to the EMR next is most appropriate?

"Leave the AED on the patient, even though she is breathing and has a pulse."

You are by the side of a 64-year-old male patient who collapsed at home. After assessing his level of consciousness, airway, and breathing, you determine that he is unresponsive with an open airway, but not breathing. The patient still has a weak carotid pulse. Which instruction should you immediately give to your partner?

"Let's attempt placement of an OPA or NPA and start ventilations."

You have arrived at the residence of a 66-year-old female patient who is in cardiac arrest. In the living room, you find Emergency Medical Responders performing CPR on the patient. They quickly report that they found the patient in cardiac arrest and have been doing CPR for 5 minutes. Which of these statements should you make at this time?

"Let's stop CPR so I can check the airway, breathing, and circulation."

Which of these statements made by a patient would the EMT regard as a symptom?

"My pain is sharp, the worst I've ever felt."

A 66-year-old male patient is complaining of chest pain. The EMT is considering assisting with the patient's prescribed nitroglycerin. Which of these statements made by the patient is most relevant to the EMT at this time?

"My urologist just started treating me for problems I am having with sex."

You have just applied the AED to a female patient in cardiac arrest and the machine is ready to analyze the heart rhythm. Which of these instructions is appropriate to give at this time?

"Stop CPR and clear the patient."

When obtaining vital signs for a 67-year-old male patient with dizziness and nausea, your partner states that the pulse seems to disappear periodically when the patient takes a deep breath. As a knowledgeable EMT, your best response would be:

"That is an important finding. We will have to let the doctor know about it."

After two cardiac arrests occurred on its premises over the last 6 months, a large home improvement center has purchased a fully automated AED. You have been asked to provide education on its use. During an instructional session, a student asks you what will happen when the AED indicates that a shock is indicated. Your response should be:

"The AED will automatically charge and shock the patient."

The EMT shows she understands the difference between a metered-dose inhaler (MDI) and a small-volume nebulizer (SVN) when she states:

"The MDI provides medication during one or two of the patient's breaths; the SVN provides a continuous flow of medication until gone."

A patient who was shoveling snow developed chest pain, immediately sat down in a nearby bus shelter, and called 911. Prior to moving him into the ambulance, your partner performs a primary assessment and reports that the patient's capillary refill is 5 seconds. Which of these would be an appropriate statement for you to make?

"The cold temperature may cause the capillary refill to be 5 seconds; we should assess further."

Which of these statements, made by the EMT, shows an understanding of medication administration and drug dosages?

"The proper dose of a medicine should be administered unless medical direction orders otherwise."

Which of these patients is considered the lowest priority for a rapid secondary exam and immediate transport?

A 72-year-old man complaining of leg pain for a week

For which of these patients would a capillary refill time of 3 seconds be most indicative of poor perfusion?

A 4-year-old male

Which of these blood pressure readings is normal for a 7-year-old male?

114/62 mmHg

For stable patients, an EMT should take vital signs every

15 minutes

Which of these patients would be classified as unresponsive?

A 46-year-old-male who does not respond when his fingers are pinched

How many major categories of shock are there?

4

The Chain of Survival has links.

5

You are assessing a trauma patient who was ejected from a car when it overturned. Currently he opens his eyes to painful stimuli, demonstrates no verbal response to questioning, and exhibits decerebrate rigidity in response to pain. What is this patient's Glasgow Coma Scale score?

5

For unstable patients, an EMT should take vital signs every

5 minutes

Immediately following the onset of cardiac arrest, brain cells begin to die after:

5 minutes

You should reassess vital signs during transport every _______ minutes for critical patients and _______ every minutes for noncritical patients.

5; 15

The circulatory phase of cardiac arrest typically lasts how long?

6 minutes

If the pulse rate, rhythm, or character is not normal, an EMT should continue taking the count for _______ seconds.

60

In an adolescent, a normal resting pulse rate would be _______ to ______ beats per minute.

60; 100

Which of these patients would the EMT identify as having the most adequate breathing, free from any respiratory distress?

A 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall

Which of these patients should the EMT recognize as having a normal skin temperature?

A 36-year-old male complaining of nausea with warm skin

Which of these patients should the EMT recognize as tachycardic for his or her age bracket?

A 37-year-old male with a complaint of fatigue and a heart rate of 104

An 86-year-old female patient has called 911 for rectal bleeding. There is a large amount of dark red blood and clots in the toilet and on the patient's clothing. The Emergency Medical Responder reports a blood pressure of 84/68 mmHg with a heart rate of 124 beats/min. Given this information, the EMT should expect findings of:

A narrowed pulse pressure and possible shock

The EMT should request advanced life support (ALS) backup for a patient in cardiac arrest because:

ALS treatment decreases the possibility of the patient going back into cardiac arrest once successful defibrillation has occurred

To determine a patient's level of responsiveness, you would use the pneumonic.

AVPU

is a suspension used to treat a poisoning or an overdose emergency.

Activated charcoal

List the eight medications that an EMT may administer or help a patient to self-administer.

Activated charcoal Oral glucose Oxygen Aspirin Metered-dose inhaler Nitroglycerin Epinephrine Naloxone

List common sources from which to gather information about specific medications.

American Hospital Formulary Service AMA Drug Evaluation Physicians' Desk Reference (PDR) Package Inserts Poison Control Centers EMS Pocket Drug Reference Guide

You are providing care to a patient with altered mental status amid a large crowd gathered for a concert. Which characteristic of the crowd should concern you the most in relation to personal safety?

An angry mood developing within the crowd

You are preparing to attach an AED when you notice that the patient has an implanted pacemaker. What should you do?

Apply the AED, but avoid placing the electrodes over the pacemaker

Which of these is a generic drug name?

Aspirin

Which of these medications would the EMT administer PO?

Aspirin

As you approach a seemingly unresponsive patient, you observe a 1- to 2-inch circle of dark blood on his shirt. He also appears pale and diaphoretic. What should you do first?

Assess his airway

You have been summoned to a retail store, where you are directed to a middle-aged woman who was found in the bathroom on the toilet. Your assessment shows her to be responsive to painful stimuli with an open airway and labored breathing. Her pulse is fast and regular, and her skin is warm to the touch. The primary assessment has been completed and the appropriate care given. As the stretcher is prepared, you perform the secondary assessment. When assessing her chest, you note the presence of crackles to both lungs. What should you do next?

Assess the abdomen

While using the AED to treat a patient in cardiac arrest, your partner informs you that he can feel a carotid pulse. What should you do immediately?

Assess the patient's airway and breathing adequacy

You have been directed to a car that struck another vehicle at a moderate rate of speed. You note deformity and starring of the windshield on the driver's side. What should you do to determine whether the deformity to the windshield was caused by the driver hitting his head or by the air bags?

Assess the patient's head

You are unable to auscultate a blood pressure in a patient's right arm. What should you do next to obtain the most accurate baseline assessment of this patient's vital signs?

Auscultate the blood pressure in the left arm

An epinephrine ________-_______ may be prescribed for patients with a history of severe allergic reactions.

Auto injector

In compensated shock, the body is able to maintain a near-normal ___________- and perfusion of the vital organs.

BP

Assessment of a patient who is unresponsive reveals pupils that are both large at 6 millimeters and do not change size in response to light. The EMT would best document this finding as:

Bilateral dilation of the pupils, unresponsive to light

The force of blood against the walls of the blood vessels is known as the

Blood pressure

Your partner states that he wants to palpate the blood pressure. Which equipment would you hand him?

Blood pressure cuff

A patient states that he is short of breath, is light-headed, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open airway, adequate breathing, and a rapid pulse of 120 beats/min. The patient's skin is hot to the touch, and he has a blood pressure of 116/84 mmHg. The patient informs you that he was diagnosed with pneumonia 3 days ago and has not been taking the prescribed antibiotics. Which of these assessment findings would the EMT best recognize as a sign related to the patient's chief complaint?

Blood pressure of 116/84 mmHg

A patient with chest pain tells you that he feels the same now as when he had a heart attack 2 years ago. He is diaphoretic, nauseated, and vomiting; he has a pulse of 84, respirations of 16 breaths/min, and a blood pressure of 78/50 mmHg. The patient is allergic to aspirin. He asks you to assist him in taking one of his nitroglycerin pills because his arthritis makes it too hard for him to open the medication bottle. Which of the assessment findings represents a contraindication to the nitroglycerin?

Blood pressure of 78/50 mmHg

Which of these would indicate a normal pupillary exam has occurred?

Both pupils constrict when light is directed into one eye

In patients younger than 1 year, an EMT should first attempt to assess a(n) _____pulse.

Brachial

The bladder of a blood pressure cuff should be centered over the _______ artery.

Brachial

When obtaining a blood pressure, the EMT listens for a pulse over which blood vessel?

Brachial artery

If a patient is breathing more slowly than normal for his age, the medical term ____________________ is used to describe the patient's condition.

Bradypnea

List ways you can reduce a patient's anxiety at the emergency scene. Your Answer:

Bring order to the environment Introduce yourself Gain patient consent Position yourself properly Use communication skills Be courteous Use touch when appropriate

A patient goes into cardiac arrest at 11:40 a.m. Which of these treatments gives the patient the best chance for recovery?

CPR at 11:41 a.m. and defibrillation at 11:43 a.m.

What is the measurement of expired CO2 that typically provides a numeric display of the partial pressure of CO2 in torr or mmHg?

Capnometry

A 20-year-old female patient is found unresponsive. The first step of the secondary assessment for this patient is to:

Conduct a rapid medical assessment

You are assessing an elderly patient with a decreased level of consciousness. Your assessment reveals the patient to have a patent airway, labored respirations, and weak, rapid pulses. The skin is pale, cool, and cyanotic in the extremities. You also observe diaphoresis and a delayed capillary refill. Vital signs for this patient are heart rate, 136 beats/min; blood pressure, 66/40 mmHg; and respirations, 40 and shallow. Auscultation of the lungs reveals profound rales located throughout each lung. The patient's temperature is 99°F and there is obvious jugular vein distention and pedal edema. Additionally, family states that the patient has an extensive cardiac and diabetic history. Based on this information, you should suspect which kind of shock?

Cardiogenic

You have been dispatched for an 89-year-old female patient who fell in her kitchen and was found by family members several hours later. Should something go awry on scene, which of these serves to give you the most safety and security?

Carrying a portable radio with you into the house

It is critical that the EMT never apply the AED to a person who is not in cardiac arrest because an accidental shock could:

Cause the beating heart to go into cardiac arrest

Shock is a critical condition that results in inadequate __________ perfusion

Cellular

You have been called for an elderly male patient who suddenly collapsed. On scene, you find an 82-year-old man lying on the garage floor. Assessment reveals him to be unresponsive and not breathing. What should you do immediately?

Check for a carotid pulse

You cannot locate a radial pulse on a 54-year-old male patient who is alert, confused, and breathing adequately. What should you do immediately?

Check for the carotid pulse

The EMT realizes that the best means of preventing failure of the AED is to:

Check the AED battery and its supplies at the beginning of each shift

The patient's answer to the question "Why did you call EMS?" is called the .

Chief complaint

When gathering information from a patient, the EMT should try as much as possible to ask ______ ___________questions.

Close ended

You have assisted the patient in taking one of his nitroglycerin tablets due to cardiac-type chest pain. Five minutes later, you note the patient's blood pressure is 108/74 mmHg. To determine if the nitroglycerin has affected the blood pressure, the EMT should:

Compare this finding to the baseline blood pressure

shock is the condition in which the body can maintain near-normal vital signs despite some fluid/blood loss.

Compensatory

What are the two stages of shock?

Compensatory and decompensatory

List eight medication forms.

Compressed powder or tablet Liquid for injection Gel Suspension Fine powder for inhalation Gas Spray Liquid/vaporized fixed-dose nebulizer

A patient with a history of diabetes is confused and irritable. According to family members, he accidentally took too much insulin this morning and did not eat breakfast. Since he is conscious with an intact gag reflex, medical direction orders you to administer oral glucose. Which component of this situation best represents the indication for the medication?

Confusion and irritability

A patient who is short of breath and has a history of right arm paralysis from a stroke has asked you to help him use his metered-dose inhaler containing albuterol. Since your medical director requires on-line authorization for albuterol, you would:

Contact medical direction for authorization

Each drug also has ____________ , or situations in which the drug should not be administered because of the potential harm that could be caused to the patient.

Contraindications

Which of the following is a sign of early shock?

Correct! Tachycardia Hypertension Bradycardia Bradypnea

When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would:

Count the number of beats that occur in 1 minute

A 40-year-old male patient has crashed his motorcycle. He complains of pain to his right leg. When palpating his leg, you are assessing for:

Crepitation

Assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify:

Cyanosis caused by inadequate oxygenation of the tissues

If there is a decrease in cardiac output, a decrease in blood flow or perfusion of the pulmonary capillaries, or a decline in metabolic activity, the ETCO2 level and reading will

Decreased

List four significant external signs of vehicle impact to look for and document during the scene size-up.

Deformity to the vehicle greater than 20 inches Intrusion into the passenger compartment Displacement of a vehicle axel Rollover

A conscious and alert 64-year-old female patient complains of chest pain and mild shortness of breath. She appears to have no difficulty speaking and states that the pain suddenly started about 2 hours ago. Her daughter on scene advises you there is a history of blood clots in the lungs of her family, and she is scared and would like her mother to be evaluated. Which of these steps should you take first?

Determine the adequacy of the patient's breathing

You and your partner are first on the scene of a bleacher collapse at a local raceway. As you exit the ambulance, you note several patients seated throughout the debris from the collapsed structure. In this situation, which action would you perform first?

Determine the number of patients

When assessing a patient's pupils, the EMT should:

Determine the size of the pupil and then look for a change in pupillary size while shining a light in the eye

You have been dispatched to a residence for an 89-year-old female patient with a nonspecific complaint. When assessing this patient, what should you do first to develop an initial impression regarding emergency?

Determine whether the complaint is medical or trauma related

It has been reported that two people have been shot in an alleyway. As you pull up to the scene, you see a police officer standing over a person with blood on his shirt and pants. In this situation, what is your first priority?

Determining the overall safety of the scene

Atrovent, if prescribed to the patient, is indicated for:

Difficulty breathing

Anaphylactic shock is a type of _______ shock.

Distributive

the ______ of a drug is simply how much of the drug should be given to the patient.

Dose

A patient arrests at 1313 hours. E-911 is activated and dispatches an ambulance at 1315 hours. The ambulance arrives on scene at 1319 hours, and the EMTs reach the patient's side and start care at 1321 hours. After transporting the patient, the patient is transferred to the ED staff at 1346 hours. Based on that information, which of these statements would be considered correct?

Down time is 8 minutes

Distributive shock is associated with a decrease in ____________ volume.

Intravascular

A patient's approximate age, sex, appearance, and chief complaint are all elements of the .

General impression

List the four types of names by which every drug is known.

Generic Chemical Trade (brand) Official

Which personal protective equipment must the EMT take on every call?

Gloves

A pulse oximetry reading obtained on room air is considered normal when it is:

Greater than 97 percent

Which of these assessment findings indicates that the patient has intact motor function in his lower extremities?

He can wiggle his toes when instructed

The lower energy level delivered by the biphasic defibrillator is thought to cause less damage.

Heart cell

A patient fell 20 feet from a ladder, and is now confused and anxious. Which of these signs/symptoms suggests that the patient is in shock?

Heart rate of 110 beats/min

One way to get an accurate patient _______ is to use the acronym SAMPLE.

History

A patient has been involved in a very serious motor vehicle collision and is in shock. Assessment findings indicate that he sustained blunt trauma to the abdominal and pelvic areas. Which type of shock is the patient most likely suffering?

Hypovolemic

List the three basic goals of the scene size-up.

Identify possible hazards and ensure scene safety Identify what led you to being called to the scene Determine whether any factors might require a call for additional assistance

You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step?

Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt

A female patient called 911 when she noticed blood in her stool, and became scared and anxious. Her pulse rate is 124 and her blood pressure is 88/60 mmHg. After you get her vital signs, she nervously asks you how they are. Given her anxiety, you should:

Inform her of the vital signs

As an EMT, you may assist patients in taking which kind of prescribed medication?

Inhalers used for difficulty breathing

The route by which the EMT would administer epinephrine is:

Intramuscular

An alert and oriented 69-year-old female patient complains of low, right-sided abdominal pain. She describes the pain as "knife-like" and states that it started suddenly 1 hour ago. Her only medical history is hypertension, for which she takes the medication Lisinopril. Which of these assessment findings shows that the EMT is appropriately assessing this patient given the chief complaint?

No abdominal guarding noted

Snoring, wheezing, gurgling, and crowing are examples _____-_ of breathing.

Noisy

When the body is in a shock state, which hormone released from the adrenal glands stimulates primarily alpha-1 and beta-1 receptors, but has no effects on beta-2 receptor sites?

Norepinephrine

During your primary assessment, you note the patient's skin to be warm, pink, and dry. This finding would seem to indicate:

Normal circulation

Please tell what each letter stands for in OPQRST.

O - Onset P - Provocation/Palliation/Position Q - Quality R - Radiation S - Severity T - Time

A female patient with a history of asthma called 911 with a complaint of shortness of breath. On scene, you assisted her with the administration of her metered-dose inhaler containing albuterol. What can the EMT do to best determine if this patient's condition is improving?

Obtain a pulse oximetry reading and breath sounds every 5 minutes

A 44-year-old male patient was cutting limbs from high in a tree when he fell. He is found to be unresponsive with snoring respirations. His breathing is inadequate at a rate of 8 breaths/min and his carotid pulse is weak and difficult to locate. Following the primary assessment and initial management of life threats, which of these actions will the EMT complete while performing the secondary assessment?

Obtain vital signs and get a past medical history from the family

You have just determined that a 92-year-old female patient found in bed is unresponsive, but still has a carotid pulse. Your next action would be to:

Open the airway manually

List the four routes by which the EMT may administer or help a patient to self-administer medications.

Oral Sublingual Inhalation Injection

Proper care of cardiac arrest for a 6-year-old pediatric patient when there are no available pediatric AED pads would include:

Placement and use of the adult pads with adult energy levels

A 5-year-old boy has been vomiting profusely for two days. Your assessment indicates that his airway is open, respirations adequate, and radial pulse fast and weak. His skin is cool and moist, and the capillary refill time is 5 seconds. This patient is most likely:

Poorly perfused

When comparing the pediatric Chain of Survival to the adult Chain of Survival, the EMT would note that the pediatric version differs in which way?

Prevention of cardiac arrest

Forming the general impression starts during which phase of patient assessment?

Primary assessment

You arrive on the scene of a motor vehicle collision and are presented with a patient who complains of chest pain after striking his chest on the steering wheel. On-scene Emergency Medical Responders are maintaining cervical spine motion restriction manually. The patient is alert and oriented and has a patent airway. His respirations are 24 breaths/min with good chest rise and fall, and his skin is warm and dry. He describes some shortness of breath, his heart rate is 96 beats/min, and his SpO2 is 92% on room air. At this time you should:

Provide oxygen via nasal cannula at 2-4 liters per minute

You have arrived by the side of a cyanotic patient who is responsive only to painful stimuli and exhibiting stridorous respirations. What is the most appropriate action by the EMT?

Provide positive pressure ventilation with supplemental oxygen

A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are pulse, 118; respirations, 18 breaths/min; blood pressure, 102/86 mmHg; and SpO2, 96%. Which complaint would make the most sense given this clinical presentation?

Rectal bleeding

If a scene becomes unsafe after you have entered, you should first:

Remove yourself from the scene

En route to the hospital, you start the reassessment of a 22-year-old trauma patient. You should begin this assessment by:

Repeating the primary assessment

The most common source of infection in sepsis is _______ infection.

Respiratory

Which of these findings related to breathing would be most concerning to the EMT in an adult patient?

Respiratory rate of 18, complaint of weakness Respiratory rate of 22, normal chest wall expansion Respiratory rate of 10, chest expansion of about 1 inch Correct! Respiratory rate of 20, use of accessory muscles

You have been assigned to a football game to provide standby coverage. While taking a break, you decide to walk to a nearby concession stand for a soft drink. On the way, you come across a group of people standing around a male patient who collapsed and is on the ground. Your assessment reveals him to be unresponsive, not breathing, and pulseless. A bystander states that the patient just collapsed moments ago. An AED is located less than 1 minute from your location. The nearest EMT is 5 minutes from your location. What should you do immediately?

Retrieve the nearby AED

The term ________ refers to how a medication is given to or taken by a patient.

Route

Please tell what each letter stands for in SAMPLE

S - Signs and Symptoms A - Allergies M - Medications P - Pertinent Past History L - Last Oral History E - Events Leading to the Injury or Illness

Which PPE would be most appropriate for the EMT who must enter a confined space?

SCBA

When assessing the responsive medical patient's condition, you would use the ________-- and ___________ mnemonic questions.

Sample; OPQRST

You are assessing a 4-year-old patient whose panicked mother states that she cannot wake him. The child is breathing but his eyes are closed. To best determine the child's mental status, you should first:

Say loudly, "Open your eyes!"

is the first phase of patient assessment.

Scene size-up

List three categories of people for whom the EMT must be concerned in ensuring scene safety.

Self and other team members Patients Bystanders

Which of these pieces of information would be obtained by the EMT when getting a history using the SAMPLE mnemonic?

Sensation of dizziness prior to falling

You are assessing a patient who is in bright sunlight after collapsing in the hot sun at a picnic. If you cannot immediately move the patient out of the sun, assessment of the pupils will be made more accurate by:

Shading the patient's eyes

You are treating a 4-year-old child who sustained trauma after being ejected from a motor vehicle rollover. Your assessment has revealed a blood pressure of 72/52 mmHg, a heart rate of 118 beats/min, and respirations of 28 breaths/min and unlabored. The pulse oximetry reading on ambient air is 92%. How would you describe these findings?

Shock findings for this age

After you assist a patient with use of her EpiPen, she tells you that it is much easier for her to breathe. However, her heart rate has increased from 92 to 118 beats/min. Regarding the epinephrine, the EMT recognizes the increased heart rate as a(n):

Side effect

You are called to a long-term care facility to assess and transport a patient with a high fever. You do not have a thermometer on your unit. Which alternative sign should you use to confirm the patient's increased body temperature?

Skin on the abdomen that is hot and flushed

An unresponsive 54-year-old male patient was found by family in his bed. They state that he has not been feeling well and complained of chest pain before going to bed approximately 1 hour ago. According to family, he has no prior medical history and does not take any medications. The primary assessment reveals no life-threatening conditions. When performing the secondary assessment on this patient, the EMT should:

Start by examining the patient's head

After the AED gives a "no shock advised" message, it is determined that the patient has a weak pulse and slow and shallow respirations. You would immediately:

Start positive pressure ventilation

The patient's family states that their 16-year-old daughter has a history of asthma and has been complaining of shortness of breath for the past two days. She has been taking her metered-dose inhaler with some relief, but this morning, they found her lethargic and struggling to breathe. Your assessment reveals the patient to be responsive to verbal stimuli with an open airway and shallow respirations of 44 breaths/min. You hear minimal wheezing in both lungs. What is your immediate action in caring for this patient?

Start positive pressure ventilation

A 51-year-old male patient who experienced cardiac arrest has regained a pulse after one shock from the AED. The dispatcher informs you that the paramedic unit you have requested for assistance is coming from the eastern end of the county and has a 20-minute ETA. The hospital is 15 minutes west of your location. Which action would be most appropriate given this situation?

Start transport to the hospital and inform the ALS dispatcher of your intent

Which of these characteristics would be considered a pulse "quality" factor?

Strength

The harsh, high-pitched sound that indicates labored breathing is

Stridorr

A 66-year-old female patient has been struck by a car. Your assessment reveals gurgling respirations, rapid breathing, and cool, diaphoretic skin. You also note bruising to her chest and abdomen. What should you do immediately?

Suction the airway

A patient's ________ are conditions that an EMT cannot observe but can learn about only when the patient describes them.

Symptoms

When reviewing a prehospital care report, you note that a patient received nitroglycerin sublingually. As an EMT, you should recognize that this medication was a:

Tablet placed under the tongue

Correctly assessing orthostatic vital signs involves:

Taking the blood pressure in the supine, seated, and standing positions

When a person is in shock, what is occurring in the body?

The cells are not getting enough oxygen, and waste products are accumulating

You are observing a new EMT just hired by your EMS agency. You know he has correctly positioned the blood pressure cuff on the patient's arm when:

The cuff is on the same level as the patient's heart

Your partner reports that a patient's blood pressure is 156/78 mmHg. From this reading, you realize:

The diastolic blood pressure is 78 mmHg

To best determine the type and extent of injuries sustained by a patient who has fallen, the EMT should consider which of these pieces of information?

The distance fallen and the type of surface landed on

Which of these is considered a benefit of the automated external defibrillator?

The ease and speed with which it can be used

The EMT is correct when he identifies baseline vital signs as:

The first set of vital signs obtained

A 69-year-old man complains of weakness to the left arm and leg. He also states that he is nauseated and has a headache. The patient's past medical history includes stroke and diabetes. In relation to this information, which of these statements is true?

The headache is a symptom related to the chief complaint

Your service has a new AED. During the in-service program on the new device, the instructor informs you that it is a semi-automated AED and uses a biphasic wave form, as opposed to the monophasic form used by the previous AED. As a knowledgeable EMT, you should recognize that:

The new AED will defibrillate the patient with smaller amounts of electrical energy

An alert and oriented 87-year-old female patient has fallen and suffered a 3-cm laceration to the back of her head. According to the patient, her walker became caught in the carpet, causing her to trip. When obtaining a medical history, who should the EMT address first?

The patient

List three potential sources of information about the nature of a patient's illness.

The patient Family members or bystanders Physical evidence at the scene

When in shock, the body has a slightly delayed compensation mechanism that utilizes:

The release of hormones

When obtaining a blood pressure for a patient, the radial pulse disappears when the gauge reads 130 mmHg. When deflating the cuff, the EMT hears a pulse at 118 mmHg. The pulse disappears at 76 mmHg. Given this, which of these statements is true?

The systolic blood pressure is 118 mmHg

A family has called 911 for a 41-year-old male family member whom they cannot wake up. They state he has been threatening to kill himself and believe that he may have intentionally overdosed on his pain medications. As you enter the patient's bedroom, you observe him supine on the floor with his eyes closed. As he breathes, you hear snoring respirations. As a knowledgeable EMT, you recognize that this condition is likely caused by:

The tongue partially blocking the airway

What is the purpose of assessing the pulse on an unresponsive patient during the primary assessment?

To determine the presence of a heartbeat

A patient in cardiac arrest has regained a pulse after two shocks, but is still apneic. Which action would be appropriate next?

Transport the patient supine and secured to a long spine board as treatment is continued

Near the end of a workday, a construction worker fell 10 feet from scaffolding, landing on his head and left shoulder. He is found to be spontaneously alert, but confused. His airway is open and his breathing is adequate. Coworkers state that he was unresponsive for a period of 2 minutes following the fall and is on medications for depression and heart problems. Based on this information, the EMT should initially classify him as which kind of patient?

Trauma

A 67-year-old male patient, who has a history of diabetes and previous heart attack, fell down three stairs. His chief complaint is pain and deformity to his right wrist. The EMT would initially classify this patient as a:

Trauma patient

During the primary assessment, any life-threatening condition that is identified must be .

Treated immediately

An AED could be used on a patient of any age who is in ventricular fibrillation

True

Asystole is the absence of electrical activity and pumping action in the heart.

True

Downtime is the time from when the patient goes into cardiac arrest until CPR is started.

True

Septic shock is a form of distributive shock.

True

The metabolic phase starts 10 minutes after cardiac arrest.

True

There are three major etiologies or causes of shock

True

While treating a patient who was assaulted by a mob of angry people in a bar, the EMT finds the patient to be confused, tachycardic, with cool skin and a poor capillary refill. Based on this information, how would you categorize this patient?

Unstable

A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which skin color would the EMT expect given this status?

Yellow-orange

The skin condition that may indicate a spinal injury is

abnormally dry.

You suspect that a patient involved in a motor vehicle collision is in shock. Which sign or symptom of shock would you expect to see last?

achycardia Increased respirations Correct! Decreased blood pressure Pale and diaphoretic skin

of a drug are the therapeutic effects that a drug will have.

action

The scene size-up should take place

at the beginning and throughout the entire call.

Assessment of circulation includes checking capillary refill, pulse, skin color, temperature, and condition, as well as checking for possible major

bleeding

In distinguishing signs from symptoms, an example of a symptom would be

chest pain.

When checking pupils, an EMT should look for all of the following except

color.

A chemical substance that is used to treat or prevent a disease or condition is called a

drug.

The medication of choice in the treatment of anaphylactic shock is

epinephrine.

The act of breathing out is called

exhalation.

Hypovolemic shock is due to

fluid loss.

The patient's approximate age, sex, and chief complaint are part of the

general impression.

Epinephrine is an example of a drug's

generic name.

Standard Precautions would most often include

gloves, eyewear, and mask.

An assessment finding jugular vein distention may indicate

heart failure.

All of the following are basic etiologies of shock except

inadequate respiratory rate.

All of the following are effects of sympathetic nervous system stimulation except

increased respiratory rate.

The most common uses of a drug in treating a specific condition are known as

indications.

When assessing the patient's skin, you note the color of the skin to be yellow. This is known as

jaundice.

The "L" in SAMPLE stands for

last oral intake.

The rhythmic beat generated by the contraction of the left ventricle is called the

pulse

When controlling the scene, the EMT should

remain compassionate about providing care.

The respiratory rate, the systolic blood pressure, and the GCS are the major components of the:

revised trauma score.

Establishing the number of patients is an important part of the

scene size-up.

Drug actions that are not desired and that occur in addition to the desired therapeutic effects are referred to as

side effects

The proper term for a blood pressure cuff is

sphygmomanometer

A thick slurry of activated charcoal is an example of a

suspension.

A heart rate greater than 100 beats per minute in an adult patient is called

tachycardia.

When responding to a known crime scene, you should initially

turn off the siren and emergency lights several blocks before arrival.

EMTs should not enter a known crime scene

until the scene has been secured by police.