Assessment and Airway management
You should gather a patient's medical history and perform a secondary assessment: A. After life threats have been identified corrected in the primary assessment. B. Shortly after making patient contact and determining their complaint. C. Immediately after you form a visual general impression of the patient. D. After initial treatment has been rendered and you are en route to the hospital.
A. After life threats have been identified and corrected in the primary assessment.
If the amount of pulmonary surfactant is decreased: A. Alveolar surface tension increases B. Alveoli are able to expand more easily C. Pulmonary gas exchange is enhanced D. Diffuse alveolar hyperinflation occurs
A. Alveolar surface tension increases
As a paramedic, one of the most important skills you will develop is the ability to: A. Assess a patient. B. Take a blood pressure. C. Start an IV. D. Interpret a 12-lead ECG.
A. Assess a patient
An adult patient with an abnormal respiratory rate should: A. Be evaluated for other signs of inadequate ventilation B. Receive ventilatory assistance with a bag-mask C. Be given oxygen at 4 L/min with a nasal cannula D. Be assessed immediatly for heart rate abnormalities.
A. Be evaluated for other signs of inadequate ventilation.
An acute sudden change in mental status secondary to a significant underlying factor/incident is called: A. Delirium B. Mania C. Altered Mental Status D. Psychotic episode
A. Delirium
Patients with COPD typically experience an acute exacerbation of their condition because of: A. Environmental changes such as weather or the inhalation of trigger substances. B. Chronic noncompliance with their prescribed medications and home oxygen C. Progressively worsening pneumonia that results in a diminished cough reflex D. A secondary condition such as congestive heart failure or a pneumothorax
A. Environmental changes such as weather or the inhalation of trigger substances
The initial summary of the patient's condition based on the clinical presentation and the exclusion of other possible causes is known as the: A. Field impression B. Working diagnosis C. Differential diagnosis D. Final diagnosis
A. Field impression
The purpose of the primary survey is to: A. Identify and correct life threats B. Take vital signs C. Collect a thorough patient history D. Ensure the scene is safe
A. Identify and correct life threats
When a patient's respirations are too rapid and too shallow: A. Inhaled air may only reach the anatomic dead space before being exhaled B. The majority of inhaled air lingers in areas of physiologic dead space. C. The increase in tidal volume will compensate for a rapid respiratory rate. D. Minute volume increases because a larger amount of air reaches the lungs.
A. Inhaled air may only reach the anatomic dead space before being exhaled
The lowest portion of the pharynx that opens into the larynx anteriorly and the esophagus posteriorly is the: A. Laryngopharynx B. Oropharynx C. Hyperpharynx D. Nasopharynx
A. Laryngopharynx
The general type of illness a patient is experiencing is called the: A. Nature of illness B. General impression C. Chief complaint D. Differential diagnosis
A. Nature of illness
Pulse oximetry is used to measure the: A. Percentage of the hemoglobin that is saturated with oxygen. B. Percentage of carbon dioxide that is eliminated from the body. C. Amount of oxygen dissolved in the plasma portion of the blood D. Exchange of oxygen and carbon dioxide at the cellular level
A. Percentage of the hemoglobin that is saturated with oxygen
What does the P in the SOAP acronym represent? A. Plan B. Palpate C. Place D. Person
A. Plan
Your patient says, "I can't catch my breath." In response, you state, "That's very helpful. Let me think about that for a moment." This dialogue is an example of: A. Reflection B. Facilitation C. Clarification D. Interpretation
A. Reflection
You could ask the question, "Would you say the pain is similar to or worse than with the previous episodes?" When determining which characteristic of a patient's pain? A. Severity B. Region C. Progression D. Quality
A. Severity
The presence of diffuse rhonchi (low-pitched crackles) in the lungs indicates: A. Thick secretions in the large airways B. Isolated consolidation of secretions C. Right-sided congestive heart failure D. Air being forced through narrowed airways
A. Thick secretions in the large airways
When caring for a patient who is mentally challenged: A. You may have to obtain the medical history from a family member. B. Your priority should be to transport the patient to a psychiatric facility. C. It is highly unlikely that you will obtain a reliable medical history. D You should speak to the patient as though they are a young child
A. You may have to obtain the medical history from a family member
The main focus of your size-up is the safety and well-being of: A. Your EMS team B. Your patient C. The bystanders D. The patient's family
A. Your EMS team
Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by: A. Performing 30 chest compressions and reassessing. B. Reopening the airway and reattempting to ventilate. C. Sweeping the patient's mouth with your fingers. D. Administering 15 subiaphrogmatic thrusts a once
B. Reopening the airway and reattempting to ventilate
Cor pulmonale is defined as: A. Left-sided heart failure secondary to mitral valve damage B. Right-sided heart failure secondary to chronic lung disease C. Increased preload caused by severe hypertension D. Rupture of the alveoli due to increased surface tension
B. Right-sided heart failure secondary to chronic lung disease
In prehospital care, the priorities of evaluation and treatment are based on: A. The receiving physician's online orders. B. The degree of threat to the patient's life. C. Standard treatment guidelines and algorithms. D. Your overall experience as a paramedic.
B. The degree of threat to the patient's life.
When asking questions to a patient's sexual history, it is important to remember that: A. You should inquire about the patient's HIV status. B. It is essential to obtain the history in a private setting. C. The patient's sexual preference is especially relevant. D. A physical examination should be performed as well
B. it is essential to obtain the history in a private setting.
In contrast to negative-pressure ventilation, positive pressure ventilation occurs when: A. Air is drawn into the lungs B. Air is forced into the lungs C. Intrathoracic pressure fails D. The diaphragm contracts
B. Air is forced into the lungs
To the patient, your entire assessment should: A. Not deviate at all from a strict format B. Appear to be a seamless process C. Yield a definitive field diagnosis D. Only focus on the complaint
B. Appear to be a seamless process
Making your patient aware that you perceive something inconsistent with their behavior is called: A. Interpretation B. Confrontation C. Facilitation D. Clarification
B. Confrontation
If your patient becomes seductive or makes sexual advances toward you, you should: A. Threaten the patient with a sexual harassment lawsuit. B. Ensure that a witness is present at all times. C. Ask your partner to assume care of the patient. D. Continue providing care as usual.
B. Ensure that a witness is present at all times.
The exchange of oxygen and carbon dioxide between the alveoli and the blood in the pulmonary capillaries is called: A. Internal respiration B. External respiration C. Intrapulmonary respiration D. Pulmonary ventilation
B. External respiration
Which of the following cells are responsible for the production of mucus that blankets the lining of the conducting airways? A. Cilia cells B. Goblet cells C. Parenchymal cells D. Ductal cells
B. Goblet cells
The best way to prevent the transmission of disease is: A. Wearing PPE B. Handwashing C. Changing gloves between patients D. Using alcohol-based sanitizers
B. Handwashing
A patient with respiratory distress who is willing to lie flat: A. Likely has basilar pneumonia B. May be acutely deteriorating C. Should be intubated at once D. Has minimal fluid in the lungs
B. May be acutely deteriorating
If chest compression and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should: A. Perform a blind finger sweep of the mouth B. Perform laryngoscopy and use Magill forceps C. Gain airway access via the cricothyroid membrane D. Alternate chest compression and abdominal thrusts.
B. Perform laryngoscopy and use Magill forceps
Bedridden patients who are immunocompromised and have excessive pulmonary secretions are prone to developing: A. Bronchospasm B. Pneumonia C. A pneumothorax D. A pulmonary embolism
B. Pneumonia
Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus? A. Adults were vaccinated against the virus that causes croup, whereas most children were not. B. Children's immune systems are not as developed as those of adults, so they are more prone to infection. C. A child's airway is narrower than an adult's, and even minor swelling can result in obstruction. D. The virus that causes croup replicates for more aggressively in children than is does in adults
C. A child's airway is narrower than an adult's, even minor swelling can result in obstruction
Frothy sputum that has a pink tinge indicates: A. Antihistamine use B. Chronic Bronchitis C. Congestive heart failure D. Tuberculosis
C. Congestive heart failure
A key part of making your practice of prehospital care successful is for you to: A. Strictly adhere to your department's standard operating procedures so that they become a rote series of actions. B. Let the patient guide the questions that you ask in order to build a cohesive rapport on which you can build C. Develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care. D. Approach every patient in the same fashion with the realization that pa - wrong answer
C. Develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care.
A working hypothesis of the nature of a patient's problem is called the: A. Field impression B. History of present illness C. Differential diagnosis D. Chief complaint
C. Differential diagnosis
Which of the following is part of your overall job as a paramedic: A. Determining the patient's prognosis B. Definitively diagnosing the patient's problem C. Efficiently executing a patient care plan D. Definitively ruling
C. Efficiently executing a patient care plan
Standard precautions were developed to: A. Encourage health care workers to wear gloves. B. Prevent a career-ending disease. C. Ensure health care workers would treat all patients the same way. D. Prevent accidental injury to the patients.
C. Ensure health care workers would treat all patients the same way.
A neighbor finds her elderly female friend unresponsive on her kitchen floor. As you are performing your primary survey, the neighbor tells you that she does not know what happened to her friend. The patient moans when you speak to her and is breathing at a normal rate with adequate depth. You should: A. Quickly place her on the stretcher, obtain a 12-lead ECG tracing, and perform a detailed physical exam. B. Apply supplemental oxygen via nonrebreathing mask, place her in a lateral recumbent p
C. Insert an airway adjunct, apply supplemental oxygen, and implement spinal motion restriction precautions.
What type of medication is montelukast (Singulair)? A. Glucocorticoid B. Selective beta-2 antagonist C. Leukotriene blocker D. Corticosteroid
C. Leukotriene blocker
On arrival at a manufacturing facility, you suspect the presence of an uncontrolled hazardous material. What should you do first? A. Thoroughly review the material safety data sheet. B. Seek a description of the substance from employee on scene C. Notify dispatch of your need for a hazardous material team D. Load the patient as quickly as possible and leave the scene
C. Notify dispatch of your need for a hazardous material team.
Which of the following conditions would likely present with a rapid onset of dyspnea? A Asthma B. COPD C. Pulmonary embolism D. Pneumonia
C. Pulmonary embolism
Wheezing is resolved with medications that: A. Reduced soft-tissue swelling in the larynx B. Cause Bronchoconstriction and improved airflow C. Relax the smooth muscle of the bronchioles. D. Dry up secretions in the lower airway
C. Relax the smooth muscle of the bronchioles
In which situation would Cheyne-Stokes respirations be considered an ominous finding? A. Obstructive sleep apnea B. Apneic periods less than 5 seconds C. Traumatic brain injury D. Alcohol intoxication
C. Traumatic brain injury
A patient with a history or asthma is at greatest risk for respiratory arrest if they: A. Have used their inhaler twice in the previous week B. Were recently evaluated in an emergency department. C. Were previously intubated for their condition D. Take a bronchodilator and a corticosteroid
C. Were previously intubated for their condition
Which of the following statements regarding anemia is correct: A. Anemic patients typically present with flushed skin and bradycardi B. Patients with anemia have a chronically high level of hemogloben C. Anemia is a condition caused exclusively by a deficiency of iron. D. Anemia results in a decreased ability of the blood to carry oxygen.
D. Anemia results in decreased ability of the blood to carry oxygen
You receive a call for "man down." While en route to the scene, you ask the dispatcher to provide additional information, but the dispatcher advises you the caller was abrupt on the phone and then hung up. You should: A. Assume that the caller panicked because the patient is critically ill. B. Ask the dispatcher if law enforcement is en route to the scene. C. Stage in a safe area until contact with the caller can be reestablished D. Advise the dispatcher to send a second paramedic crew to th
D. Ask the dispatcher if law enforcement is en route to the scene.
Hypoventilating patients: A. Typically do not have an open airway B. Experience an increase in blood pH C. Eliminate too much carbon dioxide D. Become hypercapnic and acidotic
D. Become hypercapneic and acidotic
COPD is characterized by: A. Narrowing of the smaller airways that is often reversible with prompt treatment. B. Small airway spasms during the inhalation phase, resulting in progressive hypoxia C. Widespread alveolar collapse due to increased pressure during the exhalation D. Charges in pulmonary structure and function that are progressive and irreversible
D. Changes in pulmonary structure and function that are progressive and irreversible
Which of the following PPE items is required on all calls? A. Gown B. Eye protection C. Helmet D. Gloves
D. Gloves
Stretch receptors in the lungs trigger which of the following reflexes, which helps to regulate depth of respirations and keeps the lungs from overinflating? A. Phrenic-Greenfield reflex B. Hepato-jugular reflex C. Greenfield-Redding reflex D. Hering-Breuer reflex
D. Hering-Breuer reflex
A patient with respiratory splinting: A. Is holding their arm against the chest B. Has an increased tidal volume due to a chest injury C. Is often tachypneic with deep breathing D. Is breathing shallowly to alleviate chest pain
D. Is breathing shallowly to alleviate chest pain.
According to NIOSH, the rate of on-the-job injuries for EMS personnel: A. Is roughly equal to that for the general workforce. B. Cannot be assessed due to poor self-reporting among EMS providers. C. Demonstrates what a safe industry EMS has become. D. Is three times greater than that for the general workforce.
D. Is three times greater than that for the general workforce.
Difficulty with exhalation is most characteristic of: A. Upper airway obstruction B. Supraglottic swelling C. Acute pulmonary edema D. Obstructive lung disease
D. Obstructive lung disease
When dealing with a patient who has multiple symptoms, the most effective way develop an appropriate care plan is to: A. Assume that all complaints are linked B. Address all complaints are linked C. Perform a complete head-to-toe exam. D. Prioritize the patient's complaints
D. Prioritize the patient's complaints
A patient with orthophea: A. Generally has a slow, shallow respiratory pattern. B. Is awakened from sleep with severe dyspnea C. Prefers to lie flat in order to facilitate breathing. D. Seeks a sitting position when short of breath.
D. Seeks a sitting position when short of breath
Which of the following actions would be your lowest priority prior to engaging in the care of a conscious patient? A. Noting the mechanism of injury B. Assessing the scene for safety C. Gathering dispatch information D. Speaking with immediate family
D. Speaking with immediate family.
Chest vibrations you can feel as the patient breathes due to large airway sections are called: A. Hepatojugular reflux B. Crackles C. Croup D. Tactile fremitus
D. Tactile fremitus
If a patient's family member is hostile and begins shouting at you, you should: A. Remain professional and ignore the family member so that you can provide appropriate patient care. B. Have your partner physically remove the family member from the patient care area and continue your assessment. C. Firmly tell the family member that their behavior is unacceptable and childish and that they are worsening the situation. D. Tell the family member that if they continue to shout you will not feel
D. Tell the family member that if they continue to shout you will not feel safe and will need to call law enforcement.
More often than not, the paramedic will form a general impression of a patient based on: A. Conditions found in the primary assessment. B. Baseline vitals signs and SAMPLE history. C. A rapid, systematic head-to-toe assessment D. The initial presentation and chief complaint.
D. The initial presentation and chief complaint.
