Chapter 11
The fire department has requested your assistance at a residence where the family's carbon monoxide (CO) detector has been going off. There are three patients. You first assess a 28-year-old female patient who states she has a sinus headache but otherwise feels fine. Her vital signs are pulse, 90; respirations, 16 breaths/min; blood pressure, 118/60 mmHg; and SpO2, 100%. Given these assessment findings, you should immediately: A. Administer high-concentration oxygen B. Inform her that the CO detector has malfunctioned C. Recheck the oxygen saturation on the patient's opposite hand D. Call for advanced life support assistance
A. Administer high-concentration oxygen
You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. The patient still has a good pulse and acceptable blood pressure. The pulse oximeter reads 95% and the ETCO2 monitor reads 28 mmHg. Given these findings, the EMT should: A. Ask the EMT student ventilating the patient to slow the ventilatory rate B. Increase the amount of oxygen being delivered to the BVM reservoir C. Administer a tube of oral glucose since the patient's airway is protected D. Place the patient in semi-Fowler's position to help reduce intracranial pressure
A. Ask the EMT student ventilating the patient to slow the ventilatory rate
The EMT is correctly using a noninvasive blood pressure monitor when she: A. Auscultates a blood pressure before applying and activating the device B. Alternates arms for each blood pressure reading that is obtained with the device C. Places the cuff of the noninvasive BP monitor on the patient's forearm D. Confirms each reading on the device by palpating a pressure in the opposite arm
A. Auscultates a blood pressure before applying and activating the device
Which of these would indicate a normal pupillary exam has occurred? A. Both pupils constrict when light is directed into one eye B. One pupil dilates and the other constricts in response to light C. The patient reflexively closes the eyes to light D. The pupils are equal and do not change shape in response to light
A. Both pupils constrict when light is directed into one eye
You are assessing a 61-year-old male patient who is confused. During the primary assessment, you cannot locate a radial pulse. Your immediate action should be to: A. Check for a carotid pulse B. Apply the AED C. Start CPR D. Call for ALS assistance
A. Check for a carotid pulse
A 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right pupil only, while looking at both pupils. What would be a normal finding? A. Constriction of the right and left pupils B. Dilation of the left pupil only C. Dilation of the right pupil only D. Constriction of the right pupil only
A. Constriction of the right and left pupils
The EMT is correctly calculating a patient's respiratory rate when he or she: A. Counts the number of breaths for 30 seconds and multiplies by 2 B. Obtains a pulse oximetry reading and divides it by 3 C. Assesses the patient for any sign of respiratory difficulty D. Counts the number of breaths in 1 minute and divides by 4
A. Counts the number of breaths for 30 seconds and multiplies by 2
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? A. Every 15 minutes B. Only baseline vital signs are required C. Once at the scene and once en route to the ED D. Every 5 minutes
A. Every 15 minutes
What is the name of the pulse that is palpated in the groin area? A. Femoral B. Inguinal C. Carotid D. Pedal
A. Femoral
When using a pulse oximeter on an adult patient, the EMT knows that the sensor is most often attached to the patient's: A. Finger B. Forehead C. Ear D. Chest
A. Finger
To test a pediatric patient's capillary refill, the EMT will: A. Firmly compress and then release pressure on the nail bed B. Apply pressure to an arm and then release that pressure C. Apply gentle pressure to the radial pulse and watch color changes to the hand D. Examine the inside lining of one or both eyelids
A. Firmly compress and then release pressure on the nail bed
A pulse oximetry reading obtained on room air is considered normal when it is: A. Greater than 97 percent B. 100 percent C. Greater than 90 percent D. Greater than 75 percent
A. Greater than 97 percent
You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step? A. Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt B. Inflate the cuff to a reading of 300 mmHg, and then deflate the cuff slowly until you hear a pulse C. Inflate the cuff to three times the patient's age and listen for a heartbeat D. Inflate the cuff to 300 mmHg, and then leave the cuff inflated for 30 seconds prior to deflation
A. Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt
You have been called to a bar for a patient who was involved in an altercation and is complaining of abdominal pain. Law enforcement is present. The patient has been handcuffed and is sitting on the sidewalk. He has an odor of alcohol on his breath, his speech is slurred, and he is angrily yelling at the police officers. Which action would be most appropriate for the EMT to take when talking to the patient? A. Maintain eye contact to help establish a rapport B. Stand and communicate with the patient from 3 to 4 feet away C. Place your hand on the patient's shoulder to keep him subdued D. Stand above the patient to establish authority
A. Maintain eye contact to help establish a rapport
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? A. Obtain a pulse oximetry reading and breath sounds every 5 minutes B. Re-obtain a SAMPLE history and look for new information C. Inquire if the patient feels the need for another dose of albuterol D. Ask the patient if she finds it easier to breathe
A. Obtain a pulse oximetry reading and breath sounds every 5 minutes
When you are obtaining the blood pressure of a patient in a standing position, the patient states that he suddenly feels weak and is going to pass out. Your immediate action should be to: A. Place the patient back into bed B. Ask the patient if he is having chest pain C. Determine the blood pressure by palpation D. Hold the patient upright until the blood pressure is obtained
A. Place the patient back into bed
Which step should be taken by the EMT to obtain an accurate pulse oximetry measurement? A. Remove nail polish from the patient's fingernail if present B. Administer oxygen before assessing the oxygen saturation C. Elevate the patient's hand above his heart D. Secure the probe to the patient's finger with tape
A. Remove nail polish from the patient's fingernail if present
When should the EMT use the pulse oximeter? A. Routinely on all patients with a medical or trauma complaint B. On any and all patients 1 year of age and older C. Only if the patient has a history of lung disease D. Only on patients who complain of shortness of breath
A. Routinely on all patients with a medical or trauma complaint
Correctly assessing orthostatic vital signs involves: A. Taking the blood pressure in the supine, seated, and standing positions B. Determining whether the patient's pulse disappears during deep inspiration C. Taking the blood pressure and heart rate three times, 2 minutes apart D. Determining whether the patient's respirations and heart rate are within normal limits
A. Taking the blood pressure in the supine, seated, and standing positions
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? A. The patient B. Family members C. The patient's primary care doctor D. EMRs on scene
A. The patient
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? A. The systolic blood pressure is 118 mmHg B. The diastolic blood pressure is 118 mmHg C. The systolic blood pressure is 76 mmHg D. The diastolic blood pressure is 130 mmHg
A. The systolic blood pressure is 118 mmHg
Which of these statements indicates an appropriate understanding of palpating a blood pressure? A. "A palpated blood pressure is typically a little lower than a blood pressure obtained by auscultation." B. "A palpated blood pressure is recorded when the brachial pulse fades out as the BP cuff is deflated." C. "It is best to determine a palpated blood pressure using a stethoscope and pulse oximeter." D. "Palpated blood pressure is the technique of choice when the patient has a cardiac complaint."
A. "A palpated blood pressure is typically a little lower than a blood pressure obtained by auscultation."
Which of these statements made by your EMT partner indicates that he understands assessment of a patient's breathing? A. "A rate less than 8 times per minute may allow adequate breathing, but requires further evaluation and assessment." B. "As long as the patient is breathing more than 20 times per minute, he is getting enough oxygen in his body." C. "To determine if a patient is adequately breathing, the EMT must get a full set of vital signs." D. "If the respiratory rate is normal, the patient is breathing adequately and getting enough oxygen."
A. "A rate less than 8 times per minute may allow adequate breathing, but requires further evaluation and assessment."
When using the OPQRST mnemonic, the EMT is getting information as it applies to the "P" category when she asks: A. "Do you feel more short of breath when you are lying down?" B. "Can you rate the pain on a scale of 1 to 10?" C. "What time did the symptoms start?" D. "Does the chest pain spread to your back?"
A. "Do you feel more short of breath when you are lying down?"
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? A. "The cold temperature may cause the capillary refill to be 5 seconds; we should assess further." B. "If his skin is also warm and moist, then the patient is most likely in shock." C. "That finding likely indicates he has lost blood and the skin is not being adequately perfused." D. "That is a significant finding. We really need to get him on oxygen and get moving to the hospital."
A. "The cold temperature may cause the capillary refill to be 5 seconds; we should assess further."
Which of these statements concerning assessment of the pulse is correct? A. "The heart rate can be determined by doubling the number of beats counted in 30 seconds." B. "A brachial pulse should be felt first in any patient younger than 6 years of age." C. "After much experience, an EMT can calculate the pulse rate by just feeling it for a few seconds." D. "To get the most accurate rate, the EMT should place a stethoscope over the pulse site and count the number of beats in 1 minute."
A. "The heart rate can be determined by doubling the number of beats counted in 30 seconds."
When obtaining a medical history using the SAMPLE mnemonic, which of these statements relates to the "P" component? A. "There is a history of pancreatitis." B. "The pulse is 116 beats per minute." C. "The physician is Dr. Coleman." D. "The pain is rated at 8/10."
A. "There is a history of pancreatitis."
The EMT is appropriately using the SAMPLE mnemonic when he asks which question? A. "When did you eat last?" B. "Have you thought about stopping smoking?" C. "Why did you call for the ambulance?" D. "Who is your doctor?"
A. "When did you eat last?"
You are called for a 2-year-old female child who is sick. When testing her capillary refill, what would be the greatest cause for concern? A. 3-second capillary refill time B. 1-second capillary refill time C. 2-second capillary refill time D. Immediate return of color
A. 3-second capillary refill time
Your partner states that he wants to palpate the blood pressure. Which equipment would you hand him? A. Stethoscope and pulse oximeter B. Blood pressure cuff C. Blood pressure cuff and stethoscope D. Stethoscope
B. 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? A. Chest pain that worsens with inspiration B. Blood pressure of 116/84 mmHg C. Recent diagnosis of pneumonia D. Complaint of light-headedness
B. Blood pressure of 116/84 mmHg
When obtaining a blood pressure, the EMT listens for a pulse over which blood vessel? A. Antecubital vein B. Brachial artery C. Carotid vessel D. Radial artery
B. Brachial artery
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: A. Retake the blood pressure and compare it to a normal BP of 120/80 mmHg B. Compare this finding to the baseline blood pressure C. Take another blood pressure measurement in five minutes D. Ask the patient if he feels his blood pressure has changed
B. Compare this finding to the baseline blood pressure
When assessing a patient's pupils, the EMT should: A. Cover one eye and shine a light in the other eye, watching for changes to the size of the pupil B. Determine the size of the pupil and then look for a change in pupillary size while shining a light in the eye C. Instruct the patient to blink several times and observe the size of the pupils D. Shine a light in one eye and watch for the pupil to dilate
B. Determine the size of the pupil and then look for a change in pupillary size while shining a light in the eye
The EMT is correctly palpating a central pulse when he palpates the: A. Radial pulse B. Femoral pulse C. Brachial pulse D. Posterior tibial pulse
B. Femoral pulse
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: A. Tell her they are normal B. Inform her of the vital signs C. Change the subject D. Reassure her that she is fine
B. Inform her of the vital signs
You have been dispatched to a residence for a 14-year-old female patient complaining of abdominal pain. As you enter the living room, you see the conscious patient lying on a couch with her father and an Emergency Medical Responder at her side. Which action should the EMT perform first? A. Ask her father to leave the room B. Introduce yourself and your partner C. Get permission to treat the patient D. Determine the chief complaint
B. Introduce yourself and your partner
Which of these would be an indication to palpate the blood pressure? A. Non-life-threatening condition B. Noisy environment C. Tachycardic pulse rate D. Normal pulse rate
B. Noisy environment
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: A. Obtain vital signs B. Perform a primary assessment C. Determine the type of medication taken D. Get a pulse oximeter reading
B. Perform a primary assessment
You are trying to get a pulse oximeter reading on an 18-month-old child with difficulty breathing. Every time you place the sensor on the child's finger, he becomes upset and removes it. What is your best course of action? A. Place the sensor on the other hand B. Place the sensor on the child's toe C. Restrain the child until a reading is obtained D. Attach the sensor to his neck
B. Place the sensor on the child's toe
Which of these methods most accurately assesses a patient's skin temperature? A. Using the palm to feel the patient's forehead B. Placing the back of the hand on the patient's abdomen C. Placing the inside of the EMT's arm against the patient's arm D. Placing the tips of two fingers on the patient's wrist
B. Placing the back of the hand on the patient's abdomen
Friends called 911 for a 37-year-old female who intentionally overdosed on a narcotic drug at a college party. Which eye-related findings would reinforce that the patient did indeed take a narcotic? A. Bloodshot eyes with large pupils B. Pupils that are constricted C. Nonreactive pupils that are unequal D. Pupils that constrict to light
B. Pupils that are constricted
You have been called to assess a conscious and alert 5-year-old child whose chief complaint is nausea and vomiting over the last 2 hours. When assessing his pulse, you should first check which pulse? A. Pedal B. Radial C. Carotid D. Brachial
B. Radial
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? A. Persistent cough B. Rectal bleeding C. Fever D. Headache
B. Rectal bleeding
Which of these findings related to breathing would be most concerning to the EMT in an adult patient? A. Respiratory rate of 10, chest expansion of about 1 inch B. Respiratory rate of 20, use of accessory muscles C. Respiratory rate of 22, normal chest wall expansion D. Respiratory rate of 18, complaint of weakness
B. Respiratory rate of 20, use of accessory muscles
Which of these pieces of information would be obtained by the EMT when getting a history using the SAMPLE mnemonic? A. Reason for calling for an ambulance B. Sensation of dizziness prior to falling C. No life threats to the airway, breathing, or circulation D. Pulse, 144; respiration, 16 breaths/min; BP, 132/88 mmHg
B. 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: A. Using a blue-tinged light B. Shading the patient's eyes C. Retracting the eyelid D. Hydrating the eyes with saline drops first
B. Shading the patient's eyes
A mother has called 911 because her 2-year-old daughter is fussy and not eating. When assessing the toddler, what would be the best indication of her perfusion status? A. Auscultation of breath sounds B. Skin color and temperature C. Palpated blood pressure D. Heart rate
B. Skin color and temperature
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? A. Fingertips that are cool and blue B. Skin on the abdomen that is hot and flushed C. Cyanotic skin around the mouth D. Decreased heart rate and flushed skin
B. Skin on the abdomen that is hot and flushed
Your partner reports that a patient's blood pressure is 156/78 mmHg. From this reading, you realize: A. The constant pressure in the veins is 156 mmHg B. The diastolic blood pressure is 78 mmHg C. The pulse pressure is 224 mmHg D. The systolic blood pressure is 78 mmHg
B. The diastolic blood pressure is 78 mmHg
The EMT is reviewing a patient care report and finds the following documentation "ETCO2 is 43 mmHg." What does this mean? A. The hemoglobin saturation with carbon dioxide is normal B. The exhaled carbon dioxide level is normal C. The patient is intubated D. The patient is hypoxic and in need of oxygen
B. The exhaled carbon dioxide level is normal
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: A. The nasopharynx being blocked by mucus or heavy secretions B. The tongue partially blocking the airway C. The airway swelling shut D. The respiratory rate being less than 10 breaths/min
B. The tongue partially blocking the airway
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. "Any systolic blood pressure of less than 100 mmHg in a child is an emergency." B. "A minimally acceptable systolic pressure can be estimated by doubling the child's age and adding it to 70." C. "Since pediatric emergencies are less common than adult emergencies, it is best to call medical direction and ask what is normal." D. "It is helpful to ask the parent or caregiver what is normal for the child and compare your reading to that."
B. "A minimally acceptable systolic pressure can be estimated by doubling the child's age and adding it to 70."
Your EMT student has a good understanding of end-tidal carbon dioxide monitoring when she states: A. "Only paramedics and AEMTs are allowed to utilize end-tidal capnography." B. "Any disturbance to the breathing, circulation, or metabolic state of the patient can alter the reading." C. "The normal value should be 45 to 55 mmHg." D. "End-tidal carbon dioxide monitoring should be used only when the patient is being artificially ventilated."
B. "Any disturbance to the breathing, circulation, or metabolic state of the patient can alter the reading."
Which of these statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient? A. "If a delayed capillary refill is observed in a patient of any age, there is a high probability he or she is in shock." B. "Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescents or adults." C. "Capillary refill is a very reliable sign of shock in any patient between the ages of 18 and 65 years." D. "The possibility of chronic circulatory diseases makes the capillary refill test an excellent sign of circulation in the adult patient."
B. "Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescents or adults."
Which of these statements made by an EMT indicates an accurate understanding of checking a patient's skin temperature? A. "To properly evaluate a patient's skin temperature during the primary assessment, the EMT needs a thermometer." B. "Checking the skin temperature is not precise, but provides a good estimate of abnormally high or low body temperatures." C. "Flushed skin always indicates a high body temperature." D. "With experience, the EMT can precisely determine a patient's body temperature by feeling the skin."
B. "Checking the skin temperature is not precise, but provides a good estimate of abnormally high or low body temperatures."
An obese female patient has called you with a complaint of abdominal pain. The regular adult cuff will not fit around her arm, so you retrieve the large adult cuff from your supplies. Embarrassed, the woman says, "My arm is so fat. Do you really need to roll up my sleeve to get my blood pressure?" Your best response would be: A. "If you do not want me to take your blood pressure, I do not have to." B. "I am not concerned with the size of your arm. I am interested in your blood pressure." C. "I am getting your blood pressure, not measuring your arm, but you really need to lose some weight." D. "I have seen plenty of big arms, and yours is nothing compared to some of them."
B. "I am not concerned with the size of your arm. I am interested in your blood pressure."
When using the SAMPLE mnemonic, which of these statements made by the patient would be categorized under the letter "M"? A. "I was diagnosed and treated for breast cancer." B. "I take Zocor, but I am not sure why." C. "I have never had a surgical procedure." D. "My doctor's name is Dr. Hansen."
B. "I take Zocor, but I am not sure why."
You are transporting a depressed patient who states that she is thinking of killing herself by taking a "whole bunch of pills." After providing you this information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. Which of these statements would be most appropriate for you to make at this time? A. "Has the cat got your tongue? If you talk to me, I can help you." B. "I understand if you do not want to talk. I will be sitting here if you need anything." C. "I don't understand why you won't talk. You called 911 for help, didn't you?" D. "I need you to talk to me. I cannot help you if you refuse to talk to me."
B. "I understand if you do not want to talk. I will be sitting here if you need anything."
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: A. "It allows us to monitor your blood pressure and respiratory status." B. "It measures the amount of oxygen being carried by your blood cells." C. "It tells us how well your heart is pumping blood." D. "It provides us with the most accurate measure of your heart rate."
B. "It measures the amount of oxygen being carried by your blood cells."
A patient who appears to be intoxicated has fallen and is complaining of pain to his right arm. He is loud and using profane language. What should be your initial approach to the patient? A. "Stop yelling or I will have to strap you to the stretcher." B. "Let me put an ice pack on your wrist. It will help it feel better." C. "I cannot help you if you keep yelling like that!" D. "If you do not quiet down, I will call the police and they will arrest you."
B. "Let me put an ice pack on your wrist. It will help it feel better."
Which of these statements made by a patient would the EMT regard as a symptom? A. "I have a history of high blood pressure that I take medicine for." B. "My pain is sharp, the worst I've ever felt." C. "There is a bruise to my left elbow." D. "I slipped and fell down the stairs."
B. "My pain is sharp, the worst I've ever felt."
An EMT has accurately checked the skin color of a dark-skinned patient. How would this finding be best documented on a patient care report? A. "Forehead and face show pink skin color." B. "Pale color noted to the conjunctiva." C. "Thoracic and abdominal skin normal in color." D. "Warm skin noted on the upper arm."
B. "Pale color noted to the conjunctiva."
The EMT is correct when he makes which of these statements about assessment of the pupils? A. "Dilated pupils are less of a concern than pupils that are constricted." B. "Some people naturally have unequal pupils, but both should react to light." C. "If a patient's pupils are dilated but react to light, the pupillary exam is considered normal." D. "Constricted pupils are less of a concern than are dilated pupils."
B. "Some people naturally have unequal pupils, but both should react to light."
Which of these questions would be asked when obtaining a medical history, using the SAMPLE mnemonic, for a female patient who is crying and complaining of dizziness? A. "You seem upset. Do you want to talk about it?" B. "What were you doing when the dizziness started?" C. "Why exactly did you call the ambulance today?" D. "Who is your doctor and when was your last office visit?"
B. "What were you doing when the dizziness started?"
How should the EMT document a pulse oximetry reading on the prehospital care report? A. 97% O2 B. 97% SpO2 C. 97% PO2 D. 97% PO
B. 97% SpO2
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? A. Pale and cyanotic B. Yellow-orange C. Bluish-gray D. Pinkish and flushed
B. Yellow-orange
While reviewing a patient care report for a quality assurance process, the EMT should recognize that a blood pressure has been palpated when she sees: A. P / 118 B. 118/178 (palpated) C. 178 / P D. Palp: 178/118 mmHg
C. 178 / P
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. Normal blood pressure since the patient is alert and oriented B. A normal heart rate given the patient's age C. A narrowed pulse pressure and possible shock D. Diastolic hypertension and risk for stroke
C. A narrowed pulse pressure and possible shock
Which of these descriptions would be obtained when asking about the "A" component of the SAMPLE history? A. Abdomen soft B. History of asthma C. Allergy to penicillin D. Airway is open
C. Allergy to penicillin
Which of these patients should the EMT recognize as having a normal skin temperature? A. A 25-year-old female who is dizzy with cool skin B. A 47-year-old female with chest pain and warm-to-hot skin C. A 36-year-old male complaining of nausea with warm skin D. An 88-year-old male who is weak with cool and dry skin
C. A 36-year-old male complaining of nausea with warm skin
For which of these patients would a capillary refill time of 3 seconds be most indicative of poor perfusion? A. A 24-year-old female B. A 67-year-old female C. A 4-year-old male D. An 81-year-old male
C. A 4-year-old male
Where would the EMT palpate for a popliteal pulse? A. Upper arm B. Top of foot C. Behind the knee D. Posterior ankle
C. Behind the knee
When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would: A. Double the number of beats counted in 30 seconds B. Feel the carotid pulse for 30 seconds and multiply by 2 C. Count the number of beats that occur in 1 minute D. Listen to the pulse with a stethoscope
C. Count the number of beats that occur in 1 minute
You observe your partner correctly obtaining a patient's blood pressure when he: A. Places the stethoscope under the cuff and deflates it B. Stops inflation and starts deflation as soon as the carotid pulse disappears C. Deflates the cuff 2 mmHg per second while listening with a stethoscope D. Inflates the cuff maximally prior to slowly deflating and listening for a pulse
C. Deflates the cuff 2 mmHg per second while listening with a stethoscope
You are assessing a confused dark-skinned patient who complains of a headache. When checking his skin color, you should: A. Examine the skin around his ears and nose B. Observe the skin on his forehead C. Evaluate the palms of his hands or conjunctiva D. Look at and feel the skin on his neck and chest
C. Evaluate the palms of his hands or conjunctiva
You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. How often should vital signs be reassessed on this patient? A. Only baseline vital signs are required B. Every 15 minutes C. Every 5 minutes D. Once at the scene and once en route to the ED
C. Every 5 minutes
You are attempting to get a history from a 56-year-old female patient who is short of breath. When you ask questions, the daughter continually answers for the patient. To best handle this situation, you should: A. Move the patient to the ambulance for the rest of the assessment B. Have the Emergency Medical Responders remove the daughter C. Explain to the daughter it is important for the patient to answer whenever possible D. Contact medical direction for advisement
C. Explain to the daughter it is important for the patient to answer whenever possible
An EMT has an accurate understanding of diastolic blood pressure when she tells you that diastolic pressure: A. Should always be rounded to the nearest 10 B. Can be easily obtained by palpating the blood pressure C. Is the pressure in the arteries when the heart is not contracting D. Can be estimated as one-third of the systolic blood pressure
C. Is the pressure in the arteries when the heart is not contracting
You have been dispatched to a residence for a female patient with unknown injuries. At the patient's side, you quickly become aware that the 43-year-old female was assaulted by her husband. The husband comes into the room and states, "Don't you touch her, or I will take care of you, too!" What should be the EMT's immediate action? A. Control any active bleeding, and then leave the house B. Stay with the patient and contact law enforcement C. Leave the house immediately, taking the patient with you, if possible D. Restrain the husband so that you can care for the patient
C. Leave the house immediately, taking the patient with you, if possible
In patients with which of these conditions would the EMT most likely get an inaccurate pulse oximeter reading despite proper application of the sensor? A. Increased heart rate B. Elevated body temperature C. Low blood pressure D. Unresponsiveness
C. Low blood pressure
You are assessing a female patient with a complaint of shortness of breath. When assessing her skin, which finding should be recognized as abnormal? A. Pink B. Warm C. Moist D. Dry
C. Moist
Which pulse site is commonly palpated during the process of obtaining a blood pressure by the palpation technique? A. Carotid B. Brachial C. Radial D. Pedal
C. Radial
When assessing a patient who does not speak the same language as you or your partner, the best approach in the immediate care of the patient is to: A. Transport the patient to a hospital with interpreters for her language B. Contact medical direction to get physician input C. Request that a family member act as an interpreter D. Try to find a neighbor who speaks the patient's language
C. Request that a family member act as an interpreter
You are caring for a 5-year-old male patient with a complaint of difficulty breathing. Your assessment indicates that the patient is tachypneic with labored breathing. While gaining more information about the patient's respiratory function, which finding would you recognize as most important? A. Skin that is hot and dry B. Nasal congestion and runny nose C. Skin retractions between the ribs during inhalation D. Systolic blood pressure of 92 mmHg
C. Skin retractions between the ribs during inhalation
To assess a patient's blood pressure, the EMT will need a: A. Pulse oximeter and stethoscope B. Pulse oximeter C. Sphygmomanometer D. Pair of gloves and stethoscope
C. Sphygmomanometer
Which of these characteristics would be considered a pulse "quality" factor? A. Tone B. Regularity C. Strength D. Rate
C. Strength
A young female patient has been stung by a bee and complains that her "throat is closing up." She states that she is allergic to bee stings; the last time this happened, she had to have a "tube put into my windpipe." She is struggling to breathe and can speak only a few words at a time. Knowing that allergic reactions can cause swelling in the pharynx and the larynx, what airway sound would indicate that the patient indeed has swelling in this area? A. Wheezing B. Snoring C. Stridor D. Gurgling
C. Stridor
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: A. The cuff covers one-third of the patient's upper arm B. The cuff is centered over the top of the radial artery C. The cuff is on the same level as the patient's heart D. The cuff is placed over the antecubital space and elbow
C. The cuff is on the same level as the patient's heart
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? A. The history of diabetes is a contributing symptom of the chief complaint B. The dizziness is a sign indicating the severity of the chief complaint C. The headache is a symptom related to the chief complaint D. The history of diabetes is a sign related to the chief complaint
C. The headache is a symptom related to the chief complaint
When assessing a patient's pulse, you can locate the right radial pulse, but not the left. What is the most likely explanation for this finding? A. There is a problem with the patient's veins B. The patient is in the early stage of cardiac arrest C. The left radial artery may be occluded D. The left radial artery is extremely large
C. The left radial artery may be occluded
Which of these statements is true regarding vital signs obtained from a patient with nausea and vomiting? A. If the vital signs are within normal limits, it is safe to let the patient refuse transport B. The patient's complaint is considered significant only if accompanied by abnormal vital signs C. The vital signs will help the EMT determine the relative stability or instability of the patient D. The vital signs will allow the EMT to diagnose the cause of the nausea and vomiting
C. The vital signs will help the EMT determine the relative stability or instability of the patient
You cannot obtain a reading on the pulse oximeter after applying the sensor to the patient's finger. What would be the most common reason for this difficulty? A. The patient is hypertensive B. The patient's oxygen saturation is less than 90% C. The patient's hands are cold D. The patient's pulse is faster than 100 beats per minute
C. The patient's hands are cold
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? A. "Documenting several sets of vital signs is the only way to get full reimbursement from insurance companies for the EMS call." B. "You must get at least two sets of vital signs because that is what the national standard calls for." C. "Examining several sets of vital signs can also indicate the effectiveness of your treatment." D. "You must at least get a pulse rate every 15 minutes, since this is the most important vital sign."
C. "Examining several sets of vital signs can also indicate the effectiveness of your treatment."
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: A. "I understand it hurts. Please go on." B. "So what you are saying is that it hurts more when you breathe?" C. "I see. Can you describe what the pain feels like?" D. "Hmmm. That really seems to hurt a lot."
C. "I see. Can you describe what the pain feels like?"
You have applied the pulse oximeter to a 73-year-old male patient who complains of weakness and heart palpitations. Your partner reports that the patient's breath sounds are clear and equal, with a respiratory rate of 16 breaths/min and skin that is warm but pale in color. He then states the following vital signs: pulse, 92; blood pressure, 168/70 mmHg; and SpO2, 92% on room air. Given this information, which of these instructions would be most appropriate? A. "The SpO2 is probably normal for him since he is very pale." B. "Let's recheck the SpO2 in 2 minutes for any change." C. "Let's initiate oxygen at 2 liters per minute via a nasal cannula." D. "The reading must be wrong since he displays no cyanosis."
C. "Let's initiate oxygen at 2 liters per minute via a nasal cannula."
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: A. "That finding is important because it suggests the radial artery is partially blocked." B. "Given the patient's age, that is a typical finding and not an immediate concern." C. "That is an important finding. We will have to let the doctor know about it." D. "Let's move the patient to the stretcher for transport. That is an early sign of cardiac arrest."
C. "That is an important finding. We will have to let the doctor know about it."
A patient presents with skin that is cool to the touch. The EMT shows he understands this condition when he states: A. "The patient must have an infection somewhere in his body." B. "We should check his breath sounds; the patient probably has a lung infection, such as pneumonia." C. "This may indicate a problem with the patient's blood circulation." D. "The patient most likely has a past medical history of hypertension."
C. "This may indicate a problem with the patient's blood circulation."
Which of these is an example of an open-ended question? A. "Does your chest hurt?" B. "Are you dizzy?" C. "Why did you call 911?" D. "Did you take your medications today?"
C. "Why did you call 911?"
The EMT recognizes which heart rate would be considered normal for a 24-year-old male patient who is resting comfortably? A. 54 beats/min B. 110 beats/min C. 124 beats/min D. 62 beats/min
D. 62 beats/min
You are assessing a 49-year-old male patient who complains of lower back pain. Which finding would be pertinent medical information related to the back pain that the EMT will obtain using the SAMPLE mnemonic? A. Last tetanus shot 5 years ago B. Childhood case of measles C. Heart rate of 48 and cool, clammy skin D. Arthritis in the spine and pelvis
D. Arthritis in the spine and pelvis
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? A. Move the blood pressure cuff down to the forearm B. Use an automatic blood pressure monitor C. Palpate the blood pressure in the right arm D. Auscultate the blood pressure in the left arm
D. Auscultate the blood pressure in the left arm
Which of these patients should the EMT recognize as tachycardic for his or her age bracket? A. A 24-year-old female with diabetic complications and a heart rate of 54 B. A 2-year-old female with vomiting and a heart rate of 116 C. An 86-year-old male with chest pain and a heart rate of 96 D. A 37-year-old male with a complaint of fatigue and a heart rate of 104
D. A 37-year-old male with a complaint of fatigue and a heart rate of 104
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: A. Bilateral midsize pupils that are reactive to light B. Constricted pupils bilaterally, nonreactive to light C. Nonreactive pupils of decreased size bilaterally D. Bilateral dilation of the pupils, unresponsive to light
D. Bilateral dilation of the pupils, unresponsive to light
You determine a patient's heart rate to be 48 beats/min. That heart rate would be categorized as: A. Tachycardic B. Tachypneic C. Normal D. Bradycardic
D. Bradycardic
Assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify: A. Jaundice caused by an increase in blood flow to the extremities B. Erythema caused by a decrease in body temperature C. Pallor caused by a decrease in blood flow to the tissues D. Cyanosis caused by inadequate oxygenation of the tissues
D. Cyanosis caused by inadequate oxygenation of the tissues
During the primary assessment of a geriatric patient complaining of shortness of breath and fever, you quickly locate the radial pulse. What should you do next? A. Assess the patient's breathing B. Establish the patient's level of consciousness C. Obtain a blood pressure D. Determine the rate and quality of the pulse
D. Determine the rate and quality of the pulse
You believe a patient for whom you are caring is starting to experience respiratory failure. Which of these findings is supportive of this suspicion? A. SpO2 of 94% B. Heart rate of 118 beats/min C. Bilateral wheezing on exhalation only D. ETCO2 of 56 mmHg
D. ETCO2 of 56 mmHg
The purpose of the OPQRST mnemonic is to guide the EMT in: A. Determining the stability of vital signs B. Getting a past medical history C. Establishing any allergies to medications D. Exploring the patient's chief complaint
D. Exploring the patient's chief complaint
A patient with liver cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition as: A. Pallor B. Flushed C. Cyanotic D. Jaundice
D. Jaundice
As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, what do you expect to see when you reach the patient's side? A. The patient has a past medical history of blindness B. Both pupils are large and change shape in response to light C. The patient must wear corrective lenses D. Neither pupil will react when light is directed into the eyes
D. Neither pupil will react when light is directed into the eyes
When evaluating a patient's skin color, the EMT should: A. Examine the change in skin color when applying, then releasing pressure to the nail beds B. Look at the skin on the upper chest and feel it for warmth C. Examine the skin color of the face and compare it with the color of the arms D. Observe the nail beds and/or mucous membranes inside the eyelids
D. Observe the nail beds and/or mucous membranes inside the eyelids
The EMT should recognize normal skin color in a healthy patient as: A. Warm B. White C. Red D. Pink
D. Pink
An EMT has an accurate understanding of systolic blood pressure when he tells you that systolic blood pressure is: A. Represented by the bottom number B. The pressure in the veins C. Caused by constriction of the arteries D. Produced when the heart contracts
D. Produced when the heart contracts
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? A. Obtain a full set of vital signs, excluding the patient's temperature B. Prepare and apply the pulse oximeter before administering oxygen C. Attempt to determine what happened to the patient or any existing medical problems D. Provide positive pressure ventilation with supplemental oxygen
D. Provide positive pressure ventilation with supplemental oxygen
After you apply the pulse oximeter to a patient who complains of chest discomfort, she asks you what you are assessing. You would respond by telling her that the pulse oximeter: A. Can tell how much carbon dioxide she is exhaling with each breath B. Provides the most accurate evaluation of the true heart rate C. Is a tool used to see if the airway needs to be opened D. Provides information about the amount of oxygen circulating in the blood
D. Provides information about the amount of oxygen circulating in the blood
Emergency Medical Responders inform you that a 27-year-old male patient with altered mental status has an open airway and is breathing 9 times every 30 seconds. His pulse rate is 40 beats/min, and he has bruises to his chest. Based on this vital sign and presentation information, the EMT should recognize the: A. Heart as beating adequately B. Heart rate as irregular C. Blood pressure as normal D. Respiratory rate as normal
D. Respiratory rate as normal
Medical direction has asked that you obtain orthostatic vital signs for a 54-year-old female patient who complains of dizziness and weakness. Her baseline vital signs obtained while she was sitting in a chair were pulse, 84; respirations, 26 breaths/min; blood pressure, 118/62 mmHg; and SpO2, 95%. Which one set of vital signs upon reassessment would indicate that this patient has a positive orthostatic test? A. Supine blood pressure of 100/64 mmHg and respirations of 22 breaths/min B. Standing pulse of 88 with the additional complaint of nausea C. Standing SpO2 of 88% and heart rate of 96 beats/min D. Standing blood pressure of 92/54 mmHg and heart rate of 106 beats/min
D. Standing blood pressure of 92/54 mmHg and heart rate of 106 beats/min
You determine a patient's radial pulse is readily palpable, but has uneven intervals between beats. This finding would best be documented on the prehospital care report as: A. Thready and regular B. Bounding and regular C. Prominent and bounding D. Strong and irregular
D. Strong and irregular
The EMT is correct when he identifies baseline vital signs as: A. A set of vital signs most close to normal B. Any change in two consecutive sets of vital signs C. The most important set of vital signs D. The first set of vital signs obtained
D. The first set of vital signs obtained
A blood pressure is reported as 116/68 mmHg. Given this finding, which of these statements is true? A. The top number reflects the diastolic blood pressure B. The systolic pressure is determined by subtracting 68 from 116 C. The diastolic blood pressure is 116 mmHg D. The systolic blood pressure is 116 mmHg
D. The systolic blood pressure is 116 mmHg
An EMT is correctly assessing a patient's radial pulse when he: A. Simultaneously checks for a heart rate on both sides of the neck B. Uses his thumb to feel for the pulse on the patient's lower arm, near the base of the thumb C. Uses the palm of his hand to feel the pulse on the upper arm D. Uses his fingertips to feel for a pulse on the anterior and lateral aspects of the patient's wrist
D. Uses his fingertips to feel for a pulse on the anterior and lateral aspects of the patient's wrist
The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states: A. "The SAMPLE mnemonic helps EMTs diagnose a patient's medical problem." B. "The SAMPLE mnemonic is important because it will give the EMT the patient's exact chief complaint." C. "It is important to use the SAMPLE mnemonic because the emergency department will need the information." D. "After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care."
D. "After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care."
An EMT student asks you if it matters whether the blood pressure cuff seems too small for a patient, if a reading can still be obtained. You should respond: A. "Using a cuff that is too small can cause damage to the blood vessels." B. "As long as the radial pulse remains intact, the cuff size is irrelevant." C. "As long as the reading is obtained, it should be accurate." D. "Cuffs that are too small provide inaccurately high readings."
D. "Cuffs that are too small provide inaccurately high readings."
Which of these questions would the EMT ask when using the OPQRST mnemonic? A. "Did you take any medications today?" B. "Have you ever had any surgeries?" C. "Do you have any medical conditions?" D. "Does the pain feel dull or sharp?"
D. "Does the pain feel dull or sharp?"
Which of these blood pressure readings is normal for a 7-year-old male? A. 76/50 mmHg B. 120/80 mmHg C. 94/30 mmHg D. 114/62 mmHg
D. 114/62 mmHg
Which of these blood pressures represents diastolic hypertension in an adult patient? A. 246/Palpation B. 240/88 mmHg C. 158/44 mmHg D. 136/92 mmHg
D. 136/92 mmHg
Which of these patient descriptions contains only vital signs? A. Heart rate, 88 beats/min; respiratory rate, 14 breaths/min; blood glucose level, 98 mg/dL B. Chief complaint of dizziness; skin, cool and clammy; respiratory rate, 16 breaths/min C. Chief complaint of dizziness; BP, 110/76 mmHg; breath sounds, clear and equal D. Skin, warm and dry; heart rate, 74 beats/min; pupils equal and reactive
D. Skin, warm and dry; heart rate, 74 beats/min; pupils equal and reactive
