Emt final
You are triaging patients at the scene of a multiple vehicle crash when you encounter a young male who is unresponsive and is not breathing. After you open his airway, he begins to breathe at a rapid rate. According to the START triage system, you should:
tag him as immediate (red), place him in the recovery position, and move to the next patient.
A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she
Is experiencing septic shock
An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the MOST appropriate method of immobilizing this patient?
Leave her on her side and use blanket rolls to immobilize her to the long backboard.
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
Rapid transport to a trauma center
You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. Which of the following should be your MOST appropriate action?
Rapidly remove the patients from their residence using a blanket or clothes drag.
A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:
blunt injury to the kidney.
In addition to ensuring his or her own safety, the EMT's responsibility when caring for a patient with a behavioral emergency is to
diffuse and control the situation and safely transport the patient.
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:
epinephrine
You are treating a patient who experienced a significant exposure to cyanide. He is semiconscious and is breathing inadequately. The MOST appropriate method of providing assisted ventilations to this patient is to:
use a bag-mask device
What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?
5,600 mL
You are dispatched to a residence for a young female who was kicked in the abdomen by her boyfriend. While en route to the scene, you should ask the dispatcher if:.
law enforcement is at the scene.
A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. His is conscious and alert with adequate breathing. The MOST appropriate care for this patient includes:
leaning him forward and pinching his nostrils together.
While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should:
report the incident to your supervisor after the call
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:
seal the mouth and nose.
It is 10:30 PM and you have requested air medical transport for a critically injured patient. When you arrive at the designated landing zone, you should:
survey the area for power lines or other hazards.
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless, and her skin is cool and pale. You should be MOST concerned with:
the fact that her clinical signs could indicate that she is bleeding internally.
Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
A mentally competent adult can withdraw his or her consent to treat at any time
You are interviewing a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate to say?
"It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his BSA.
18%
Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min, his Revised Trauma Score (RTS) is
9
You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?
A 49-year-old female with diabetes and difficulty breathing
A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?
Administer oxygen, transport at once, and request a paramedic intercept.
You are assessing a 30-year-old female who presents with respiratory distress and tachycardia after she opened a package that was delivered to her home. The patient tells you that there was a fine white powder on the package, but she did not think it was important. This patient has MOST likely been exposed to
Anthrax
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:
Apply oxygen as needed, clean the wound, and transport
A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:
Assess for a carotid pulse for up to 45 seconds
You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control?
Begin transport to the hospital and closely monitor her condition while en route.
You are dispatched to the scene of a building explosion. Upon arrival, you see people frantically fleeing the building, screaming, "Everyone is passing out!" You should:
Carefully assess the situation and ensure your own safety
A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:
Complete renal failure
A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?
Compression of the head against the roof
After intubating a 44-year-old unconscious, apneic male, you place him on the ambulance stretcher and prepare to load him into the ambulance. After he is placed into the ambulance, you should:
Confirm that the ET tube is still correctly positioned
A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. In addition to administering oxygen, you should:
Contact medical control and administer oral glucose
While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your most appropriate action should be to:
Continue transporting your patient and notify dispatch of the crash
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should:
Document this on your patient care report and advise the emergency department staff of what the child's parents told you
Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade?
Engorged jugular veins
You are transporting a 54-year-old male in cardiac arrest. An EMR is driving the ambulance as you and your partner attempt to resuscitate the patient. What is the MOST logical way of notifying the hospital?
Have the driver contact dispatch and relay the patient information to the hospital.
A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his heart rate is elevated. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?
Have you experienced recent abdominal trauma?
You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect:
Lyme disease
Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:
Perform CPR for another 2 minutes and reassess
You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
Retreat at once and call law enforcement
Your paramedic partner has just acquired a 12-lead ECG on a middle-aged man with chest discomfort. The patient is conscious, but anxious. His blood pressure is 140/84 mm Hg and his heart rate is 80 beats/min. He has a history of hypertension and type 2 diabetes. Your partner states that she believes the patient is experiencing a myocardial infarction of the anterior wall. Which of the following is the MOST likely basis for her statement
She has detected ST segment elevation in leads V3 and V4.
You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:
a ruptured cerebral artery.
You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for PID?
a shuffling gait when walking
A 35-year-old mildly obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is
acute cholecystitis
You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with:
acute pulmonary embolism
While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to:
administer drugs via the IV route to achieve the fastest effect.
Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient's circulatory status, you should direct your partner to:
administer oxygen with the appropriate device.
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should:
administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:
administer oxygen and prepare for rapid transport.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:
administer oxygen and transport her to the hospital.
You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:
administering blow-by oxygen and transporting the child with her mother.
A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should:
advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.
You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the health care system caused his disease. What stage of the grieving process is this patient's behavior consistent with?
anger
An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should:
apply a cervical collar and immobilize him with a vest-style device
A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should
apply direct pressure to the wound
Following direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should:
apply high-flow oxygen, consider spinal precautions, and transport without delay.
A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should
apply supplemental oxygen, immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
A 49-year-old male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (Vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering 100% oxygen, you should:
ask him if he took his Viagra within the past 24 hours.
A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert; his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction and he tells you that he does. You should:
ask him what he takes, how much, and when he last took it.
A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should:
ask the daughter how her father normally behaves.
Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should:
ask the incident commander where the ambulance should be staged.
You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should:
assess her for crowning.
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:
assess the adequacy of his respirations.
A 33-year-old female presents with lower abdominal quadrant pain. She is conscious and alert, but in moderate pain. While your partner is asking her questions about her medical history, you take her vital signs. When you assess her radial pulse, you are unable to locate it. You should:
assess the rate, regularity, and quality of her carotid pulse.
You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to
assess the scene for potential hazards.
You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should:
assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has points to his severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should
assign him a delayed (yellow) category and continue triaging the other patients.
During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should:
assist her ventilations with a bag-mask device.
You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should:
assist her ventilations with a bag-mask device.
A 62-year-old male presents with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering 100% oxygen and contacting medical control, you should:
assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg
After eating at a local restaurant, a 20-year-old male complains of blurred vision, difficulty speaking, and difficulty breathing. He is conscious; however, his respirations are profoundly labored and producing minimal tidal volume. You should:
assist his ventilations with high-flow oxygen.
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:
assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.
A female patient with a suspected spinal injury is breathing with a marked reduction in tidal volume. The MOST appropriate airway management for her includes:
assisting ventilations at an age-appropriate rate.
A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should:
avoid applying pressure to the globe when you are covering the eye.
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
avoid placing him in a supine position if possible and administer oxygen.
An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should
be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.
A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should:
begin CPR and apply the AED.
You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should:
begin ventilatory assistance.
A 21-year-old male was thrown over the handlebars of his motorcycle when he rear- ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious, but restless, and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. In addition to applying high-flow oxygen and protecting his spine, you should
bind his legs together on the backboard, keep him warm, and transport without delay.
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
cardiogenic hypoperfusion.
You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:
closely monitor him and reassess him frequently.
A 30-year-old male experienced a crushing injury when his arm was trapped between the back of a truck and a loading dock. Upon your arrival, the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:
compartment syndrome
Your EMS system uses a computerized PCR in which you fill in the information electronically and then send it to the emergency department via a secure Internet server. The PCR has a comprehensive series of drop-down boxes, which are used to identify your assessment findings and specify the treatment that you provided; it also has a section for your narrative. When completing your PCR after a call, you should
complete a thorough and accurate narrative because drop-down boxes cannot provide all of the information that needs to be documented.
You are transporting a stable patient with a possible pneumothorax. The patient is receiving 100% oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is MOST likely causing this patient's deterioration?
compression of the aorta and vena cava
While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should:
confirm this information with law enforcement personnel at the scene
A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:
cover both of his eyes and transport to the hospital.
You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should:
determine the patient's baseline mental status.
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include:
dimming the lights in the back of the ambulance and transporting without lights and siren.
Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should:
direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:
disconnect the ventilator and use a bag-mask device.
A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:
encourage him to cough, give oxygen as tolerated, and transport
You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 9-1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should
ensure that he is aware of the risks of refusing medical care
A 50-year-old female is found semiconscious by her son. Your assessment reveals that her respirations are slow and shallow and there is vomitus draining from her mouth. When you attempt to suction her oropharynx, she begins to gag. You should:
ensure that her airway is clear, attempt to insert a nasopharyngeal airway, and assist her ventilations with a bag-mask device.
The rescue team is in the process of extricating a 40-year-old male from his truck. The patient's wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should:
ensure that she is in a safe area, away from the scene.
Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:
firmly massage the uterine fundus with a circular motion.
A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:
follow standard precautions
As the first arriving emergency responder at the scene of a suspected terrorist or WMD incident, you should request additional resources as needed and then:
function as the incident commander until additional personnel arrive.
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
gastrointestinal bleeding
. You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two bystanders performing CPR on the patient, a 58-year-old male. Your initial action should be to:
have the bystanders stop CPR and assess the patient.
A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries did this patient likely NOT experience?
head injury
You suspect that a 75-year-old man has internal injuries after he fell and struck his ribs and abdomen on the corner of a table. When assessing and treating an injured patient of this age, you must recall that:
his ability to physiologically compensate for his injury may be impaired due to an inability to increase cardiac output.
You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose level is 450 mg/dL. She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with:
hyperosmolar hyperglycemic nonketotic coma (HHNC).
Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should:
immediately request additional resources.
A 45-year-old male was working on his roof when he fell approximately 12 feet,landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:
immobilize his spine and perform a focused secondary exam.
A hiker was injured when he fell approximately 20 feet from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The MOST appropriate method of immobilizing and moving the patient to the ambulance is to:
immobilize his spine with a long backboard and place him in a basket stretcher.
You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:
initiate ventilatory assistance.
A 78-year-old female presents with an acute change in her behavior. The patient's son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer's disease 6 months ago. The patient's speech is slurred and she is not alert to her surroundings. You should:
inquire about the possibility of head trauma.
You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:
insert a nasopharyngeal airway and begin assisted ventilation.
During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, shallow breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:
instruct him to assist her ventilations while you perform a rapid assessment.
When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:
internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.
Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in obvious distress. Your first action should be to:
introduce yourself to the patient
Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered
legal but unethical
While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:
lift the air bag and look for deformity to the steering wheel.
Law enforcement personnel request your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:
load him into the ambulance and begin rapid cooling interventions.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:
maintain his airway and assist his ventilations.
You respond to a construction site where a steel girder collapsed on a 22-year-old male's chest. Coworkers removed the girder prior to your arrival. Your assessment reveals that he is unconscious and apneic, but has a pulse. You should:
maintain stabilization of his head, open his airway with the jaw-thrust maneuver, ventilate with a bag-mask device, and prepare to intubate him.
You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should:
manage all threats to airway, breathing, and circulation and consider requesting an ALS unit.
At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should:
mark off a danger zone around the downed lines.
Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be MOST concerned that this patient:
may vomit and aspirate
You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:
obtain a description of how the seizure developed
You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:
open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.
You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:
partially remove the dressing.
Your initial attempt to ventilate an unresponsive apneic 30-year-old man is met with resistance and you do not see the chest rise. Your second ventilation attempt is also unsuccessful. You should
perform 30 chest compressions
You and your partner arrive at the side of a 60-year-old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should:
perform CPR for about 2 minutes and then apply the AED
After successfully intubating a 56-year-old man who is in cardiac arrest, you should
perform asynchronous CPR
A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face and his respirations are slow and shallow. The EMT must immediately:
perform oropharyngeal suctioning.
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:
pinching the patient's nostrils and having him lean forward.
A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should:
place her in a left lateral recumbent position.
A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:
place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.
A 50-year-old male develops acute respiratory distress and cyanosis shortly after an IV line has been established. You should administer high-flow oxygen and:
place him on his left side with his head down.
Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes
placing the mother supine with her head down and pelvis elevated.
When arriving at the scene of an overturned tractor-trailer rig, you note that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but bleeding profusely from the head. After notifying the hazardous materials team, you should:
position the ambulance upwind.
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for:
potential airway compromise.
You have just completed your primary assessment of a 48-year-old man with crushing chest pain. The patient has been given 324 mg of aspirin and is receiving high-flow oxygen via nonrebreathing mask. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should
prepare the patient for immediate transport.
You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:
proceed with treatment and utilize law enforcement if necessary
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should
provide emotional support and visually assess her for obvious trauma.
An important aspect in the treatment of a patient with severe abdominal pain is to
provide emotional support to the hospital
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:
provide reassurance and give oxygen as needed.
A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully.
Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, reduced tidal volume, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should
provide some form of positive-pressure ventilation
Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should:
puncture the sac and suction the baby's mouth and nose.
Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should
put on high-visibility safety vests
A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:
record the time and dose of the injection, and transport promptly.
You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should:
reevaluate the rate and volume of your ventilations.
You are en route to an emergency call when you approach a slow-moving vehicle on a two-way road. You can see oncoming traffic in the other lane. The driver has his windows up and does not realize that you are behind him. You should:
remain at a safe distance until it is safe to pass
You respond to a call for an unknown emergency. When you arrive at the scene, the patient's husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should:
remain in a safe place and request law enforcement.
Your partner is performing one-rescuer CPR on a middle-aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medication patch over the same area where one of the AED pads will be placed. You should:
remove the medication patch, wipe away any medication residue, and apply the AED pads.
You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should:
remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.
A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should
repeat the epinephrine injection after consulting with medical control.
During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should
repeat the primary assessment
You and your partner respond to the scene of a 49-year-old male with acute abdominal pain. As you enter his residence, you find him lying on the floor in severe pain. He is conscious and alert. The patient appears to weigh in excess of 350 lb. Your FIRST action should be to:
request additional personnel before making any attempts to lift him.
You are assessing a 13-month-old female who is running a fever and has been vomiting. While you are performing your physical examination on this child, you will MOST likely find that she:
responds to her name but is fearful of your presence.
A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to:
restrain the patient with appropriate force in order to treat his injuries.
You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that:
small infants are nose breathers and require clear nasal passages at all times.
Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:
spleen
A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse on the side of the injury is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 15 minutes. You should:
splint the elbow in the position found and transport.
A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
stabilize her head and perform a primary assessment.
You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should:
stabilize his head and check for a pulse
While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:
stand behind him and administer abdominal thrusts.
You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should:
start CPR and attach the AED as soon as possible.
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:
subdural hematoma
You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, and is breathing at a normal rate with adequate depth. You should:
suction her oropharynx and apply 100% oxygen
A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
suction her oropharynx for 15 seconds.
During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
suction his oropharynx for up to 15 seconds.
You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that
the patient is at risk for vomiting and aspiration.
A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that:
the patient is experiencing delirious behavior, which suggests a new health problem.
You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include
thoroughly suctioning her oropharynx
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger, a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:
transport to a trauma center.
The MOST important treatment for a patient with severe abdominal pain and signs of shock includes
transporting the patient without delay.
A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should
try repositioning the hearing aid or remove it and turn down the volume.
You are dispatched to a residence for a patient with chest pain; however, you are unfamiliar with the address and cannot find the location in your map book. A nearby police officer radios you and tells you that he knows how to get to the scene. You should:
turn off your lights and carefully follow the police officer to the scene
You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should:
turn the backboard onto its side.
After assessing your patient, you determine that his condition is stable. You provide the appropriate treatment and then load him into the ambulance. While en route to the hospital, you should:
turn your emergency lights off and obey all traffic laws.
While at the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should:
use the mobile radio in the ambulance to contact dispatch.
A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occurred?
ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that this patient:
was given flunitrazepam (Rohypnol).
