Emergency Airway Management and Respiratory Care, Exams of Nursing

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You are called to the local fast food restaurant and find a 36-year- old woman with labored breathing. What should you do first? A. Assess the adequacy of the patient's breathing B. Apply 100% supplemental oxygen C. Initiate positive pressure ventilation D. Insert a nasal airway Correct Answer A. Assess the adequacy of the patient's breathing Before taking any action you must fully evaluate the quality of the patient's breathing. This includes rate, regularity, and depth of breathing. After assessing the patient's breathing, you can choose the appropriate care. Your 23-year-old female patient just delivered a baby. As you assess the neonate, you note that he is having trouble breathing. You discover his pulse to be 50 bpm, and cyanosis around the lips and fingers. What is your first intervention? Correct Answer Start compressions. In a neonate, that key number is 60. If their heart rate is below 60, start compressions immediately. If the heart rate is 60-100, assist the patient with ventilations via BVM. You arrive to find a 40-year-old female complaining of palpitations and dizziness. Your assessment reveals SpO2 reading of 86%, BP 102/78, pulse 128/irregular, and respirations of 26 per minute.

The patient tells you she has no past medical problems. What do you suspect is happening based on the information? Correct Answer hypoxemia This patient should be considered hypoxic due to a pulse oximeter reading of 86% with no significant pulmonary medical history. This patient's respiratory rate and pulse are elevated due to the hypoxemia. What is the cause of digital clubbing? Correct Answer Chronic hypoxia Digital clubbing is a sign of chronic hypoxia in young people with congenital heart disease and older people with severe chronic lung disease. You and your partner just ran a patient with trauma to the head and face. Following the call, the patient's family informed you that the patient is HIV positive. According to the Ryan White Act, the hospital must notify the designated infection control officer within how many hours? Correct Answer 48 hours You are dispatched to an imminent delivery. When you arrive, the patient is walking around the house and tells you her membranes just ruptured before she called 911. How should you proceed? Correct Answer Have her lie on the gurney in a position of comfort and transport rapidly. Ruptured membranes is also known as the water breaking, or rupture of the amniotic sac. Although it is an indication that labor has begun, it doesn't mean that delivery is imminent, especially if the patient is walking around. O2 isn't indicated unless there is some respiratory signs and symptoms associated with the birth.

The corpus luteum works to produce which of the following hormones? Correct Answer Progesterone The implementation of tsunami warning system with monthly drills is known as what? Correct Answer Disaster Mitigation Which of the following is not one of the three accepted ways to clear an airway? A. Head tilt/chin lift maneuver B. Recovery Position C. Suctioning D. Finger Sweep Correct Answer A. Head-Tilt-Chin-Lift Make sure you read the question carefully and think this one through! The recovery position is an accepted way of attempting to clear an airway through the use of gravity. Finger sweeps are the manual way to clear an airway and suctioning is the mechanical way to do so. The head tilt chin lift maneuver is a means to open the airway, not clear it. You have just finished giving 5 abdominal thrusts to a choking victim when he becomes unresponsive, falling to the ground. You are able to control the fall, but the victim is unresponsive and not breathing. What would the correct care for this victim be? Correct Answer Begin CPR!! When a victim becomes unresponsive and is not breathing secondary to choking, immediately starting CPR is crucial. The one change is to look in the mouth for an object before giving breaths.

You have been dispatched to the local high school for a seizure. Your patient is a 15-year-old female who began to seize during a school assembly. Her friends are hysterical and attention of everyone is focused on the seizing student. Your patient has been exhibiting tonic-clonic activity and moaning loudly for the past 4 minutes. The patient does have a history of seizures as well as several psychiatric conditions. Although unable to obtain a BP due to her movement, you palpate a strong radial pulse of 70 bpm and the pulse oximeter reads 99%. It also is brought to your attention that the patient's boyfriend broke up with her this morning. What do you suspect is wrong with your patient? Correct Answer Pseudoseizure! A pseudoseizure is a psychogenic nonepileptic seizure that occur as a result of psychological causes. A patient will not be able to verbalize during a real seizure and it will also result in a decrease in respiratory activity, as the diaphragm experiences tonic-clonic activity (this inhibits normal breathing and will cause the patient's oxygen saturation to drop) - your patient's SpO2 is 99%. Which of the following is correct in ranking the importance of CPR components during a pediatric arrest? Correct Answer C-A-B Chest compressions are the most important part of CPR as they circulate blood through the body and perfuse vital organs. Interruptions to chest compressions should be minimal (pulse check, shock delivery) and chest compressions should be resumed as soon as possible. D size oxygen cylinders are capable of carrying how many liters of oxygen? Correct Answer 360 A D cylinder carries 360 L of oxygen. At 10L per minute by oxygen mask, the cylinder will run dry in 36 minutes.

Which of the following is a sign of sepsis in an adult patient? A. Temperature of 96 degrees Fahrenheit B. Respiratory rate of 18 breaths/min C. Heart rate of 70 beats/min D. Blood glucose of 150 mg/dl in a diabetic Correct Answer A. Temperature of 96 degrees Fahrenheit A temperature of 96 degrees Fahrenheit can indicate infection. In sepsis, patients will usually have an elevated respiratory rate and heart rate. A blood glucose greater than 140 mg/dl is abnormal in patients who don't have diabetes. If you weren't sure what might be a finding in sepsis you may have been able to get by just by seeing which measurement was abnormal. You are assigned initial triage at a five-car MVC. Three patients were ejected and lie pulseless on the pavement. Three patients have already gotten out of their car and are standing when you arrive. One patient sits in the passenger seat, unable to move because of a broken leg, but otherwise appears uninjured. One patient is sitting in the driver seat, clutching their chest in pain and breathing at 40 breaths/min. How many of these patient would be classified "red"? Correct Answer 1 If someone can walk, they are classified minor (green). If someone is pulseless, they are classified dead (black). If a patient has a broken leg, but otherwise has no emergency symptoms, they are classified delayed (yellow). The last patient is your only immediate (red) patient. Remember "30- 2 - CAN DO". Over 30 respirations, over 2 seconds cap refill, or the inability to follow simple commands are all criteria for being classified immediate. If you struggle with this, look up START triage in your book.

Which of the following statements about hydrofluoric acid is correct? A. It leeches calcium from the body, causing life-threatening alterations to cellular function B. Irrigation of the affected area should be avoided C. It only causes burns to the affected body surface D. It is a very mild toxin with a low mortality rate Correct Answer A. It leeches calcium from the body, causing life-threatening alterations to cellular function. Hydrofluoric acid initially burns the skin but continues causing damage to the body as it begins to leech calcium. Hydrofluoric acid exposures should be irrigated with copious amounts of water and transported immediately. You are dispatched to a 9-year-old female not acting right. Her mom states that she has been sick for a few days and has been very sleepy for the past 12 hours. Vitals - BP: 82/62, P: 98, R: 10, SpO2: 86%. What is your first intervention? A. Ventilate with a bag-valve-mask B. Apply a nasal cannula C. Rapid transport and manage the patient enroute to the hospital D. Apply a non-rebreather mask Correct Answer A. Ventilate with a bag-valve-mask

There is a lot of information missing from this question and you just have to go with what you're given and make the best choice. As you assess this patient, seeing respirations at 10 should alert you that she's unable to adequately breathe for herself. Both a non-rebreather and nasal cannula are not appropriate with respirations so low. You can't transport this patient without first intervening. You are transporting a 29-year-old female for abdominal pain. During your patient interview and history gathering, you learn that the patient is HIV positive. All of the following body fluids are capable of transmitting HIV except for? A. Sputum B. Cervical secretions C. Vaginal secretions D. Blood Correct Answer A. Sputum HIV is transmitted by contact with blood, semen, and vaginal or cervical secretions. However, these fluids have to make contact with mucous membranes or open wounds (the fluids can also transmit via vaginal or anal sex as well as the placenta to the fetus). Where is the urethra meatus located in a female? Correct Answer Superior to the vagina The external urethral opening (urethral meatus) is located between the clitoris and the vagina. You have responded to a motor vehicle crash and arrive to find one car head-on into a tree. Your female patient is complaining of

severe abdominal pain. She is 34 weeks pregnant. Her abdomen is firm and tender and she is otherwise atraumatic. What is your primary differential diagnosis? Correct Answer Abruptio placentae A third trimester pregnancy with severe abdominal pain and traumatic injury should alert you to abruptio placentae. From the information given, a miscarriage and imminent delivery are possibilities, but not your primary suspicion. What's a normal adult blood glucose reading? Correct Answer 80

• 120 Which of the following is not a key element in the infection process? A. Inflammation B. Pathogen C. Reservoir D. Mode of transmission Correct Answer A. Inflammation This is the body's response to infection Agnosia is a cognitive disturbance. It is: Correct Answer Agnosia is the failure to recognize objects or stimuli despite the sensory ability to do so. Cystitis is an inflammation of which anatomical structure? Correct Answer Inner lining of the bladder

Which breathing pattern is characterized as having an irregular pattern, rate, and depth with intermittent patterns of apnea? Correct Answer Biot Biot respirations may indicate severe brain injury or brain stem herniation. Pursed (or puckered) lip breathing is a sign of respiratory distress that patients will exhibit in an attempt to do which of the following? A. Keep the bronchioles from collapsing during exhalation B. Allow the diaphragm to contract with more force C. Decrease their tidal volume D. Increase their lung capacity Correct Answer A. Keep the bronchioles from collapsing during exhalation Pursed lip breathing is a true sign of respiratory distress. It should be noted while you are placing oxygen on them. You are called to a 60-year-old female in respiratory distress. When you arrive, she is only able to speak in 3-4 word sentences and is very anxious. Her pulse is 110, respirations 24 and labored, skin is pink, warm, and diaphoretic. Oxygen should be administered? A. At 12-15 L/min via Non-rebreather mask B. At 12-15 L/min via BVM C. At 2-6 L/min via nasal canula

D. Oxygen should not be administered until the patient is asked if she has COPD Correct Answer A. At 12-15 L/min via Non- rebreather mask The patient is in mild respiratory distress. She is breathing at an adequate rate and does not yet require BVM ventilation. You are treating a 56-year-old male who has been diagnosed with chronic obstructive pulmonary disorder (COPD). The patient's skin is cool and clammy, respirations are slow and shallow, and appears to have a slightly altered mental status. The patient has labored breathing at a rate of 8 breaths per minute and has a heart rate of 125 beats per minute. The patient has an Albuterol inhaler prescribed to treat his COPD. You call medical control and are ordered to assist the patient in self-administering the inhaler. You check that the inhaler is the right medication, dosage, and is prescribed in his name. The patient tries to self administer the medication, but is having difficulty due to his altered mental status. You should? A. Provide 100% supplemental oxygen and call for ALS back up. B. Ask a bystander to administer the inhaler to the patient. C. Let the patient hold the inhaler to his mouth, but depress the tri Correct Answer A. Provide 100% supplemental oxygen and call for ALS back up. The order that you received from medical control was to assist the patient in self-administering the inhaler. Due to his altered mental status he is unable to self-administer the medication. You should provide 100% supplemental oxygen, managing his airway as needed, and have ALS transport immediately.

You are on scene with a 67-year-old female in severe respiratory distress. Your patient has been a smoker for over 40 years and has developed emphysema. Prior to your arrival, she used two home nebulizer treatments with no relief. She is sitting in the tripod position and appears very tired, with a respiratory rate of approximately 40 breaths/minute. What should be your next action? Correct Answer Deliver oxygen via BVM Although having a baseline, room-air oxygen saturation is helpful, you should not withhold oxygen from patients in respiratory distress in order to aquired that baseline value. With a respiratory rate over 30 and the patient becoming tired from effort of breathing, you need to intervene with oxygen via BVM. You are called to a homeless shelter for a 64-year-old male who has been experiencing shortness of breath. The patient states the shortness of breath has been progressively getting worse throughout the day and he has been coughing up green tinged sputum. He also states he thinks he had a heart attack last year. Lung sounds are clear in the upper fields but there are crackles in the patients lower left quadrant. Upon physical examination you notice a 6 cm semi healed laceration on the patient's shin with redness around the injury. Vital signs are as follows: HR 118, BP 164 / 98, SPO2 90% on room air, RR 22, skin is very warm and dry with no discoloration. The only medications you can find for the patient are metoprolol and hydrochlorothiazide. Your primary treatment path for this patient would follow which disease process? Correct Answer Pneumonia The patients history of coughing up green tinged sputum and physical examination findings indicate the patient is suffering from pneumonia. You're called to a private residence for a 72-year-old male who has an altered mental status. VS are BP 102/58, HR 104, RR

6/min, SpO2 is 88%. What should be your first intervention? Correct Answer Place an appropriately sized NPA. First things first. If you're going to ventilate the patient using a BVM you need to first place an appropriately sized OPA or NPA or both. As always, follow your local protocols out in the field. The volume of air inhaled in a single breath is referred to as? Correct Answer Tidal volume What is the suggested flow rate for administration of an albuterol neb set? Correct Answer 6 - 8 liters per minute Your patient has gone unresponsive, breathing 8/minute. You start delivering breaths by BVM, but haven't attached 100% oxygen. What concentration of oxygen are you delivering to your patient? Correct Answer 21% You are dispatched to a report of gunshots having been fired at a night club. After confirming the scene is safe, you enter to find a 23 - year-old male lying supine on the floor and bleeding profusely from his abdominal region. He appears to be CAOx4 and is very anxious. During your assessment, you find what appears to be a gunshot wound to the left upper quadrant of his abdomen. After controlling his bleeding, his vital signs are: BP 150/98, HR 108, and RR 40 with equal and bilateral chest rise. What would be the most appropriate next step in treating this patient? Correct Answer Apply high-flow oxygen via bag valve mask at 15 lpm Due to the patient's respiratory rate of 40, it's necessary to start him on a BVM to assist with his already labored breathing. A NRB may help, but would not be as effective as a BVM in this case. Finally, there is no indication to administer NTG.

You respond to a high school for a 15-year-old who is choking. The patient is conscious and coughing forcefully. Assessment reveals a respiratory rate of 26, diminished breath sounds on the left side and SpO2 reading of 94%. What is patient's most immediate threat? Correct Answer Complete airway obstruction This patient is currently experiencing a partial airway obstruction and we're worried about it turning into a complete obstruction. Although a diagnosis of aspiration pneumonia is possible due to assessment findings, it is not an immediate threat. You arrive to a private residence and find a 34-year-old male in the tripod position, and you can hear stridorous respirations from the doorway. The patient is drooling and feels hot to the touch. What life-threatening condition do you suspect your patient has? Correct Answer Epiglottitis Epiglottitis is a life-threatening, upper respiratory illness. The epiglottis becomes inflamed and begins to obstruct airflow to the trachea. The fever, drooling, and respiratory distress are class presentation. Epiglottitis occurs in adults and children. Your patient struck his head on the windshield of a car following a high-speed accident where he was not wearing a seatbelt. During your assessment, vital signs are as follows: HR 110 and BP 80/50. Based on these vital signs: Correct Answer They do not rule out increased intracranial pressure but suggests the presence of additional injuries elsewhere Which of the following personality disorders are characterized by a disregard for the rights of others? Correct Answer Antisocial Cystic Fibrosis is a genetic disorder affecting which two systems? Correct Answer Respiratory and Digestive

Through a series of steps, CF thickens the mucosal lining in the lungs and other organs (primarily digestive). This thick mucus holds germs against the cell walls and increases the patients chances of getting an infection. What abnormal breathing sound has characteristics of loud, low coarse sounds that resemble snoring and often clear with coughing? Correct Answer Ronchi During a one second ventilation in a patient who is experiencing respiratory arrest, approximately how many mL of air will a bag- mask device deliver? Correct Answer 600 mL Your patient complains of a productive cough with "greenish- brown" sputum and a temperature of 99.3 degrees Fahrenheit for the past few days. This is most consistent with? Correct Answer Bronchitis Bronchitis often presents with greenish-brown sputum, while pulmonary edema presents with a pink, frothy sputum. Pneumonia, although having very similar symptoms as bronchitis, will present with a higher grade fever. Which of the following would hinder the delivery of high-quality CPR the most? A. When performed on a bed or a couch B. When the victim is pregnant C. When the victim is obese D. When you as a rescuer are by yourself Correct Answer A. When performed on a bed or a couch

CPR must be done on a hard flat surface. If CPR is being done on a soft surface like a bed or couch, the force and effectiveness of your compressions will not be of any value to the victim. If the victim is on a bed push the bed out of the middle of the room and get the victim to the floor to start CPR. You are evaluating a 57-year-old male with shortness of breath and chest pressure. The patient tells you that he stopped taking blood thinners about six months ago and was recently evaluated for swelling/redness in his leg. What is your greatest concern with this patient? Correct Answer Pulmonary Embolism This question has limited information, but with shortness of breath and chest pain, a pulmonary embolism should always be a consideration. This may have started out as a DVT, but with the information provided, it's gotten much worse. What is the most common type of pelvic ring fracture? Correct Answer Lateral Compression Fracture This kind of fracture is caused by a sudden lateral force being applied to the pelvic ring, such as a car striking a pedestrian. A patient breathing room air is considering hypoxemic if their SpO2 is less than? Correct Answer 94% Which of the following terms is defined as the force exerted on the ventricle walls at the end of diastole? Correct Answer Preload Your patient has neck/back pain and a possible pelvic fracture after a 5 foot fall from a ladder. His blood pressure is 74 by palpation, heart rate of 136, respiratory rate of 22, and responds only to painful stimuli. Prior to your arrival, fire department responders immobilized the patient to a long backboard with a

cervical collar. How would you proceed? Correct Answer Rapid transport A reportable collision is one that: Correct Answer Causes at least $1,000 of vehicle damage or personal injury The ambulance company you work for has a fleet of type I ambulances. This means that ambulance is? Correct Answer A box-style passenger compartment on a truck chassis What is the most common route of entry for toxic exposure? Correct Answer Ingestion Ingestion is the most common route of entry for toxic exposure and includes cleaning agents, cosmetics, drugs, foods, household products and plants Your newborn patient is going to be receiving blow-by oxygen. The proper rate and delivery of this should be? Correct Answer 5L via NRB When a knee injury requires splinting and CMS is present in the limb, what is the best way to splint the inured knee? Correct Answer In whatever position the leg is found in Which of the following has the strongest neurotoxin? Coral snake, brown recluse, black widow, pit viper Correct Answer Coral snake Your patient is a 38-year-old male who was ejected from the vehicle after a motor vehicle collision. He is unconscious and has vitals of HR: 68, RR: 8 irregular, and BP: 84/P. What is your primary goal with this patient? Correct Answer C-spine precautions, long spine board, BVM, rapid transport

You are asked to assess a patient's pulse quality. Which two things will you relay back to your partner? Correct Answer Strength & regularity The quality of a patient's pulse always measures the strength and regularity. i.e. Strong and irregular. A fractured humerus or tibia can retain up to how much blood in an adult? Correct Answer 750 mL Which of the following patients would benefit from the use of aeromedical (rotor-wing) transport? A. Patients with uncontrolled hemorrhage B. Obese patients C. Medically stable patients D. Patients in cardiac arrest Correct Answer A. Patients with uncontrolled hemorrhage Patients in cardiac arrest are an absolute contraindication for all types of aeromedical transport. Rotor-wing aircraft have strict weight limits that usually require a patient to weigh 350 lbs or less (limits may vary based on helicopter type). Medically stable patients should use ground transport. You have been instructed by medical control to deliver 40% oxygen concentration to your COPD patient. What delivery device will best allow you to accomplish this? Correct Answer Venturi mask

Achieving precise oxygen concentration can only be performed by a Venturi mask. Color-coded adapters responsible for controlling the oxygen flow rate are attached. The yellow portion of a warning placard will give you information on a hazardous material's? Correct Answer Reactivity A law that is enacted by Congress is what kind of law? Correct Answer legislative You find your 56-year-old patient unconscious after being outside in freezing weather for an extended period of time. During your assessment, you note his core body temperature is 87 degrees Fahrenheit. You know that his temperature indicates: Correct Answer Moderate hypothermia is indicated with a core body temperature from 86 - 93.2 degrees Fahrenheit While approaching a vehicle involved in a motor vehicle crash, you should perform a windshield survey. A windshield survey includes all of the following except? Observing for "spidering" of the windshield Determining if the occupants are attempting to self-extricate Trying to determine if the occupants appear conscious Checking to see if the occupants are moving Correct Answer Observing for "spidering" of the windshield A windshield survey is a quick survey that will help you to form a general impression of the condition of the occupants in the vehicle and the resources you will need to help them.

You have been called to a home by police after they were performing a welfare check. Neighbors hadn't seen the patient in several days, which was very unusual and no one was answering the door. Police entered the home and found an 86-year-old female laying on the kitchen floor. She is alert to painful stimuli. Her skin feels cool to the touch. Your initial set of vitals is: BP 80/50, P 60 and weak, R 12 and shallow, capillary refill time is 4 seconds, GCS is 9. Which of the previous vital signs is most likely to be inaccurate? Correct Answer CRT While capillary refill time is a useful tool to quickly assess perfusion, there are numerous factors that can cause it to be an unreliable evaluation. Geriatric patients often have diminished perfusion. Cold environments can also lead to an unreliable assessment. Cold environments will cause the blood vessels to constrict as the body shunts blood away from the periphery. This will result in a longer capillary refill time. What is the preferred method for initially providing ventilations to an apneic patient when no pocket mask is available? Correct Answer Two-person BVM with 100% oxygen You have been designated as the landing zone supervisor for a critical motor vehicle crash. While setting up the landing zone, you should mark the designated area with how many traffic cones? Correct Answer 5 Use four cones to identify the landing zone boundaries. Place the fifth cone on the upwind side of the landing zone (for the pilot to reference during the final approach and landing). You respond to a 5-year-old female with circumferential burns to both arms. What percentage of her body is burned? Correct Answer 18%

You are called to an open field for an unconscious 34-year-old male. The area has been very stormy and you suspect that he was hit by lightning. Bystanders report seeing many lightning strikes hit the ground. After assuring that the scene is safe, how would you first treat this patient? Assess the patient's circulation, airway, and breathing Begin CPR Place the patient in full c-spine precautions and move them to the ambulance Expose the patient to cover any burns Correct Answer Assess the patient's circulation, airway, and breathing The questions states that the scene is already secure and there is no need to rapidly remove this patient to the ambulance before assessing C-A-B. A S.O.A.P. pre-hospital care report consists of 4 distinct parts. What does the 'A' stand for? Correct Answer Assessment Which of the following areas would you assess to check a patient's skin color? Nail bed Cheeks Leg

Arm Correct Answer Nail bed Oral mucosa, conjunctiva, and nail beds are all great areas to examine a patient's skin color. Your patient was traveling at a high rate of speed and hit a brick wall. It is possible that he may have suffered life-threatening injuries due to severe deceleration forces. Which organ may have been lacerated by the ligamentum teres resulting in hemorrhage in this event? Correct Answer The liver You are assessing a 28-year-old female patient who was ejected from a motorcycle versus auto MVC. She is reporting no sensation in her lower extremities up to the nipple line and you suspect a spinal cord injury. If this were the case, at approximately which vertebrae would the spinal cord transection have occurred? Correct Answer T4 Which of the following is not part of the prehospital examination of the patient with suspected abdominal trauma? Auscultating bowel sounds Assessment of the thorax for injury Checking stability of the pelvis Asking the patient about the abdominal pain first, then palpating the abdomen in all four quadrants. Correct Answer Auscultating bowel sounds NOT in trauma

Stage 2 hemorrhage is associated with a circulating blood loss of what percentage range? Correct Answer 15 - 30% Your patient is an 18-year-old male who was slashed across the abdomen with a machete. He has a mass of omentum and a small bowel protruding from the wound. Which of the following is your primary concern with this patient? Correct Answer Ensuring an open airway by anticipating vomiting, providing oxygen, keeping the patient warm, monitoring for and treating shock. During an MCI, which of the following positions is responsible for coordinating the movement of patients from the treatment area to ambulances? Transportation officer Staging officer Triage officer Treatment officer Correct Answer Transportation officer The following criteria are used to assess a patient when using the START triage method? Respirations, Capillary refill, Following simple commands Allergies, Medications, Medical history Eye movement, Motor response, Verbal Airway, Breathing, Circulation Correct Answer Respirations, Capillary refill, Following simple commands

START triage is used to make a rapid (30-60 sec) assessment during multiple patient scenes when resources are limited. It measures the respirations, cap refill, and the ability of the patient to follow simple commands. The mnemonic 30- 2 - "CAN DO" is used as a reminder of the criteria you're using to assess the patient. What color tag should a person with altered mental status receive during triage? RED YELLOW GREEN Black Correct Answer RED When obtaining a history from your patient, she tells you she has a history of right ventricular failure. The most common cause of right ventricular failure is: Correct Answer Left ventricular failure You are on scene with a 7-year-old male patient involved in a motor vehicle crash. He is complaining of head, neck, and back pain. As you begin spinal immobilization of this patient, you notice his head is large and is causing hyperflexion of his neck. Where should you place padding in pediatric patients when performing spinal immobilization? Correct Answer Underneath the shoulders and torso Pediatric patients tend to have larger heads in comparison to their body which causes the hyperflexion. Placing padding underneath

their shoulders and torso will reduce the natural hyperflexion of the their neck when they are supine. At what fetal age would you expect to hear fetal heart tones? Correct Answer 20 weeks You are treating a victim at a MVC who has sustained multiple traumatic injuries. You have been on scene for 15 minutes, stabilizing and immobilizing your patient. You are in a region which contains a Level I trauma center 50 minutes away and a Level III trauma center 10 minutes away. What is your choice of treatment facilities and why? Correct Answer Level III because it will be able to stabilize and transfer serious patients, if needed The most appropriate hospital in this case would be a Level III trauma center. Trauma patients fall into the golden hour, meaning if the patient reaches definitive care (an OR) within an hour of the injury, they have the highest chance of survival. You know that you have been on scene for 15 minutes, only leaving 45 minutes left in the golden hour. You don't know how long it took you to get there or when the call was placed in regards to your dispatch, which adds time. The Level III will be able to stabilize the patient and, if needed, transfer them to a higher level of care. What reflex is responsible for increasing the survivability of a drowning victim? Correct Answer Mammalian diving reflex During a technical rescue, whose safety is the last priority? Correct Answer Rescue patient Although it may seem counterintuitive, the safety of the rescue patient comes "last" during a technical rescue incident. Patient safety is still very important but the safety of yourself, the rescue team, and any bystanders or involved personnel is more important.

Your agency is participating in a mass casualty drill. Your supervisor is the triage officer and has assigned you to triage. You triage the following five patients: 21-year-old male unconscious and apneic even after performing a head-tilt/chin-lift maneuver, 20-year-old female with altered mental status and is not following simple commands, 34-year-old male with uncontrolled arterial bleeding from a partial amputation (delayed capillary refill), 29-year-old pregnant female complaining of severe abdominal pain (strong radial pulse and RR is 28), 6-year-old male with obvious deformities to both lower extremities (radial pulse is present and RR is 24) What is the correct triage count that you report to the triage officer? Correct Answer The 21-year- old male unconscious, apneic even after performing a head- tilt/chin-lift maneuver should be triaged as DECEASED. The 20- year-old female with altered mental status and is not following simple commands should be triaged as IMMEDIATE. The 34- year-old male with uncontrolled arterial bleeding from a partial amputation (delayed capillary refill) should be triaged as IMMEDIATE. The 29-year-old pregnant female complaining of severe abdominal pain (strong radial pulse and RR is 28) should be triaged as MINOR. The 6-year-old male with obvious deformities to both lower extremities (radial pulse is present and RR is 24) should be triaged as DELAYED. the triad that indicates abdominal aortic aneurysm: Correct Answer abdominal pain, hypotension, and pulsating abdominal mass An increase in hydrogen ions and/or a decrease in bicarbonate ions will cause? Correct Answer Acidosis!! You respond to a medical lab for an employee who had an unknown chemical splashed in his eye. Your patient is complaining of a burning feeling in the affected eye. You should?