Emergency Medical Care: Airway, Breathing, and Circulation, Exams of Nursing

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NYS EMT STATE EXAM WRITTEN LATEST 2023-

ACTUAL EXAM 250 QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES (VERIFIED

ANSWERS) |AGRADE

Which of the following arteries is the MOST RELIABLE for detecting an adult's pulse?

• Brachial
• Femoral
• Carotid -Radial? - ANSWER- Carotid Difficulty sleeping, loss of appetite, and inability to concentrate are all warning signs of: -Type A personality -Job burn-out
• Diabetes -Stress - ANSWER- Stress A special kind of stress encountered by emergency responders that results from exposure to incidents of a critical nature is:

Downloaded at Knoowy - Upload your own study documents and earn -Pre-incident stress -Personal stress -Workplace stress -Critical incident stress - ANSWER- Critical incident stress Which of the following is a warning sign of stress?

• Isolation -Loss of appetite -Problems sleeping
• Anxiety -All of the above - ANSWER- All of the above During the Initial Assessment, after ensuring adequate respiration, what is the NEST step in caring for a patient? -Ensure adequate circulation -Immobilize angulated fractures -Check for paralysis of the limbs -Determine level of consciousness - ANSWER- Ensure adequate circulation As you lift a patient into the rear of the ambulance, a reporter recognizes the patient as a state senator. Immediately, the press demands to be told what has happened to the Senator. You should: -Advise the press that you are unable to comment

Downloaded at Knoowy - Upload your own study documents and earn -Deny that patient is the Senator -Tell the press your diagnosis -Advise the press to contact the Senator's family - ANSWER- Advise the press that you are unable to comment If the patient care protocols have been revised, it is the EMS Provider's responsibility to: -Attend in-service training with the agency medical director to become familiar with the new protocols -Continue to use the old protocols because they are already familiar -Begin to use the new protocols as soon as the agency receives them -Operate only when in direct communication with the physician - ANSWER- Attend in-service training with the agency medical director to become familiar with the new protocols You arrive at the scene of an automobile accident where several bystanders are trying to remove an unconscious patient from one of the vehicles. What should you do? -Have police respond to control the crowd -Apply a cervical collar and help extricate the patient -Have the crowd stop the extrication process immediately -Tell the crowd to continue their extrication efforts - ANSWER- Have the crowd stop the extrication process immediately A single EMT finds a non-breathing pulseless victim of a motor vehicle accident lying prone in the road he/she suspects a spinal injury, the EMT should:

Downloaded at Knoowy - Upload your own study documents and earn -Apply a cervical collar and attempt to ventilate -Turn the patient's body as a unit and begin CPR -Leave the patient in place and attempt to apply the principles of CPR -Do nothing until help arrives - ANSWER- Turn the patient's body as a unit and begin CPR During the Initial Assessment, you are assessing a conscious trauma patient complaining loudly of pain in the leg. You should: -Begin to obtain the history -Assess the leg immediately -Discontinue the Initial Assessment, start the Detailed Physical Exam -Continue with your initial assessment - ANSWER- Continue with your initial assessment If a EMT is transporting a patient to the hospital and the patient suddenly stops talking, the next step should be to: -Consult with an advanced EMS provider -Repeat the Initial Assessment -Initiate a priority transport -Stop the ambulance - ANSWER- Repeat the Initial Assessment The overall purpose of the Initial Assessment is to: -Identify and correct life threatening problems and set priorities

Downloaded at Knoowy - Upload your own study documents and earn -Ensure that airway is open and locate breathing problems -Identify and treat major extremities injuries -Identify minor problems and provide treatment - ANSWER- Identify and correct life threatening problems and set priorities In what order is the Detailed Physical Exam usually conducted on an adult patient? -Head, neck, extremities, chest, pelvis, abdomen -Head, neck, chest, abdomen, pelvis, extremities -Head, neck, abdomen, chest, pelvis, extremities -Head, chest, abdomen, neck, pelvis, extremities - ANSWER- Head, neck, chest, abdomen, pelvis, extremities A driver has crashed into a tree. In what order should you check for the signs of life-threatening problems in this accident victim? -Pulse, respirations, hemorrhage -Respirations, hemorrhage, pulse -Hemorrhage, pulse, respirations -Respirations, pulse, hemorrhage - ANSWER- Respirations, pulse, hemorrhage If a life-threatening problem is discovered during the Initial Assessment, you should: -Finish the Initial Assessment and then go back to correct the problem -Complete both the Initial Assessment and the secondary survey -Transport the patient to the hospital immediately

Downloaded at Knoowy - Upload your own study documents and earn -Correct the problem before continuing with the Initial Assessment - ANSWER- Correct the problem before continuing with the Initial Assessment In assessing a pediatric trauma patient's capillary refill time, a normal finding would be a refill time of: -Greater than 5 seconds -Less than 2 seconds -Greater than 2 seconds -Greater than 4 seconds - ANSWER- Less than 2 seconds All of the following are symptoms EXCEPT:

• Headache -Weak pulse -Chest pain -Nausea - ANSWER- Weak Pulse Which of the following is an example of a sign?
• Cyanosis
• Nausea
• Dizziness -Chest Pain - ANSWER- Cyanosis

Downloaded at Knoowy - Upload your own study documents and earn You are assessing an unconscious patient who responds to a sternal rub by moaning. Using AVPU how would this patient be described:

• Alert
• Verbally -Painful stimulus -Unresponsive - ANSWER- Painful stimulus AVPU determines level of consciousness After you have determined that the scene is safe, the FIRST step in caring for a patient is to: -Check for a carotid pulse -Open the airway -Determine unresponsiveness -Check for breathing - ANSWER- Determine unresponsiveness When performing a physical exam, the EMT must inspect and palpate for deformities, tenderness, swelling, and: -Open injuries -Opportunistic infections -Occlusive injuries -Osteoporosis - ANSWER- Open injuries

Downloaded at Knoowy - Upload your own study documents and earn Deformities, Open injuries, Tenderness, Swelling Providing care within the scope of practice would be considered behavior in accordance with: -The sovereign immunity doctrine -Approved protocols -Professional Standards -Institutional Standards - ANSWER- Professional Standards The extent of medical procedures a EMT is authorized to perform is called the: -Medical release -Scope of practice/care -Duty to act -Physician relationship -Skill set - ANSWER- Scope of practice/care Which of the following is the EMT's BEST defense in a lawsuit? -Excellent documentation of patient care -Current certification -Knowledge of all legal aspects of emergency care -Being proficient - ANSWER- Excellent documentation of patient care

Downloaded at Knoowy - Upload your own study documents and earn EMS providers must be certified to perform legally at their level of training. The New York State law that establishes this level is the: -Good Samaritan Law -General Municipal Law -Medical License Law -Public Health Law - ANSWER- Public Health Law Public Health Law Article 30, Part 800 covers all Emergency Medical Technicians from liability except for gross negligence The first action taken by the EMS provider at the scene of an emergency should be: -Triage of all victims -Completion of the initial scene size-up -Notification to the electric and gas companies -Requesting additional ambulances - ANSWER- Completion of the initial scene size-up What is the legal basis for treating a patient whose judgement is impaired because he/she is unconscious, severely ill, or badly injured? -Applied consent -Implied consent -Informed consent -Good Samaritan Act - ANSWER- Implied consent

Downloaded at Knoowy - Upload your own study documents and earn The main tube which carries air to the lungs is called the:

• trachea
• esophagus
• bronchiole -alveolus - ANSWER- Trachea All of the following are part of the respiratory system EXCEPT the:
• Alveoli
• Esophagus
• Epiglottis -Bronchi - ANSWER- Esophagus Foreign matter is kept from entering the trachea by the:
• Pharynx
• Esophagus
• Uvula -Epiglottis - ANSWER- Epiglottis A stoma can be defined as: -An artificial trachea that carries air from the pharynx into the lungs -An opening from the front of the throat directly into the esophagus

Downloaded at Knoowy - Upload your own study documents and earn -An opening from the front of the throat directly into the trachea -The tube that connects the pharynx to the stomach - ANSWER- An opening from the front of the throat directly into the trachea Which of the following is a recognizable sign of a foreign body partial airway obstruction with poor air exchange: -Deep rapid respirations -A high pitched noise while inhaling

• Hyperventilation -Silent crying - ANSWER- A high pitched noise while inhaling A previously conscious patient with a partial airway obstruction starts to become unconscious, and the patient's "crowing" noises have stopped. The EMT should: -Continue to treat the patient as a partial airway obstruction patient -Treat the patient as a complete airway obstruction patient -Administer oxygen by a non-rebreather mask -Suction the patient's pharynx - ANSWER- Treat the patient as a complete airway obstruction patient The signs and symptoms of inadequate breathing are: -A sudden attack of a dry hacking cough with pain -Immediate air hunger and mild cyanosis followed by slow and shallow respirations -Sudden shortness of breath with productive cough producing rusty sputum

Downloaded at Knoowy - Upload your own study documents and earn -Sudden shortness of breath, unequal chest expansion and diminished breath sounds - ANSWER- Sudden shortness of breath, unequal chest expansion and diminished breath sounds The only artery that carries unoxygenated blood away from the heart is called the: -Coronary arteriole -Hepatic artery -Pulmonary artery -Aorta - ANSWER- Pulmonary artery You arrive at the scene of a call and find an unconscious adult victim. The initial attempt to ventilate proves unsuccessful. The NEXT step should be: -Deliver 5 abdominal thrusts -Check carotid pulse -Reposition the head and attempt to ventilate again -Reposition the head and perform a finger sweep - ANSWER- Reposition the head and attempt to ventilate again When taking Vital Signs on an unstable patient it is important to take them every: -2-3 minutes -5 minutes -10 minutes -15 minutes - ANSWER- 5 minutes

Downloaded at Knoowy - Upload your own study documents and earn Vital signs for a stable patient is every 15 minutes When you are administering mouth-to-mask ventilations without supplemental oxygen, approximately how much oxygen are you providing for the non-breathing patient:

• 16%
• 18%
• 20% -21% - ANSWER- 16% With supplemental oxygen 50% Standard oxygen cylinders are fully pressurized to approximately: -1500 psi -2000 psi -2500 psi -3000 psi - ANSWER- 2000 psi Which of the following is a description of the correct placement for AED electrodes? -Under the right clavicle and over the lower left rib cage -Under the right clavicle and on the patients lower stomach -On the sternum and over the lower left rib cage

Downloaded at Knoowy - Upload your own study documents and earn -Over the right lower rib cage and over the left lower rib cage - ANSWER- Under the right clavicle (white lead) and over the lower left rib cage (red lead) Which of the statements about using an AED is TRUE? -While the AED is analyzing the patient's rhythm, it is acceptable to be touching the patient or continue performing CPR -The AED will ask the user to interpret the heart rhythm -CPR must be stopped for the entire cycle of analysis for the AED to accurately assess the patient's heart rhythm -First responders should immediately attach an AED to every patient - ANSWER- CPR must be stopped for the entire cycle of analysis for the AED to accurately assess the patient's heart rhythm In which of the following situations can an AED be used? -A conscious patient experiencing trouble breathing -A patient in cardiac arrest -An unconscious child who has a pulse -A conscious adult having chest pain - ANSWER- A patient in cardiac arrest According to the CPR guidelines, when ventilating a non-breathing child how many times per minute should ventilations be performed? -10 to 15 -10 to 20 -15 to 20

Downloaded at Knoowy - Upload your own study documents and earn -12 to 20 - ANSWER- 12 to 20 Once every 3-5 seconds According to the CPR guidelines, a child is defined as: -1 year to 8 years old -Birth to 8 years old -1 year to puberty -Birth to puberty - ANSWER- 1 year to puberty When ventilations are being performed on a victim who is suspected of having a spinal injury, the victim's neck should be kept in a: -Prone position -Hyperextended position -Neutral position -Flexed position - ANSWER- Neutral position The management of airway obstruction in the conscious infant (birth - 1 year) includes: -Back slaps and chest thrusts -Back slaps, abdominal thrusts, and chest thrusts -Abdominal thrusts and chest thrusts

Downloaded at Knoowy - Upload your own study documents and earn -Finger sweeps, back slaps, and abdominal thrusts - ANSWER- Back slaps and chest thrusts The management of airway obstruction in the unconscious infant includes: -Back slaps and chest thrusts -Back slaps, abdominal thrusts, and chest thrusts -Perform CPR and check mouth after each cycle -Finger sweeps, back slaps, and abdominal thrusts - ANSWER- Perform CPR and check mouth after each cycle Infant, child, and adult unconscious airway obstruction check mouth then perform CPR and check mouth again after each cycle In caring for a non-breathing patient with a stoma or tracheostomy tube; the EMS Provider must: -Use a nasopharyngeal airway -Use extra force with each ventilation -Cover the neck opening -Ventilate through the neck opening - ANSWER- Ventilate through the neck opening A correct statement concerning airway management of a patient who has a suspected spinal cord injury is that: -The cord injury takes precedence over the airway; the patient can be ventilated only if this can be done without moving the cord

Downloaded at Knoowy - Upload your own study documents and earn -The airway takes precedence over the cord injury; the airway must be opened regardless of the damage it might do to the cord -There is no difference in management; in the presence of a cord injury, the airway is still opened in the usual way -Special techniques must be employed to open the airway without moving the cord

• ANSWER- Special techniques must be employed to open the airway without moving the cord The ratio of compression to ventilations when one or two rescuers apply CPR to an adult is:
• 15:
• 15:
• 30: -30:2 - ANSWER- 30: Child and infant one rescuer - 30: Child and infant two rescuer 15: When CPR is being performed on a child, the rate of chest compression is:
• 60/min
• 70/min
• 100/min -120/min - ANSWER- 100/min

Downloaded at Knoowy - Upload your own study documents and earn How far down must you compress the sternum when you are giving cardiopulmonary resuscitation to an adult: -1 to 1 1/2 inches -1 1/2 to 2 inches -2 to 2 1/2 inches -2 1/2 to 3 inches - ANSWER- 1 1/2 to 2 inches Child and infant 1/3 to 1/2 chest depth How many breaths per minute should you provide a non-breathing adult when you are ventilating by the mouth-to-mask procedure: -8 to 10 -10 to 12 -13 to 15 -18 to 20 - ANSWER- 10 to 12 5-6 seconds if intubated 8-10 breaths per minute. If compressions are needed they are continuous with no breaks for breaths In placing the hands on the patient's sternum to perform CPR, the EMS Provider should: -Hold the fingers of the bottom hand in a fist formation and the fingers on the top hand curved up

Downloaded at Knoowy - Upload your own study documents and earn -Fold the fingers under and make a firm fist -Hold the fingers outward and slightly away from the chest wall -Allow the fingers to curve and conform to the patients chest - ANSWER- Hold the fingers outward and slightly away from the chest wall You are performing two-rescuer CPR on a child. The rescuer who has been ventilating informs you that the patient is now breathing spontaneously. What should you do? -Continue to provide ventilations and compressions, since you should not stop CPR once you have begun -Stop compressions and place the child in recovery position -Keep both hands on the sternum in order to be ready to resume compressions -Stop the ventilations but continue with the compressions - ANSWER- Stop compressions and place the child in recovery position When performing two-rescuer CPR; how often should the rescuer palpate the carotid artery to check for the return of a spontaneous pulse: -Every 2 minutes -Every 5 minutes -Every 10 cycles -Every minute - ANSWER- Every 2 minutes Which of the following statements concerning the performance of CPR is CORRECT?

Downloaded at Knoowy - Upload your own study documents and earn -Quick jabs and sudden jerking movement should be avoided when compressing the chest -Quick jabs are effective in providing pulses of blood to the brain -70% of the cycle should be compression and 30% of the cycle should be relaxation -Quick jabs produce jets of blood flow out of the heart and enhance stroke volume

• ANSWER- Quick jabs and sudden jerking movement should be avoided when compressing the chest To perform external cardiac compressions on a four-year-old child, you should use the: -Tips of the fingers -Thumbs of both hands -Heel of one hand -Heel of your foot - ANSWER- Heel of one hand The area of external cardiac compression on an infant should be: -At the nipple line -One finger-width above the nipple line -One finger-width below the nipple line -The upper half of the sternum - ANSWER- One finger-width below the nipple line Or 2-Thumb encircling the chest with 2 person CPR

Downloaded at Knoowy - Upload your own study documents and earn Child and adult the area of external compression is center of chest between the nipples In reference to performing external cardiac compressions you should: -Pump lightly and pump fast -Pump hard and pump slow -Pump diligently and pump slow -Pump hard and pump fast - ANSWER- Pump hard and pump fast Full chest recoil When checking for signs of circulation on a non-breathing adult the pulse check should last for: -2 to 5 seconds -5 to 10 seconds -10 to 15 seconds -15 to 20 seconds - ANSWER- 5 to 10 seconds The length of a pulse and breathing checks are the same for adult, child and infants 5 to 10 seconds Which of the following statements regarding nasopharyngeal airways (NPA) is TRUE? -NPAs should be used only in the left nostril

Downloaded at Knoowy - Upload your own study documents and earn -NPAs should be coated with water-soluble lubricant prior to insertion -NPAs are more likely to stimulate a gag reflex than would an OPA -If an obstruction is encountered as a NPA is first introduced, you should immediately switch to an OPA - ANSWER- NPAs should be coated with water- soluble lubricant prior to insertion You have inserted an OPA into the mouth of an unconscious victim who reacts by having a gag reflex. You should: -Remove the airway -Remove the airway, the reinsert it -Pull the airway out slightly -Use a smaller sized airway - ANSWER- Remove the airway If slight gastric distention occurs in a patient as a result of positive pressure ventilation, the first action the EMT should take is to: -Give abdominal thrusts to expel the air -Ventilate with just enough volume for visible chest rise -Keep the patients head and shoulders higher then the chest -Keep the patients head and shoulders lower then the chest - ANSWER- Ventilate with just enough volume for visible chest rise In mouth-to-mask ventilation, the stomach is likely to be distended if too great a force is used to inflate the lungs. Lung ventilation may become more difficult because stomach inflation: -Causes a spasm of the larynx

Downloaded at Knoowy - Upload your own study documents and earn -Pushes up on the diaphragm and increases the likelihood of vomiting -Produces a back pressure that pushes the epiglottis forward -Causes a displacement of the lungs, resulting in deviation of the trachea - ANSWER- Pushes up on the diaphragm and increases the likelihood of vomiting For a single rescuer ventilating a non-breathing patient, the pocket mask with supplement oxygen is more effective then the bag-valve-mask with supplemental oxygen because the: -Rescuer can use two hands to maintain head extension and seal the mask -Pocket-mask cushion more readily conforms to all patients -Elastic headband maintains a tight seal -Pocket mask delivers a higher concentration of oxygen - ANSWER- Rescuer can use two hands to maintain head extension and seal the mask In using a bag-valve-mask, which of the following is the BEST way to determine if adequate volume is being delivered to a patient in respiratory arrest: -Listen for air leaving the exhalation port of the bag-valve-mask -Observe for rising and falling of the patient's chest -Monitor the patient's breath sounds -Attach the oxygen reservoir and provide a flow of at least 10 liters/min of oxygen

• ANSWER- Observe for rising and falling of the patient's chest The most common problem encountered with the use of a bag-valve-mask device is the failure to: -Seal the mask properly over the victim's mouth and nose

Downloaded at Knoowy - Upload your own study documents and earn -Connect the bag to oxygen -Control the transmission of communicable diseases -Squeeze the bag at the proper inflation rate - ANSWER- Seal the mask properly over the victim's mouth and nose The proper technique for suctioning a patient's mouth is to insert the catheter with the suction: -On, and turn the suction unit off as you are withdrawing the catheter -Off, turn the suction on to remove foreign material, and then off as you withdraw the catheter -On, and suction while you insert and withdraw the catheter -Off, apply suction, and continue suction as you are withdrawing the catheter - ANSWER- Off, apply suction, and continue suction as you are withdrawing the catheter The first step which should be taken to treat a patient who is unresponsive is to: -Open the airway -Apply positive pressure ventilation -Clear the mouth -Check for a pulse - ANSWER- Open the airway An unconscious, breathing 18 year-old patient has been rescued from a car that had the engine running. The patient's skin is red; vital signs are: Pulse 88, R = 18. Oxygen should be administered with which of the following devices? -Nasal cannula

Downloaded at Knoowy - Upload your own study documents and earn -Simple face mask -Venturi mask -Non-rebreathing mask - ANSWER- Non-rebreathing mask You are called to the home of a patient who is on physician-prescribed low- concentration oxygen, and who is NOT in acute respiratory distress. According to the NYS BLS Treatment Protocols, which type of oxygen delivery device should you use during transport? -Non-rebreathing mask -Demand valve -Simple face mask -Nasal cannula - ANSWER- Nasal cannula For a trauma victim with a respiratory rate of 40 breaths per minute, shallow and irregular breathing, who is pale and has a history of emphysema, the most appropriate treatment would be to: -Use a bag valve mask with supplemental oxygen -Administer low concentration oxygen because of emphysema history -Administer supplemental oxygen with high concentration mask -Transport the patient sitting up to ease the patient's dyspnea - ANSWER- Use a bag valve mask with supplemental oxygen You are suctioning a trauma patient who has large blood clots present in the mouth. You should: -Use alcohol to clear blood clots from the suction tip