Emergency Medical Procedures and Assessments, Exams of Medicine

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OEC 6th Edition Written Exam (2021)

You arrive at an accident scene and find a patient lying on the ground with her right arm straight out to the side (at a 90-degree angle to her body). You ask her if she is able to pull the arm toward her body, but she cannot. You would document this as an inability to __________ her right arm. Select one: A. adduct B. abduct C. hyperextend D. hyperflex - ANS adduct You have been called to the lodge for a behavioral emergency. When you arrive, you find a male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he suddenly fell to the ground and was grunting and shaking. From this description, what should you suspect first that the man has had? Select one: A. A diabetic reaction B. A syncopal episode C. An absence seizure D. A generalized seizure - ANS generalized seizure A basket stretcher is a good method for transporting a patient: Select one: A. with a fractured femur. B. who is extremely heavy. C. on an LSB in any terrain. D. out of the backcountry. - ANS out of the backcountry.

You are assessing a 30-year-old man who has fallen about 20 feet. He is alert and oriented but states that he cannot move or feel his legs. Additionally, because his blood pressure is 82/48 mmHg, you suspect neurogenic shock. Which of the following additional assessment findings reinforces your suspicion of neurogenic shock? Select one: A. Heart rate of 144 B. Shallow rapid respirations C. Heart rate of 44 D. Warm and dry skin - ANS Heart rate of 44 For any submersion injury that is not a life-threatening water-related emergency, a complete secondary assessment is performed using: Select one: A. SAMPLE. B. OPQRST. C. DCAP-BTLS. D. AVPU. - ANS The correct answer is: DCAP-BTLS. When a young child at a neighborhood cookout cries out that he was stung by a bee on his forearm, you should: Select one: A. ask if anyone has an epinephrine auto-injector and assist in giving the injection. B. immobilize the arm and place it at the level of the child's heart to prevent spread of the venom. C. scrape the stinger off the skin with a firm, flat object such as a credit card and then apply ice to reduce the swelling and pain. D. scrub the area with soap and water to remove the stinger. - ANS scrape the stinger off the skin with a firm, flat object such as a credit card and then apply ice to reduce the swelling and pain.

Upon finding an unconscious patient at the scene of a bad accident, your next step should be to: Select one: A. begin your assessment but not provide any treatment until another patroller arrives. B. delay your examination and ask other patrollers to respond as witnesses. C. assume "implied consent" and begin to examine and treat the patient. D. delay your examination until you can locate a spouse or a friend of the patient. - ANS assume "implied consent" and begin to examine and treat the patient. Which describes a patient scoring U on AVPU? Select one: A. Jerks when a light shines directly at the pupil B. Does not respond to pain C. Lurches in response to loud noise D. Moans when a painful stimulus is applied - ANS Does not respond to pain While performing a primary assessment on a patient who has an isolated spinal cord injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect that the spinal cord injury has occurred? Select one: A. The cervical spine B. The lumbar spine C. The diaphragm D. The thoracic spine - ANS The cervical spine How do most problems with heart valves originate? Select one:

A. Due to injury B. From medication errors C. Congenitally D. Due to viral infection - ANS Congenitally You need to begin rewarming an unresponsive patient who has a core temperature of 93°F. Which of the following measures would most benefit this patient? Select one: A. Gently massage the patient's arms and legs. B. Place one extremity at a time into warm water. C. Give the patient warm drinks to increase internal body temperature. D. Wrap the patient in several warm blankets. - ANS Wrap the patient in several warm blankets. You apply and use an AED on a patient lying on his back. His pulse returns, and he is breathing adequately. What position is he in? Select one: A. Right lateral recumbency B. Supine C. Prone position D. Left lateral recumbency - ANS Supine The person who first organized a volunteer "ski patrol" and then was asked to organize a national patrol was: Select one: A. Roger Langely. B. Minnie Dole. C. Warren Bowman.

D. Roland Palmedo. - ANS Minnie Dole A crying 42-year-old woman states that she has sharp abdominal pain that she localizes to her right lower quadrant. When assessing this patient's abdomen, you would look for distention and symmetry and then: Select one: A. start the abdominal exam by palpating the right lower quadrant. B. avoid palpating the right lower quadrant. C. start the exam by palpating the abdomen in the quadrant farthest away from the one that is painful. D. avoid palpating the entire abdomen. - ANS start the exam by palpating the abdomen in the quadrant farthest away from the one that is painful. After jogging with your friend for about 30 minutes, she stops and asks why your heart rate increases and your heart feels like it is pumping harder after you exercise for a while. Based on your understanding of the cardiovascular system, your best response would be which of the following statements? Select one: A. "Exercise pushes more blood into your heart, so your heart has to work harder and faster to pump the blood out so you don't go into heart failure." B. "When you exercise, your blood pressure increases, so your heart has to work harder to overcome the higher blood pressure." C. "Exercise makes your body need more nutrients and oxygen. Your heart pumps harder and faster to deliver more blood containing those things to your muscles." D. "You're out of shape. Those things wouldn't happen if you exercised more." - ANS "Exercise makes your body need more nutrients and oxygen. Your heart pumps harder and faster to deliver more blood containing those things to your muscles." Attacks by which of the following creatures do not cause both soft-tissue injuries and fractures? Select one: A. Sharks

B. Swordfish C. Alligators D. Crocodile - ANS Swordfish Which of the following findings should be of greatest concern when assessing a 33-year-old woman who is 8 months pregnant? Select one: A. Vaginal bleeding and abdominal pain B. Recent onset of a fever of 99.3°F C. Shortness of breath when lying flat D. Daily contractions that are irregular and painful - ANS Vaginal bleeding and abdominal pain When assessing the vital signs of a severely hypothermic patient, OEC technicians should: Select one: A. check the patient's radial pulse to avoid exposing the patient's head and neck to the cold. B. warm their own fingers for a full minute to ensure that they can feel the patient's pulse. C. vigorously shake the patient to assess the true level of responsiveness. D. check the patient's pulse and respirations for up to one minute. - ANS check the patient's pulse and respirations for up to one minute. The function of the uterus in pregnancy is to: Select one: A. provide an environment for the ovum to develop into a fetus. B. manufacture specific blood cells needed for fetal survival. C. protect the abdominal organs during fetal growth. D. permit the excretion of wastes from the baby to the mother. - ANS provide an environment for the ovum to develop into a fetus.

A secondary assessment (including vital signs) should take about how long? Select one: A. 30 seconds B. 2-5 minutes C. 6-8 minutes D. 1 minute - ANS 2-5 minutes Which of the following signs would you recognize as an early sign of respiratory distress in a 7-year-old boy who complains of difficulty breathing? Select one: A. Ecchymosis on his chest B. Nasal flaring C. Tremors of his hands D. Barrel chest - ANS Nasal flaring You are assessing an infant who has been ill and has had a fever for the past two days. As you approach the infant, you note that she has grunting respirations. Based on your OEC training, you determine that grunting is: Select one: A. a symptom of severe respiratory disease. B. a soothing mechanism for a sick child. C. a symptom of significant dehydration. D. often normal in a child with a cold. - ANS a symptom of severe respiratory disease. When presented with a 6-year-old female with a stick impaled through her lower left abdominal quadrant, an OEC technician should:

Select one: A. pull the stick out partway. B. stabilize the stick. C. saw the stick off, leaving some in place. D. push the stick through the back of the abdominal cavity. - ANS stabilize the stick. You and a fellow OEC technician are discussing how to talk with someone experiencing a behavioral emergency. Which of the following statements indicates that you have a good understanding of the correct approach? Select one: A. "Don't encourage patients to talk about what is bothering them. They should only talk with a psychiatrist about that." B. "Demonstrate active listening skills by repeating or paraphrasing what the patient said." C. "If a patient yells, you should yell back so he will know you are not afraid." D. "If the patient is hallucinating, you should go along with them so they won't get upset." - ANS "Demonstrate active listening skills by repeating or paraphrasing what the patient said." Which of the following instructions would you give an OEC technician who is preparing to assess a stable 9-month-old boy with a rash? Select one: A. "Keep the baby calm; do not touch him during the assessment." B. "Start at the head and slowly work your way to the feet." C. "Have the mother hold him as you do the assessment." D. "Make sure that you do not undress the baby for the assessment." - ANS "Have the mother hold him as you do the assessment." Which of the following statements about traumatic injuries in the elderly is true? Select one:

A. Injuries are most commonly caused by falls. B. Head injuries are easier to detect in the elderly than in younger adults. C. Motor-vehicle collisions are responsible for over 75 percent of deaths. D. Hyperthermia is an early sign of trauma. - ANS Injuries are most commonly caused by falls. The passage of oxygen and carbon dioxide through the walls of the alveolae occurs via: Select one: A. osmosis. B. breathing. C. aspiration. D. diffusion. - ANS diffusion. You are by the side of a patient who is unresponsive and has a history of heart failure. When assessing the airway, which one of the following observations best indicates an open airway? Select one: A. You can hear normal respirations and see the chest rise and fall. B. Her mouth is open and you can hear gurgling sounds. C. She has a pulse of 80 per minute. D. You can see that her tongue has fallen back where it appears to be blocking the airway. - ANS You can hear normal respirations and see the chest rise and fall. You are called to the lodge to help a patient who has developed an allergic reaction after taking an antibiotic medication. You would describe this route of exposure as: Select one: A. contact. B. inhalation. C. ingestion.

D. injection. - ANS ingestion. The term used to describe the action of taking an extremity away from the midline of the body is: Select one: A. adduction. B. flexion. C. abduction. D. extension. - ANS abduction. While you are alone and caring for an injured skier in the aid room, a fellow patroller calls and tells you that your own young child was just injured in the terrain park. Concerned for your child, you leave the patient's care unfinished and run to the terrain park. Your action could be viewed as: Select one: A. abandonment. B. denial of care. C. a breach of ethics. D. your duty to act. - ANS abandonment. You are listening to two patrollers discuss the accident to which they just responded. Which of the following injuries would lead you to believe that one of the patients had suffered from traumatic asphyxia? Select one: A. A bilateral femur deformity B. Bluish discoloration of the neck and face C. Abdominal bruising and distention D. A chest wound that makes a sucking sound - ANS Bluish discoloration of the neck and face

Your group of climbers has reached an elevation of 8,500 feet. One of the climbers is increasingly short of breath and now has audible chest congestion. Your party has a limited supply of oxygen, which you immediately apply to the climber at 15 LPM via a nonrebreather mask. Based on your assessment that the climber has HAPE, you recognize that the next necessary treatment is: Select one: A. to place the patient in the shock position. B. a rapid descent of at least 1,500 to 3,000 feet. C. to administer diuretics such as Diamox to reduce the patient's pulmonary edema. D. to get the patient to a physician who can administer dexamethasone. - ANS a rapid descent of at least 1,500 to 3,000 feet. Which of the following instructions to a possible stroke patient describes the proper procedure for assessing an arm drift? Select one: A. "Raise your hands above your head and close your eyes." B. "Hold your arms straight out in front of you with your palms facing up with your eyes closed." C. "Hold your arms up over your head for 20 seconds." D. "Grab my fingers with both of your hands and squeeze as hard as you can." - ANS "Hold your arms straight out in front of you with your palms facing up with your eyes closed." In the incident command system, the operations section is responsible for: Select one: A. providing financial management. B. providing support for all functional areas. C. collecting, assessing, and distributing incident-related data. D. executing the strategy of the incident action plan. - ANS executing the strategy of the incident action plan.

A young boy was running through the lodge with a pencil and tripped. The pencil impaled the boy's left eye and remains lodged in place. Appropriate care for the eye would include: Select one: A. applying gentle pressure to the pencil and the eye to keep the pencil from moving. B. quickly removing the pencil from the eye to prevent the loss of vision. C. stabilizing the impaled object and providing immediate transport. D. applying ice to the affected eye to decrease pressure and reduce subsequent damage. - ANS stabilizing the impaled object and providing immediate transport. To prepare a patient with a pelvic fracture for transportation, you should: Select one: A. place the patient in a supine position on a backboard. B. apply a pelvic binder. C. place the patient in a seated position in a toboggan. D. place the patient on a scoop stretcher in the right recumbent position. - ANS apply a pelvic binder. Which of the following SPF ratings would provide the greatest level of protection? Select one: A. 6 B. 15 C. 30 D. 50 - ANS 50 Lower abdominal pain could indicate which of the following conditions? Select one: A. A urinary tract infection

B. An auditory tract infection C. An irregular heart beat D. A fractured rib - ANS A urinary tract infection When approaching most helicopters, whether running or not, the safest way is to do so from the: Select one: A. left side. B. back. C. front. D. right side. - ANS front. A patellar fracture affects which part of the body? Select one: A. The hip B. The tibia C. The elbow D. The knee - ANS The knee Displacement of the bones of a joint is known as: Select one: A. a sprain. B. a dislocation. C. a strain. D. a fracture. - ANS a dislocation.

What is the best possible way to add or amend information to a report that has already been submitted? Select one: A. Submit the additional information as an addendum to the report then sign, date, and time the addendum. B. Ask for the report back so you can add to the report, then initial the changes. C. Write the additional information on a copy of the form you kept for your records and resubmit the form with your initials and date. D. Once the report is submitted, you can no longer add information and should only add the information to your notes. - ANS Submit the additional information as an addendum to the report then sign, date, and time the addendum. When caring for someone who has been attacked by a large animal such as a moose or bear, you should assume that: Select one: A. the potential for spinal injury exists. B. unless there is a bite, there is no potential for infection. C. bleeding from claw injuries is the most dangerous injury. D. the animal probably has rabies, or it would not have attacked. - ANS the potential for spinal injury exists. You are called to assist a 62-year-old female who is complaining of fatigue, jaw discomfort, and excessive sweating. When asked, she denies having chest pain or shortness of breath. She tells you that she has a history of hypertension and takes a blood pressure pill. She also has nitroglycerin. Which statement is inappropriate for this event? Select one: A. "She is not short of breath, so we don't need to transport her." B. "I am not going to attach the AED because she is conscious and has a pulse." C. "I am going to check her blood pressure."

D. "I am going to call for ALS because she could be having a cardiac event." - ANS "She is not short of breath, so we don't need to transport her." You are working at a mountain resort and are presented with a 50-year-old woman who states that she does not feel well. From your assessment, which of the following findings would seemingly indicate that the patient is being adversely affected by the high altitude? Select one: A. A heart rate of 62 beats per minute B. An elevated blood glucose level with no history of diabetes C. A complaint of feeling short of breath on exertion D. Vomiting after eating large meals - ANS A complaint of feeling short of breath on exertion The pressure exerted on the inside walls of arteries when the left ventricle contracts is called: Select one: A. systolic pressure. B. diastolic pressure. C. ventricle pressure. D. contraction pressure. - ANS systolic pressure. In the mnemonic AEIOU-TIPS, the P stands for: Select one: A. poisoning and psychiatric conditions. B. Parkinson's disease and peripheral nerve disorder. C. parathyroid disorders and Parkinson's disease. D. parathyroid disorders and psychiatric conditions. - ANS poisoning and psychiatric conditions.

You are assessing a 2½-year-old child who was involved in a minor car collision. She is currently alert and oriented. While you are assessing her for possible injuries, which of the following actions would be considered most appropriate? Select one: A. Be stern with the child and provide strict instructions on what you expect from her. B. Examine possible painful sites first. C. Assess the child, starting at her head and moving to her feet. D. Allow the child to hold a favorite toy during the assessment. - ANS Allow the child to hold a favorite toy during the assessment. You are checking equipment at the beginning of your shift. The D size oxygen cylinder measures 1000 psi. You calculate that if you needed to use this tank at 15 LPM it would last: Select one: A. 5 minutes B. 12 minutes C. 8.5 minutes D. 15 minutes - ANS 8.5 minutes A specific toxin or poisonous secretion of an animal that is usually transmitted by a bite or sting is known as: Select one: A. venom. B. bullae. C. antigen. D. nettle. - ANS venom. A 28-year old healthy male presents with recent signs and symptoms of nausea and vomiting but very little abdominal pain. Which one of the following is your best course of action?

Select one: A. Have the patient urinate in a cup and look for blood in the urine. B. Suggest he follow up with his physician if the symptoms continue. C. Call for ALS since you suspect the patient is having a myocardial infarction. D. Suggest the patient take some over the counter analgesics to see if they help and release back to skiing. - ANS Suggest he follow up with his physician if the symptoms continue. Fontanels, which are openings in the skulls of newborns that allow brain expansion, close when the child is at approximately what age? Select one: A. 3 years of age B. 1 year of age C. 3-4 months of age D. 18-20 months of age - ANS 18-20 months of age The uphill positioning principle has exceptions. For patients with breathing difficulty, the patient should be placed either seated or uphill depending on other injuries. The uphill concept allows easier breathing because: Select one: A. air flows more easily through a patient's nose compared to a head-downhill position. B. of less pressure from the abdominal contents pushing upwards on the thorax. C. the ribs have greater flexibility of movement in the uphill position. D. it calms patients by enabling them to see where they are going during transport. - ANS of less pressure from the abdominal contents pushing upwards on the thorax. Which of the following signs or symptoms best indicates that a patient has suffered an injury to the thoracic spine? Select one:

A. Tingling in the legs B. Paralysis of the arms C. Altered mental status D. Cool and diaphoretic skin - ANS Tingling in the legs A severely hypothermic patient is in cardiac arrest. Most studies indicate that for patients who have been submerged in cold water for more than one hour, you should: Select one: A. do nothing because there is no chance such patients will survive. B. focus on rewarming and rapidly transporting the patient. C. start cardiopulmonary resuscitation. D. provide ventilations but not compressions. - ANS focus on rewarming and rapidly transporting the patient. In decompensated shock, the failure of body systems despite the body's attempt to oxygenate vital organs becomes apparent as: Select one: A. increased pulse rate and decreased blood pressure. B. augmented capillary refill and increased respiratory rate. C. increased respiratory rate and reduced level of consciousness. D. increased blood pressure and reduced pulse rate. - ANS increased pulse rate and decreased blood pressure. A patient who is conscious and breathing has been pulled from a cold stream. To decrease the patient's loss of heat via the mechanism of conduction, OEC technicians should immediately: Select one: A. thoroughly dry the patient and then apply a blanket.

B. apply hot packs to the patient. C. encourage the patient to stop shivering. D. provide positive-pressure ventilation. - ANS thoroughly dry the patient and then apply a blanket. Which of the following statements about cardiovascular disease is false? Select one: A. Cardiovascular disease is the leading cause of death in the United States. B. The underlying cause of most cases of cardiovascular disease is coronary artery disease or atherosclerosis of the coronary arteries. C. Most cases of cardiovascular disease are congenital and could be prevented with improved prenatal care. D. Cardiovascular disease involves a number of diseases that affect either the heart or blood vessels. - ANS Most cases of cardiovascular disease are congenital and could be prevented with improved prenatal care. The most important muscle of respiration is the: Select one: A. sternocleidomastoid. B. intercostal muscle. C. diaphragm. D. pectoralis major. - ANS diaphragm. Some patients experience a premonition indicating a seizure is about to happen known as a(n): Select one: A. syncopal stage. B. postictal state. C. colonic phase.

D. aura. - ANS aura. During a primary assessment, which of the following findings would most likely lead you to suspect an allergic reaction? Select one: A. Heart rate of 55 beats per minute B. Blood pressure of 100/60 mmHg C. Hives on the face and neck D. A complaint of dizziness - ANS Hives on the face and neck Which of the following actions is best to keep a behavioral patient calm and to avoid provoking a violent outburst? Select one: A. Establish that you are in control of the situation and that the patient must cooperate, or you will restrain him. B. Inform the patient that he is responsible for all of his actions, and that if he hurts you, you will sue him. C. Involve as many people as possible in the situation as a "show of force." D. Inform the patient of everything that is happening and use a calm voice throughout care. - ANS Inform the patient of everything that is happening and use a calm voice throughout care. You are managing a patient with a large flail segment in the right lateral chest. The immediate threat to this patient's life is: Select one: A. hypoxia. B. rib fractures. C. blood loss. D. infection. - ANS hypoxia.

Which of the following statements best describes the function of the respiratory system? Select one: A. Providing the body oxygen B. Transporting oxygen throughout the body C. Releasing oxygen from the body D. Providing nutrients to cells - ANS Providing the body oxygen Which of the following activities is not considered a special operation? Select one: A. A vehicle extrication B. A lift evacuation C. Toboggan transportation D. A low-angle rescue - ANS Toboggan transportation When obtaining a history of a five-year-old boy with generalized hypothermia, which of the following questions provides the most important information? Select one: A. "Does he have any medical conditions?" B. "When did he last eat or drink?" C. "Why was he outside without adult supervision?" D. "Are all of his childhood shots up to date?" - ANS "Does he have any medical conditions?" An elderly woman has fallen down three steps and is complaining of back pain. After you perform a primary assessment, which of the following questions should you ask to elicit the next important piece of information? Select one:

A. "Why didn't you use the ramp on the other side?" B. "Do you have a history of high blood pressure?" C. "Who is your family doctor?" D. "Did you become dizzy before you fell?" - ANS "Did you become dizzy before you fell?" Which description of a helmet would indicate that it needs to be removed in a prehospital setting? Select one: A. Too far down on the neck B. Too thin C. Too small D. Too large - ANS Too large Assessment and management of the trauma patient should include: Select one: A. reassessing the patient every 30 minutes. B. gathering information about the mechanism of injury. C. transporting trauma patients as soon as the Scene Size Up is complete. D. initiating CPR on all patients with chest trauma. - ANS gathering information about the mechanism of injury. A snowboarder's fall over the toe side of the board onto an outstretched hand is known as the: Select one: A. "Dog drag." B. "Mousetrap." C. "Twist." D. "Drop back." - ANS "Mousetrap."

Hyperglycemia: Select one: A. has a more rapid onset than hypoglycemia. B. has a more gradual onset than hypoglycemia. C. is more easily treated in prehospital environments than is hypoglycemia. D. is preceded by an aura, such as hallucinations or detecting unusual odors. - ANS has a more gradual onset than hypoglycemia. The most commonly abused drug in the world is: Select one: A. amphetamine. B. marijuana. C. alcohol. D. cocaine. - ANS alcohol. You are caring for an unconscious patient who has vomited and appears to have a blocked airway. Using the cross-finger technique, you open the patient's mouth and can see a large piece of undigested food near the back of the throat. You would: Select one: A. encourage the patient to cough. B. perform a finger sweep. C. insert an airway. D. administer abdominal thrusts. - ANS perform a finger sweep. Which of the following statements concerning immersion hypothermia is true? Select one:

A. It can take more than 30 minutes for an individual to become hypothermic. B. Death will typically occur within a few minutes. C. It occurs only when the entire body and head are submersed. D. The function of arm and leg muscles will not affect the outcome. - ANS It can take more than 30 minutes for an individual to become hypothermic. A patient involved in a motor vehicle collision has a deformity to the left side of the head. The skin overlying the deformity is still intact. Based on these assessment findings, which of the following conditions would be your greatest concern? Select one: A. A possible brain injury B. The potential for infection of the brain C. A spinal cord injury D. Soft tissue trauma to the scalp - ANS A possible brain injury The diaphragm separates the: Select one: A. thoracic cavity from the abdominal cavity. B. lungs from the heart. C. right lung from the left lung. D. heart and lungs from the spine. - ANS thoracic cavity from the abdominal cavity. Exposure to direct or alternating electrical current produces severe external and internal burn injuries because: Select one: A. the skin is a poor conductor with a high resistance, and blood vessels are good conductors with low resistance.

B. the skin is a good conductor with a high resistance, and blood vessels are good conductors with low resistance. C. both the skin and blood vessels are good conductors with low resistance. D. skin is a poor conductor with a low resistance, and blood vessels are good conductors with low resistance. - ANS the skin is a poor conductor with a high resistance, and blood vessels are good conductors with low resistance. A patient who sustained blunt trauma to the abdominal and pelvic areas in a very serious collision is probably in which type of shock? Select one: A. Hypovolemic B. Cardiogenic C. Obstructive D. Distributive - ANS Hypovolemic A patient with severe gastrointestinal bleeding is in what type of shock? Select one: A. Cardiogenic B. Non-Hemorrhagic C. Hemorrhagic D. Distributive - ANS Hemorrhagic Which of the following conditions must OEC technicians consider when evaluating hypotensive geriatric patients with altered mental status who show no signs of external bleeding, chest injury, or abdominal trauma? Select one: A. A hip or pelvic fracture B. A genetic hypotensive condition