Emergency Medical Procedures and Protocols, Exams of Medicine

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EMT Written State Exam Study Guide

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1. Which of the following is NOT true of medical control? A) It is determined by the dispatcher. B) It may be written or "standing orders." C) It may require online radio or phone consultation. D) It describes the care authorized by the medical director - ANSWER-A) It is determined by the dispatcher.
2. The major goal of quality improvement is to ensure that: A) quarterly audits of the EMS system are performed. B) EMTs have received BLS/CPR training. C) the public receives the highest standard of care. D) the proper information is received in the billing department. - ANSWER-C) the public receives the highest standard of care.
3. Federal legislation concerning patient confidentiality is known as: A) HIPAA. B) NAACS. C) EMTALA. D) FLCPC. - ANSWER-A) HIPAA
4. After stocking the ambulance this morning, you and your partner go out for breakfast. While entering the restaurant, you see an older gentleman clutch his chest and collapse to the floor. When you get to him, he has no pulse and is not breathing. To treat this patient, you will follow: A) off-line medical control. C) protocols. B) online medical control. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
5. After stocking the ambulance this morning, you and your partner go out for breakfast. While entering the restaurant, you see an older gentleman clutch his chest and collapse to the floor. When you get to him, he has no pulse and is not breathing. What level of training would allow you to perform an electrocardiogram and advanced life support on this patient? A) EMR B) EMT C) AEMT D) Paramedic - ANSWER-D) Paramedic
6. ______________ is a circular system of continuous internal and external reviews and audits of all aspects of an EMS system - ANSWER-Continuous quality iimprovement
7. One of the most dramatic recent developments in prehospital emergency care is the use of a(n)__________ defibrillator - ANSWER-automated external

8. The primary ________ area is the main area in which an EMS agency operates. - ANSWER-service
9. A 9-1-1 dispatch center is called a public safety __________, or PSAP - ANSWER- access point
10. ALS A) EMS professional trained in BLS interventions
11. BLS B) A system of internal reviews and audits
12. EMT C) Basic lifesaving interventions, such as CPR
13. AEMT D) Advanced procedures, such as drug administration
14. Paramedic E) EMS professional trained in ALS interventions
15. CQI F) EMS professional trained in some ALS interventions - ANSWER-10. D
16. C
17. A
18. F
19. E
20. B
21. __________ is a response to the anticipation of danger. A) Rage B) Anger C) Anxiety D) Despair - ANSWER-C) Anxiety
22. If you find that you are the target of the patient's anger, make sure that you: A) are safe. C) are tolerant and do not become defensive. B) do not take the anger or insults personally. D) All are correct. - ANSWER-D) All are correct.
23. When acknowledging the death of a child, reactions vary, but ____________ is common. A) shock B) disbelief C) denial D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
24. The quickest source of energy is ____________; however, this supply will last less than a day and is consumed in greater quantities during stress. A) glucose B) carbohydrates C) protein D) fat - ANSWER-A) glucose
25. Components of the CISM system include: A) preincident stress education. C) spouse and family support. B) defusings. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
26. Sexual harassment is defined as: A) any unwelcome sexual advance. B) unwelcome requests for sexual favors. C) unwelcome verbal or physical conduct of a sexual nature. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.

22. A 12-year-old boy told his grandmother he was going to collect the day's mail, located on the opposite side of the street, for her. As he was returning with the mail, he was struck by a vehicle and was found lying lifeless in the middle of the street. Which of the following would be appropriate to say to the grandmother? A) "Don't worry. I'm sure he'll be fine." B) "What were you thinking? You will be reported!" C) "We're placing him on a backboard to protect his back, and we'll take him to the ColumbusCommunity Hospital. Do you know who his doctor is?" D) It's best not to spend time talking to the grandmother. - ANSWER-C) "We're placing him on a backboard to protect his back, and we'll take him to the ColumbusCommunity Hospital. Do you know who his doctor is?"
23. The struggle to remain calm in the face of horrible circumstances contributes to the __________of the job. - ANSWER-emotional stress
24. Proper ___________ is the simplest, yet most effective, way to control disease transmission. - ANSWER-handwashing
25. You or your partner may develop ___________ after experiencing a particularly stressful call. - ANSWER-PTSD
26. PPE A) Contact with blood, body fluids, tissues, or air borne particles
27. OSHA B) Examples include gloves, gowns, and face shields
28. General adaptation syndrome C) The process of alarm, reaction, and recovery
29. Exposure D) Procedures to reduce transmission of infection among patients and health care personnel
30. Infection control E) Regulatory compliance agency - ANSWER-26. B
31. E
32. C
33. A
34. D
35. The process by which an individual, an institution, or a program is evaluated and recognized as meeting certain standards is called: A) the standard of care. B) competency. C) the scope of practice. D) certification - ANSWER-D) certification
36. Negligence is based on the EMT's duty to act, cause, breach of duty, and: A) expressed consent. C) mode of transport. B) termination of care. D) real or perceived damages - ANSWER-D) real or perceived damages
37. Good Samaritan laws generally are designed to offer protection to persons who render care in good faith. They do not offer protection from:

A) properly performed CPR. C) improvising splinting materials. B) acts of negligence. D) providing supportive BLS to a DNR patient - ANSWER-B) acts of negligence

34. Which of the following is generally NOT considered confidential? A) Assessment findings C) A patient's medical history B) A patient's mental condition D) The location of the emergency - ANSWER-D) The location of the emergency
35. An important safeguard against legal implication is: A) responding to every call with lights and siren. B) checking ambulance equipment once a month. C) transporting every patient to an emergency department. D) writing a complete and accurate run report - ANSWER-D) writing a complete and accurate run report
36. Definitive or conclusive signs of death that are obvious and clear to even non medical persons include all of the following, EXCEPT: A) profound cyanosis. B) dependent lividity. C) rigor mortis. D) putrefaction. - ANSWER-A) profound cyanosis.
37. At 2:00 AM, a 17-year-old boy, accompanied by his 19-year-old girlfriend, had driven to the bar to give his father (who had been drinking large amounts of alcohol) a ride home. On the way back, they were involved in a motor vehicle collision. The boy has a large laceration with profuse bleeding on his forehead. His girlfriend is unconscious in the front passenger floor. The father is standing outside the vehicle, appearing heavily intoxicated, and is refusing care. What is the best way to gain consent to begin care for the driver, considering that he is a minor and his father has an altered mental status? A) Call his mother for consent. B) Call his grandparents for consent. C) It is a true emergency, so consent is implied. D) You are covered under the Good Samaritan laws. - ANSWER-C) It is a true emergency, so consent is implied.
38. You respond to a single-vehicle crash on the highway west of town. Upon arrival you find a 33-year-old man with an open forearm fracture who has self-extricated from his pickup, which is down the road side embankment. He does not appear to have suffered any other injuries, is fully coherent, and refuses all medical care. In an effort to obtain consent to treat this patient, you should: A) summon law enforcement and request that the patient be placed into protective custody. B) clearly explain the consequences of not accepting medical treatment.

C) proceed with treatment; consent is not required because the patient is not being rational. D) properly document the refusal of care. - ANSWER-B) clearly explain the consequences of not accepting medical treatment. _ 39. Assault A) Written documentation that specifies treatment

40. Battery B) Touching without consent
41. Expressed consent C) Relating to law or forensic medicine
42. Implied consent D) Accepted level of care consistent with training
43. Medicolegal E) Unlawfully placing a patient in fear of bodily harm
44. Standard of care F) Specific authorization to provide care expressed by the patient
45. Advance directive G) Legal assumption that treatment was desired - ANSWER-39. E
46. B
47. F
48. G
49. C
50. D
51. A
52. ________ are helpful when you are away from the ambulance and need to communicate with dispatch, another unit, or medical control. A) Base stations B) Portable radios C) Mobile radios D) Cellular phones - ANSWER-B) Portable radios
53. Digital signals are used in some kinds of paging and tone-alerting systems because they transmit________ and allow for more choices and flexibility. A) numerically B) faster C) alphanumerically D) encoded messages - ANSWER-B) faster
54. Which of the following is NOT true with regard to simplex mode? A) When one party transmits, the other must wait to reply. B) You must push a button to talk. C) It is called a "pair of frequencies." D) Radio transmissions can occur in either direction, but not simultaneously in both - ANSWER-C) It is called a "pair of frequencies."
55. The patient report commonly includes all of the following, EXCEPT: A) a list of the patient's medications. C) a brief history of the patient's current problem. B) the patient's age and gender. D) your estimated time of arrival. - ANSWER-A) a list of the patient's medications

50. Standard radio operating procedures are designed to: A) reduce the number of misunderstood messages. C) develop effective radio discipline. B) keep transmissions brief. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
51. Depending on how the protocols are written, you may need to call medical control for direct orders to: A) administer certain treatments. C) request assistance from other agencies. B) transport a patient. D) immobilize a patient. - ANSWER-A) administer certain treatments
52. The __________ officially occurs during your oral report at the hospital, not as a result of your radio report en route. A) patient report C) termination of services B) transfer of care D) All of these answers are correct. - ANSWER-B) transfer of care
53. When attempting to communicate with non-English-speaking patients, you should: A) use short, simple questions and simple words whenever possible. B) always use medical terms. C) shout. D) position yourself so the patient can read your lips. - ANSWER-A) use short, simple questions and simple words whenever possible.
54. You have responded to a scene at which a 45-year-old man has run his SUV into a utility pole. On arrival, the driver was found slumped over the steering wheel, unconscious. A large electrical wire was lying across the hood of the vehicle. After securing scene safety, you were able to approach the patient and complete a primary assessment, in which you found a 6" (15.4-cm) laceration across his forehead.The patient regained responsiveness, was alert and oriented, and refused care. If the patient refuses to sign the refusal form: A) sign it yourself and state: "Patient refused to sign." B) you cannot let the man leave the scene until he either goes with you or signs the form. C) have a credible witness sign the form testifying that he or she witnessed the patient's refusal of care. D) nothing more needs done. If the patient refuses care, you don't have to document it - ANSWER-C) have a credible witness sign the form testifying that he or she witnessed the patient's refusal of care.
55. Maintaining _________ with your patient builds trust and lets the patient know that he or she is your first priority. - ANSWER-eye contact
56. Children can easily see through lies or deception, so you must always be _____ with them. - ANSWER-honest

_ 57. UHF A) A process in which electronic signals are converted into coded, audible signals

58. VHF B) Radio frequencies between 300 and 3,000 MHz
59. Repeater C) Radio frequencies between 30 and 300 MHz
60. Telemetry D) Special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency - ANSWER-
61. B
62. C
63. D
64. A
65. Your patient has been involved in an MVA. The term MVA stands for: A) motor vehicle accident. C) multiple vascular accidents.B) motor vehicle crash. D) mitral valve accumulation. - ANSWER-A) motor vehicle accident.
66. You are attending to a patient who was involved in a car crash. He was not wearing his seat belt when he ran off the highway and hit a tree. You correctly assume that he has cardiac tamponade. On arrival at the hospital the doctor performs pericardiocentesis. The suffix "-centesis" means: A) pertaining to sensation or perception. B) pertaining to puncturing an organ or body cavity. C) examination with an instrument. D) suture of; repair of. - ANSWER-B) pertaining to puncturing an organ or body cavity.
67. A patient presents with severe erythema to his left lateral chest wall and a ruptured spleen. Upon arrival at the hospital, the surgeon performs a splenectomy. The suffix "- ectomy" means: A) surgical creation of an opening. B) slowing or stopping of the normal flow of a fluid. C) decline, disintegration, or destruction. D) surgical removal of - ANSWER-D) surgical removal of
68. Your patient has had laryngitis for almost a week. It has progressed to the point that she has difficulty swallowing. What is the suffix pertaining to eating or swallowing? A) "-osis" B) "-phasia" C) "-phagia" D) "-phobia" - ANSWER-C) "-phagia"
69. Your patient was flying back home from Cuba when she developed a nose bleed and headache right behind the eyes. A physician ascertained that her previous head cold had left the patient with sinusitis.The root word "sinus" pertains to which of the following? A) Wall, divider B) Opening C) Cavity, channel, or hollow space D) Membrane - ANSWER-C) Cavity, channel, or hollow space

66. You are caring for a very sick patient who is complaining of chest pain. You have him on your cardiac monitor which is showing AF. Suddenly, the patient goes into VF, so you attach your AED and shock him. What do the abbreviations AF, VF and AED stand for? A)atherosclerotic heart disease, ventricular tachycardia, automated external defibrillator B)acute myocardial infarction, ventricular fibrillation, automated external defibrillator C)atrial fibrillation, ventricular fibrillation, automated implantable cardioverter defibrillator D) atrial fibrillation, ventricular fibrillation, automated external defibrillator - ANSWER-D) atrial fibrillation, ventricular fibrillation, automated external defibrillator
67. The suffix "-_______" means disease. - ANSWER-pathy
68. The meaning "under" can be represented by the prefixes "_______-" and "infra-." - ANSWER-sub
69. "Emesis" in the word "hyperemesis" means ________. - ANSWER-vomit
70. "_______" in the word "erythrocyte" means red. - ANSWER-erythro
71. Flexion A) A body part (or condition) on appearing on both sides of the midline.
72. Extension B) Movement away from the midline of the body.
73. Adduction C) The bending of a joint.
74. Abduction D) The straightening of a joint.
75. Bilateral E) Movement toward the midline of the body - ANSWER-71. C
76. D
77. E
78. B
79. A
80. The leaf-shaped flap of tissue that prevents food and liquid from entering the trachea is called the: A) uvula. B) epiglottis. C) laryngopharynx. D) cricothyroid membrane. - ANSWER-B) epiglottis.
81. Which of the following systems is responsible for releasing chemicals that regulate body activities? A) Nervous B) Endocrine C) Cardiovascular D) Skeletal - ANSWER-B) Endocrine
82. The _____ is connected to the intestine by the bile ducts. A) stomach B) spleen

C) appendix D) liver - ANSWER-D) liver

79. There are ________ cervical vertebrae. - ANSWER-
80. There are a total of ____ lobes in the right and left lungs. - ANSWER-
81. The movement of air between the lungs and the environment is called _____. - ANSWER-ventilation
82. Capillary A) Major artery that supplies blood to the lower extremities
83. Carotid B) Connects arterioles to venules
84. Femoral C) Imaginary vertical line descending from the middle of the forehead to the floor
85. Brachial D) Major artery of the upper arm
86. Radial E) Bending of a joint
87. Flexion F) Major artery that supplies blood to the head and brain
88. Anatomic position G) Standing, facing forward, palms facing forward
89. Midline H) The Thorax
90. The Thorax I) Major artery of the lower arm - ANSWER-82. B
91. F
92. A
93. D
94. I
95. E
96. G
97. C
98. B
99. Kidney function declines by _________________ between the ages of 20 and 90 years. A) 10% B) 50% C) 45% D) 20% - ANSWER-B) 50%
100. What is "vital capacity"? A) The volume of blood moved by each contraction of the heart B) The maximum thickness of the meninges C) The volume of air moved during the deepest points of respiration D) The amount of air left in the lungs following exhalation - ANSWER-C) The volume of air moved during the deepest points of respiration
101. Diastolic blood pressure tends to _______________ with age. A) decrease B) compensate C) increase D) decompensate - ANSWER-C) increase

94. Work, family, and stress best describe the life stage known as: A) middle adulthood. B) adolescence. C) late adulthood. D) early adulthood - ANSWER-D) early adulthood
95. You are dispatched to a public park in the middle of a sprawling subdivision for an arm injury. You arrive to find a crying 5-year-old boy cradling his swollen and deformed left forearm. His friends tell you that he was holding onto the bars of the play structure and that his arm "snapped" when he jumped into the sand below. You would expect this boy's pulse to be: A) between 60 and 80 beats/min. C) most likely above 90 beats/min. B) higher than 150 beats/min. D) around 70 beats/min. - ANSWER-C) most likely above 90 beats/min.
96. In toddlers, the pulse rate is _____ to _____ beats/min, and the respiratory rate is _____ to _____breaths/min. - ANSWER-90;150;20;
97. An infant's lungs are fragile, and providing bag-valve mask ventilations that are too forceful can result intrauma from pressure, or _____. - ANSWER-barotrauma
98. By _____ to _____ months, toddlers begin to understand cause and effect. - ANSWER-18, 24 99.Among elderly persons, _________ function in the 5 years preceding death is presumed to decline. - ANSWER-mental
99. Anxious-avoidant attachment A) A type of reasoning in which a child looks for approval from peers and society
100. Conventional reasoning B) A type of reasoning in which a child bases decisions on his or her conscience
101. Moro reflex C) An infant reflex that occurs when something touches an infant's cheek and the infant instinctively turns his or her head toward the touch
102. Post conventional reasoning D) An infant reflex in which the infant opens his or her arms wide, spreads the fingers, and seems to grab at things
103. Rooting reflex E) A bond between an infant and his or her parents in which the infant understands that the parents will be responsive to his or her needs
104. Secure attachment F) A bond between an infant and his or her caregiver in which the infant is repeatedly rejected and develops an isolated lifestyle - ANSWER-100. F
105. A
106. D
107. B
108. C
109. E
110. You should perform an urgent move in all of the following situations, EXCEPT: A) if a patient has an altered level of consciousness. B) if the patient is complaining of neck pain.

C) in extreme weather conditions. D) if a patient has inadequate ventilation or shock. - ANSWER-B) if the patient is complaining of neck pain.

107. You may injure your back if you lift: A) with your back curved. B) with your back straight, but bent significantly forward at the hips. C) with the shoulder girdle anterior to the pelvis. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
108. In lifting with the palm down, the weight is supported by the _____ rather than the palm. A) fingers B) forearm C) lower back D) wrist - ANSWER-A) fingers
109. When pulling a patient, you should do all of the following, EXCEPT: A) extend your arms no more than about 15 to 20 inches (38 to 50 cm). B) reposition your feet so that the force of pull will be balanced equally. C) when you can pull no farther, lean forward another 15 to 20 inches (38 to 50 cm). D) pull the patient by slowly flexing your arms - ANSWER-C) when you can pull no farther, lean forward another 15 to 20 inches (38 to 50 cm).
110. You should use a rigid _____, often called a Stokes litter, to carry a patient across uneven terrain from a remote location that is inaccessible by ambulance or other vehicle. A) basket stretcher B) scoop stretcher C) molded backboard D) flotation device - ANSWER-A) basket stretcher
111. You have been called to the scene of a high-speed motor vehicle collision involving two compact cars.The first vehicle was a roll-over, ejecting the driver. The second vehicle contained both a driver and a front-seat passenger who cannot be reached because the door is up against a building. For the passenger in the second vehicle, you may need to perform a(n) _____ on the driver in order to reach the patient. A) extremity lift B) emergency move C) short backboard D) You should do nothing different; treat each patient the same - ANSWER-B) emergency move
112. You should not attempt to lift a patient who weighs more than _____ pounds with fewer than four rescuers, regardless of individual strength. - ANSWER-
113. Be careful that you do not push or pull from a(n) _____ position. - ANSWER- overhead

114. The _______________ is used for patients with no suspected spinal injury who are found lying supine on the ground. - ANSWER-direct ground lift
115. The __________ may be especially helpful when the patient is in a very narrow space or when there is not enough room for the patient and a team of EMTs to stand side by side - ANSWER-extremity lift
116. Flexible stretcher A) Can be folded or rolled up
117. Stair chair B) Used to carry patients up and down stairs
118. Scoop stretcher C) Used to carry and immobilize patients with suspected spinal injuries
119. Backboard D) Specifically designed stretcher that can be rolled along the ground
120. Wheeled ambulance stretcher E) Separates into two or four pieces - ANSWER-
121. A
122. B
123. E
124. C
125. D
126. The scene size-up consists of all of the following, EXCEPT: A) determining the mechanism of injury. B) requesting additional assistance. C) determining level of responsiveness. D) using personal protective equipment (PPE) and standard precautions. - ANSWER-C) determining level of responsiveness.
127. With _____, the force of the injury occurs over a broad area, and the skin is usually not broken. A) motor vehicle collisions B) blunt trauma C) penetrating trauma D) gunshot wounds - ANSWER-B) blunt trauma
128. The best indicator of brain function is the patient's: A) pulse rate. B) papillary response. C) mental status. D) respiratory rate and depth. - ANSWER-C) mental status.
129. A normal respiratory rate for an adult is typically: A) 5 to 10 breaths per minute. C) 15 to 30 breaths per minute. B) 12 to 20 breaths per minute. D) 20 to 30 breaths per minute. - ANSWER-B) 12 to 20 breaths per minute
130. For children younger than 1 year old, you should palpate the _____ artery when assessing the pulse.

A) carotid B) radial C) femoral D) brachial - ANSWER-D) brachial

126. When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray.This condition is called: A) AVPU. B) DCAP-BTLS. C) OPQRST. D) SAMPLE - ANSWER-B) DCAP-BTLS.
127. When there are multiple patients, you should use the _______________ to help organize the triage, logistics, and treatment of patients. - ANSWER-incident command system
128. _____ is the circulation of blood within an organ or tissue. - ANSWER-perfusion
129. A brassy, crowing sound that is prominent on inspiration and suggests a mildly occluded airway is referred to as _____ - ANSWER-stridor
130. If a patient seems to develop difficulty breathing after your primary assessment, you should immediately reevaluate the _____. - ANSWER-airway
131. Skin that is cool, clammy, and pale in your primary assessment typically indicates _____. - ANSWER-hypoperfusion
132. Triage A) The reason a patient called for help
133. Orientation B) The mental status of a patient
134. Chief complaint C) The process of establishing treatment and transport priorities - ANSWER-132. C
135. B
136. A
137. All of the following are signs of hypoxia, EXCEPT: A) tachycardia. B) dehydration. C) cyanosis. D) weak pulse - ANSWER-B) dehydration
138. The proper technique for sizing an oropharyngeal airway before insertion is to measure the device from: A) the tip of the nose to the earlobe. C) the corner of the mouth to the earlobe. B) the bridge of the nose to the tip of the chin. D) the center of the jaw to the earlobe - ANSWER-C) the corner of the mouth to the earlobe.
139. Suctioning the oral cavity of an adult should be accomplished within: A) 5 seconds. B) 10 seconds. C) 15 seconds. D) 20 seconds. - ANSWER-C) 15 seconds.
140. After ___________ minutes without oxygen, brain damage is very likely.

A) 0 to 4 B) 4 to 6 C) 6 to 10 D) more than 10 - ANSWER-C) 6 to 10

139. You come upon an unresponsive patient who is not injured and is breathing on her own with a normal rate and an adequate tidal volume. What would be the advantage of placing her in the recovery position? A) It's the preferred position of comfort for patients. B) It helps to protect the patient's cervical spine when injuries are hidden. C) It helps to maintain a clear airway. D) It's easier to load the patient onto the cot from this position. - ANSWER-C) It helps to maintain a clear airway.
140. You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15 feet (4.6 m) before landing in his current position. There is discoloration and distention of his abdomen about the right upper quadrant. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. What method will you use to keep his airway open? A) Nasal cannula B) Jaw thrust C) Oropharyngeal airway D) All of these answers are correct - ANSWER-C) Oropharyngeal airway
141. While assisting with respirations, you note gastric distention. In order to prevent or alleviate the distention, you should: A) ensure that the patient's airway is appropriately positioned. B) ventilate the patient at the appropriate rate. C) ventilate the patient at the appropriate volume. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
142. Inhalation A) Exchange of air between lungs and the environment
143. Exhalation B) Amount of air moved during one breath
144. Tidal volume C) Active part of breathing
145. Ventilation D) Part of breathing during which thorax size decreases - ANSWER-
146. C
147. D
148. B
149. A
150. The proper dose of a medication depends on all of the following, EXCEPT: A) the patient's age. B) the patient's size. C) generic substitutions. D) the desired action - ANSWER-C) generic substitutions.
151. Nitroglycerin relieves the squeezing or crushing pain associated with angina by: A) dilating the arteries to increase the oxygen supply to the heart muscle.

B) causing the heart to contract harder and increase cardiac output. C) causing the heart to beat faster to supply more oxygen to the heart. D) All of these answers are correct. - ANSWER-A) dilating the arteries to increase the oxygen supply to the heart muscle.

148. The form the manufacturer chooses for a medication ensures: A) the proper route of the medication. B) the timing of the medication's release into the bloodstream. C) the medication's effects on target organs or body systems. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.
149. Epinephrine acts as a specific antidote to: A) adrenaline. B) histamine. C) asthma. D) bronchitis - ANSWER-B) histamine
150. Oral glucose: A) is a suspension. C) is placed between a patient's cheek and gum. B) should be given to all patients. D) is not carried by EMTs - ANSWER-C) is placed between a patient's cheek and gum.
151. _____ is the main hormone that controls the body's fight-or-flight response. - ANSWER-Epinephrine
152. In all but the __________ route, the medication is absorbed into the bloodstream through various body tissues - ANSWER-intravenous injection
153. A(n) _____ is a chemical substance that is used to treat or prevent disease or relieve pain. - ANSWER-medication
154. Absorption A) To bind or stick to a surface
155. Contraindication B) Amount of medication given
156. Side effect C) Therapeutic use for a particular medication
157. Adsorption D) Situation in which a drug should not be given
158. Dose E) Effect that a drug is expected to have
159. Indication F) Any action of a drug other than the desired one
160. Action G) Process by which medications travel through body tissues - ANSWER-
161. G
162. D
163. F
164. A
165. B
166. C
167. E
168. Regulation of blood flow is determined by: [1] oxygen intake. [2] systolic pressure.

[3] cellular need. [4] diastolic pressure. - ANSWER-[3] cellular need.

162. The action of hormones such as epinephrine and norepinephrine stimulates _____ to maintain pressure in the system and, as a result, perfusion of all vital organs. [1] an increase in heart rate [2] an increase in the strength of cardiac contractions [3] vasoconstriction in nonessential areas [4] All of these answers are correct. - ANSWER-[4] All of these answers are correct.
163. Basic causes of shock include: [1] poor pump function. [2] blood or fluid loss. [3] blood vessel dilation. [4] All of these answers are correct - ANSWER-[4] All of these answers are correct
164. Noncardiovascular causes of shock include respiratory insufficiency and: [1] sepsis. [2] metabolism. [3] anaphylaxis. [4] hypovolemia. - ANSWER-[3] anaphylaxis.
165. Neurogenic shock is caused by: [1] a radical change in the size of the vascular system. [2] massive vasoconstriction. [3] low volume. [4] fluid collecting around the spinal cord, causing compression of the cord - ANSWER- Fluid collecting around the spinal cord, causing compression of the cord.
166. You are called to a construction site where a 27-year-old worker has fallen from the second floor. He landed on his back and is drifting in and out of consciousness. A quick assessment reveals no bleeding or blood loss. His blood pressure is 90/60 mm Hg with a pulse rate of 110 beats/min. His airway is open and breathing is within normal limits. You realize the patient is in shock. The patient's shock is due to an injury to the: [1] cervical vertebrae. [2] skull. [3] spinal cord. [4] peripheral nerves - ANSWER-[3] spinal cord.
167. You respond to the local nursing home for an 85-year-old woman who has altered mental status. During your assessment, you notice that the patient has an elevated body temperature. She is hypotensive and her pulse is tachycardic. The nursing staff tells you that she has been sick for several days and that they called because her mental status continued to decline. You suspect the patient is in septic shock. The shock is due to: [1] pump failure.

[2] massive vasoconstriction. [3] widespread dilation. [4] increased volume - ANSWER-[2] massive vasoconstriction.

168. Pressure in the arteries during cardiac _____ is known as systolic pressure. - ANSWER-contraction
169. Blood pressure is a rough measurement of _____. - ANSWER-perfusion
170. _____ are circular muscle walls in capillaries that cause the walls to contract and dilate. - ANSWER-sphincters
171. Shock A) Fainting
172. Perfusion B) Hypoperfusion
173. Autonomic nervous system C) Regulates involuntary body functions
174. Syncope D) Early stage of shock
175. Compensated shock E) Sufficient circulation to meet cell needs - ANSWER-171. B
176. E
177. C
178. A
179. D
180. In a conscious infant who is choking, you would first give five back slaps, followed by: A) attempting to breathe. B) five chest thrusts. C) checking a pulse. D) five abdominal thrusts - ANSWER-B) five chest thrusts.
181. In most cases, cardiac arrest in children results from: A) choking. B) aspiration. C) congenital heart disease. D) respiratory arrest - ANSWER-D) respiratory arrest
182. Once you begin CPR in the field, you must continue until: A) the fire department arrives. B) the funeral home arrives. C) a person of equal or higher training relieves you. D) law enforcement arrives and assumes responsibility - ANSWER-C) a person of equal or higher training relieves you.
183. A _____ is an opening that connects the trachea directly to the skin. A) tracheostomy B) stoma C) laryngectomy

D) None of these answers are correct. - ANSWER-B) stoma

180. The proper hand placement for chest compressions is accomplished by placing the heel of one hand on the sternum: A) between the nipples. C) over the xiphoid process. B) near the clavicles. D) None of these answers are correct. - ANSWER-A) between the nipples
181. Basic life support (BLS) A) Used to maintain an open airway in an adequately breathing patient with a decreased level of consciousness
182. Advanced life support (ALS) B) Valve device that helps to draw more blood back to the heart during chest compressions
183. Cardiopulmonary resuscitation (CPR) C) Steps used to establish artificial ventilation and circulation in a patient who is not breathing and has no pulse
184. Impedance threshold device D) Procedures such as cardiac monitoring, intravenous medications, and advanced airway adjuncts
185. Recovery position E) Noninvasive emergency lifesaving care used to treat airway obstructions, respiratory arrest, and cardiac arrest - ANSWER-181. E
186. D
187. C
188. B
189. A
190. The _____ is your awareness and concern for potentially serious underlying and unseen injuries or illnesses. A) nature of illness B) index of suspicion C) general impression D) clinical impression - ANSWER-B) index of suspicion
191. You should assess pulse, motor, and sensation in all of the extremities and check for pupillary reactions if you suspect a(n) _____ problem. A) cardiovascular B) endocrine C) neurologic D) psychological - ANSWER-C) neurologic
192. The incubation period for hepatitis B is typically: A) 1 to 2 weeks. B) 5 to 10 weeks. C) 4 to 12 weeks. D) 1 to 10 weeks - ANSWER-C) 4 to 12 weeks.
193. ________ is a bacterium that causes infections and is resistant to most antibiotics. A) Meningitis B) Tuberculosis C) Hepatitis C D) MRSA - ANSWER-D) MRSA

190. __________occurs when you become focused on one aspect of the patient's condition and exclude all others - ANSWER-Tunnel vision
191. You should assess vital signs every _____ minutes in an unstable patient and every _____ minutes in astable patient - ANSWER-5;
192. Modes of transportation ultimately come in two categories: _____ and _____. - ANSWER-ground;air
193. __________is transmitted orally through oral or fecal contamination - ANSWER- Hepatitis A
194. Asthma A) Gynecologic
195. Hemophilia B) Respiratory
196. Congestive heart failure C) Endocrine
197. Substance abuse D) Toxicologic
198. Diverticulitis E) Cardiovascular
199. Diabetes mellitus F) Gastrointestinal
200. Pelvic inflammatory disease G) Hematologic - ANSWER-194. B
201. G
202. E
203. D
204. F
205. C
206. A
207. If carbon dioxide levels drop too low, the person automatically breathes: A) normally. B) rapidly and deeply. C) slower and less deeply. D) fast and shallow. - ANSWER-C) slower and less deeply.
208. If the level of carbon dioxide in the arterial blood rises above normal, the patient breathes: A) normally. B) rapidly and deeply. C) slower and less deeply. D) fast and shallow - ANSWER-B) rapidly and deeply.
209. Inflammation and swelling of the pharynx, larynx, and trachea resulting in a "seal bark" cough are typically caused by: A) emphysema. B) chronic bronchitis. C) croup. D) epiglottitis - ANSWER-C) croup.

204. _____ is a sign of hypoxia to the brain. A) Altered mental status C) Decreased respiratory rate B) Decreased pulse rate D) Delayed capillary refill time - ANSWER-A) Altered mental status
205. ____ is a genetic disorder that affects the lungs and digestive system. A) Chronic obstructive pulmonary disease B) Cystic fibrosis C) Pertussis D) Bronchiolitis - ANSWER-B) Cystic fibrosis
206. Asthma produces a characteristic _____ as patients attempt to exhale through partially obstructed air passages. A) rhonchi B) stridor C) wheezing D) rattle - ANSWER-C) wheezing
207. Always consider _____ in patients who were eating just before becoming short of breath. A) upper airway obstruction B) anaphylaxis C) lower airway obstruction D) bronchoconstriction - ANSWER-A) upper airway obstruction
208. _____passes from the blood through capillaries to tissue cells - ANSWER-Oxygen
209. __________is an odorless, highly poisonous gas that results from incomplete oxidation of carbon in combustion - ANSWER-carbon monoxide
210. One sign of foreign body aspiration in a child may be an abnormality in the _____.

• ANSWER-voice

211. A patient with a barrel chest and a "puffing" style of breathing most likely has _____. - ANSWER-emphysema
212. The only vein(s) in the body that carry oxygenated blood is/are the: A) external jugular veins. B) pulmonary veins. C) subclavian veins. D) inferior vena cava. - ANSWER-B) pulmonary veins.
213. When, for a brief period of time, heart tissues do not get enough oxygen, the pain is called: A) acute myocardial infarction. B) angina. C) ischemia. D) coronary artery disease - ANSWER-B) angina.

214. Cardiogenic shock can occur within 24 hours of a(n): A) hypertensive emergency. C) aortic aneurysm. B) acute myocardial infarction. D) unstable angina attack. - ANSWER-B) acute myocardial infarction
215. At 0500 hours, you respond to the home of a 76-year-old man complaining of chest pain. Upon arrival, the patient states that he had been sleeping in the recliner all night due to indigestion, when the pain woke him up. He also tells you he has taken two nitroglycerin tablets. His vital signs are as follows:respirations, 16 breaths/min; pulse, 98 beats/min; blood pressure, 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene? A) Provide high-flow oxygen. C) Apply an AED. B) Administer a third nitroglycerin tablet. D) Begin chest compressions - ANSWER-A) Provide high-flow oxygen
216. _____ allows a cardiac muscle cell to contract spontaneously without a stimulus from a nerve source. - ANSWER-Automaticity
217. _____ are inserted when the electrical control system of the heart is so damaged that it cannot function properly - ANSWER-Pacemakers
218. In general, a maximum of _____ dose(s) of nitroglycerin is/are given for any one episode of chest pain. - ANSWER-3
219. About _____ minutes after blood flow is cut off, some heart muscle cells begin to die. - ANSWER-30
220. _____ is the maximum pressure exerted by the left ventricle as it contracts. - ANSWER-Systolic Blood Pressure
221. Atherosclerosis A) Tissue death
222. Ischemia B) Rapid heart rhythm, greater than 100 beats/min
223. Infarction C) Unusually slow heart rhythm, less than 60beats/min
224. Tachycardia D) Calcium and cholesterol buildup inside bloodvessels
225. Thromboembolism E) Lack of oxygen
226. Bradycardia F) Blood clot floating through blood vessels until itreaches a narrow area and blocks blood flow - ANSWER-221.D 222.E 223.A 224.B 225.F 226.C
227. When blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel, the result is: A) a hemorrhagic stroke.

B) atherosclerosis. C) an ischemic stroke. D) a cerebral embolism - ANSWER-C) an ischemic stroke.

228. Patients with a subarachnoid hemorrhage typically complain of a sudden severe: A) bout of dizziness. B) headache. C) altered mental status. D) thirst - ANSWER-B) headache.
229. Hypoglycemia can mimic conditions such as: A) cystic fibrosis. B) myocardial infarction. C) high fever. D) stroke - ANSWER-D) stroke
230. The principal difference between a patient who has had a stroke and a patient with hypoglycemia almost always has to do with the: A) papillary response. B) mental status. C) blood pressure. D) capillary refill time - ANSWER-B) mental status
231. Headache, vomiting, altered mental status, and seizures are all considered early signs of: A) increased intracranial pressure. C) increased extracranial pressure. B) decreased intracranial pressure. D) decreased extracranial pressure - ANSWER-A) increased intracranial pressure
232. You are called to a home and find a 56-year-old woman supine in her bed. She appears alert but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient, "What day is it today?" Her reply is, "Butterfly." Which area of the brain is likely affected? A) Occipital lobe B) Left hemisphere C) Cerebellum D) Right hemisphere - ANSWER-B) Left hemisphere
233. The __________ controls the most basic functions of the body, such as breathing, blood pressure, swallowing, and pupil constriction. - ANSWER-brain stem
234. At each vertebra in the neck and back, two nerves, called _______ nerves, branch out from the spinal cord and carry signals to and from the body. - ANSWER-spinal
235. _____is a loss of bowel and bladder control and can be due to a generalized seizure - ANSWER-Incontinence
236. __________may reverse stroke symptoms and even stop the stroke if given within 3 to 6 hours of on set of symptoms - ANSWER-Thrombolytic therapy

237. Aneurysm A) A period following a seizure that typically includes labored respirations and altered mental status
238. Aphasia B) An inability to produce or understand speech
239. Aura C) A sense of warning experienced prior to an event
240. Hemiparesis D) Weakness of one side of the body
241. Postictal state E) A swelling or enlargement of part of an artery resulting from weakness of the arterial wall - ANSWER-237.E 238.B 239.C 240.D 241.A
242. Severe back pain may be associated with which of the following conditions? A) Abdominal aortic aneurysm B) Pelvic inflammatory disease C) Appendicitis D)Mittelschmerz - ANSWER-A) Abdominal aortic aneurysm
243. _______ commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night. A) A peptic ulcer B) Cholecystitis C) Appendicitis D) Pancreatitis - ANSWER-B) Cholecystitis
244. ______ occur(s) when there is excess pressure within the portal system and surrounding vessel and may lead to life-threatening bleeding. A) Esophageal rupture B) Esophageal varices C) Esophageal ulcers D) Esophageal reflux - ANSWER-B) Esophageal varices
245. You have been dispatched to the home of a 52-year-old woman with severe flank pain. Which of the following would be an appropriate question to ask regarding the pain? A) Have you experienced any belching? C) Is the pain constant or intermittent? B) Do you feel nauseous? D) Have you been urinating more or less? - ANSWER-C) Is the pain constant or intermittent?
246. When the abdominal muscles become rigid in an effort to protect the abdomen from further irritation, this is referred to as: A) guarding. B) tenderness. C) rebound tenderness. D) referred pain. - ANSWER-A) guarding

247. A(n) _____ is the protrusion of a loop of an organ or tissue through an abnormal body opening. - ANSWER-hernia
248. _____ is complete obstruction of blood circulation in a given organ as a result of compression or entrapment - ANSWER-strangulation
249. _____describes severe kidney failure resulting in the buildup of waste products within the blood - ANSWER-Uremia
250. __________ are solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts of uric acid crystallizing in the urine - ANSWER-kidney stones
251. Ileus A) A condition of sudden onset of pain within the abdomen
252. Retroperitoneal B) Paralysis of the bowel
253. Referred pain C) Behind the peritoneum
254. Peritonitis D) Inflammation of the peritoneum
255. Peritoneum E) Pain felt in an area of the body other than where the cause of the pain is located
256. Acute abdomen F) A membrane lining the abdomen - ANSWER-251.B 252.C 253.E 254.D 255.F 256.A
257. Normal blood glucose levels range from _____ mg/dL. A) 80 to 120 B) 90 to 140 C) 70 to 110 D) 60 to 100 - ANSWER-A) 80 to 120
258. The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as: A) diabetic ketoacidosis. C) hyperosmolar hyperglycemic non ketotic coma. B) insulin shock. D) hypoglycemia. - ANSWER-A) diabetic ketoacidosis
259. The onset of hypoglycemia can occur within: A) seconds. B) minutes. C) hours. D) days. - ANSWER-B) minutes
260. Blood glucose levels are measured in: A) micrograms per deciliter. C) milliliters per decigram. B) milligrams per deciliter. D) microliters per decigram. - ANSWER-B) milligrams per deciliter
261. A 54-year-old golfer collapsed on the 17th green at the golf course. His friend said he wasn't feeling well after the eighth hole, but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. An initial blood glucose measurement indicates 65 mg/dL. The patient loses consciousness and a second blood glucose level reads 48 mg/dL.You should:

A) call for, or rendezvous with, an ALS unit. C) provide high-flow oxygen. B) ensure a patent airway. D) All of these answers are correct. - ANSWER-D) All of these answers are correct.

262. Type 1 diabetes is considered to be a(n) _____ problem, in which the body becomes allergic to its own tissues and literally destroys them - ANSWER-autoimmune
263. Hormone A) Inherited disease that affects red blood cells
264. Insulin B) Disorder that causes an inability to develop blood clots
265. Type 1 diabetes C) Hormone that enables glucose to enter the cells
266. Type 2 diabetes D) Chemical produced by a gland that regulates body organs
267. Sickle cell disease E) A tendency to develop blood clots
268. Glucose F) Primary fuel, along with oxygen, for cellular metabolism
269. Hyperglycemia G) Extremely high blood glucose level
270. Hemophilia H) Diabetes that usually starts in childhood; requires insulin
271. Thrombophilia I) Diabetes with onset later in life; may be controlled by diet and oral medication - ANSWER-263.D 264.C 265.H 266.I 267.A 268.F 269.G 270.B 271.E
272. Anaphylaxis is not always life threatening, but it typically involves: A) multiple organ systems. B) wheezing. C) urticaria. D) wheals - ANSWER-A) multiple organ systems.
273. Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to: A) raise the pulse rate and blood pressure. C) relieve bronchospasm. B) inhibit an allergic reaction. D) All of these answers are correct - ANSWER-D) All of these answers are correct
274. You should not use tweezers or forceps to remove an embedded stinger because: A) squeezing may cause the stinger to inject more venom into the wound. B) the stinger may break off in the wound. C) the tweezers are not sterile and may cause infection. D) removing the stinger may cause bleeding - ANSWER-A) squeezing may cause the stinger to inject more venom into the wound.