Emergency Medical Procedures and Protocols, Exams of Nursing

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A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should: - ANSWER-administer 15 g of activated charcoal. A patient who has experienced a back injury, with or without spinal cord damage, would be triaged with a ___________ tag during a mass-casualty incident - ANSWER-yellow An unconscious patient found in a prone position must be placed in a supine position in case he or she: - ANSWER-requires CPR Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should: - ANSWER-Provide emotional support to the mother Substance abuse is MOST accurately defined as: - ANSWER-knowingly misusing a substance to produce a desired effect. Both areas of the pons are sued to: - ANSWER-augment respiration during physical or emotional stress A transient ischemia attack (TIA) occurs when: - ANSWER-a small clot in a cerebral artery causes temporary symptoms. A decrease in blood pressure may indicate: - ANSWER-a loss of vascular tone

Ketone production is the result of: - ANSWER-fat metabolization when glucose is unavailable. A partial-thickness burn involves the outer layer of skin and a portion of the: - ANSWER-dermal layer A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding and the patient states that she cannot see out of the injured eye. You should: - ANSWER-avoid applying pressure to the globe when you are covering the eye. At rest, the normal adult heart rate should not exceed: - ANSWER-100 beats/min Delivering a patient to the hospital involves all of the following activities, EXCEPT: - ANSWER-giving a verbal report to the clerk Common names for activated charcoal include all of the following, EXCEPT: - ANSWER-Fructose As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the: - ANSWER-alveoli Common signs and symptoms of AMI include all of the following EXCEPT: - ANSWER-pain exacerbated by breathing Breathing occurs as the result of a(n): - ANSWER-increase in carbon dioxide, which decreases the pH of the CSF During the alert and dispatch phase of EMS communications, the dispatcher's responsibilities include all of the following, EXCEPT: - ANSWER-discouraging the caller from providing care until the EMS unit arrives Initial signs and symptoms associated with viral hemorrhagic fevers include: - ANSWER-headache and sore throat

pain, and a closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert, but has bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you assign to these patients? - ANSWER-Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black) As an EMT, the performance of your duties will be compared to that of: - ANSWER-another EMT If hydroplaning of the ambulance occurs, the driver should: - ANSWER-gradually slow down without jamming on the brakes. All of the following biological agents or diseases can be transmitted from person to person, EXCEPT: - ANSWER-ricin A 23 year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretion in his mouth. How should you manage his airway? - ANSWER-Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilations. A 38 year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless and apneic. A coworker has shut off the power to the house. You should: - ANSWER-begin CPT and apply the AED. A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he: - ANSWER-is experiencing difficulty breathing. Pelvic inflammatory disease (PID) typically does NOT affect the: - ANSWER-urinary bladder. Cardiac monitoring, pharmacological interventions, and other advanced treatment skills are functions of the: - ANSWER-AEMT It would be MOST appropriate from a patient to take his or her prescribed nitroglycerin when experiencing: - ANSWER-chest pain that does not immediately subside with rest.

Acute pulmonary edema would MOST likely develop as the result of: - ANSWER-toxic chemical inhalation Activities such as walking, talking, and writing are regulated exclusively by the: - ANSWER-somatic nervous system When the level of arterial carbon dioxide rises above normal: - ANSWER-respirations increase in rate and depth An air embolism associated with diving occurs when: - ANSWER-the driver holds his or her breath during a rapid ascent Most prehospital cardiac arrests occur as the result of: - ANSWER-a cardiac dysrhythmia A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would MOST likely control the bleeding? - ANSWER-apply a topical hemostatic agent with direct pressure A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to of to the hospital. Under these circumstances, you should: - ANSWER-assess whether the patient's mental condition is impaired. Braxton-Hicks contractions are characterized by: - ANSWER-alleviation of pain with movement or changing positions You are transporting a 33 year-old male who has involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: - ANSWER-reassess his condition in 5 minutes. A functional disorder is a: - ANSWER-physiological disorder in the absence of a structural abnormality.

bubbling from it. You should: - ANSWER-apply an occlusive dressing to the wound and continue your assessment A strangulated hernia is one that: - ANSWER-loses its blood supply due to compression by local tissues. A critical function of the safety officer is to: - ANSWER-stop an emergency operation whenever a rescuer is in danger. After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should: - ANSWER-monitor her closely but recall that anxiery and tachycardia are side effects of epinephrine Bacterial vaginosis is a condition that occurs when: - ANSWER-normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms A 39 year-old female experienced a severe closed head injury. She is unconscious with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should: - ANSWER-close her eyes and cover them with a moist dressing. General guidelines for managing a patient with a behavioral emergency include: - ANSWER-using 10 codes to ensure radio traffic confidentiality A portable oxygen cylinder should have a minimum capacity of ___________ of oxygen. - ANSWER-500 L Neurogenic shock occurs when: - ANSWER-failure of the nervous system causes widespread vasodilation. Covering a patient's _________ will significantly minimize radiation heat loss. - ANSWER-head Situations in which you should use the rapid extrication technique include all of the following, EXCEPT: - ANSWER-a patient who can be properly assessed while still in the vehicle

Hyperventilation could be associated with all of the following, EXCEPT: - ANSWER-a narcotic overdose An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: - ANSWER-adequate air exchange. After assisting your patient with prescribed nitroglycerin, you should - ANSWER-reassess his or her blood pressure within 5 minutes to detect hypotension. A disposable oxygen humidifier should be considered for ambulance services that often transport patents for _______ hour(s) or more: - ANSWER- 1 Epinephrine is indicated for patients with an allergic reaction when: - ANSWER-wheezing and hypotension are present. A 40 year-old male crashes his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: - ANSWER-open his airway with the jaw-thrust maneuver. A 15 year-old male was killed when he struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should: - ANSWER-advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. In contrast to abruptio placenta, placent previa: - ANSWER-may not present with heavy vaginal bleeding. An appropriate demonstration of professionalism when your patient is frightened, demanding, or unpleasant is to: - ANSWER-continue to be nonjudgmental, compassionate, and respectful. A 52-year-old male presents with a fever of 102.5°F and a severe headache. As you assess him, you note the presence of multiple blisters on his face and chest, which are all identical in shape and size. This patient's clinical presentation is MOST consistent with: - ANSWER-smallpox

respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today? - ANSWER-High blood pressure Age-relating changes in the renal system result in: - ANSWER-a decreased ability to clear wastes from the body and a decreased ability to conserve fluids when needed. When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: - ANSWER-rate and depth of breathing. A young male is unresponsive after overdosing on an opioid. He is not breathing and his pulse is weak. The EMT should immediately: - ANSWER-ventilate with a BVM. A 40 year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an implanted pacemaker. The AED advises that a shock is indicated. What should you do? - ANSWER-Deliver the shock followed by immediate resumption of CPR. During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: - ANSWER-she is not in ventricular fibrillation. A ventilation/perfusion (V/Q ratio) mismatch occurs when: - ANSWER-a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen. Common signs and symptoms of acute hyperventilation syndrome include: - ANSWER-tachypnea and tingling in the extremities. A patient who does not respond to your questions, but moves or cries out when his or her trapezius muscle is pinched, is said to be: - ANSWER-responsive to painful stimuli. According to Occupational Safety and Health Administration (OSHA) regulations, an employer must: - ANSWER-offer a workplace environment that reduces the risk of exposure.

A 50 year-old male presents with an altered mental status. His wife tells you that he had a "small stroke" 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should: - ANSWER-prepare for immediate transport. Based on current guidelines, in which of the following situations should supplement oxygen be administered? - ANSWER-Exposure to carbon monoxide and an oxygen saturation of 95% At what age does separation anxiety typically peak in infants and small children? - ANSWER-10 to 18 months At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: - ANSWER-44% Alkalosis is a condition that occurs when: - ANSWER-blood acidity is reduced by excessive breathing. A disease vector is defined as: - ANSWER-any agent that acts as a carrier or transporter in general, injected poisons are impossible to dilute or remove because they: - ANSWER-are usually absorbed quickly into the body. Dyspnea is MOST accurately defined as: - ANSWER-shortness of breath or difficulty breathing. A 40 year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: - ANSWER-liver dysfunction In the eyes of the court, an incomplete or untidy patient care form indicates: - ANSWER-inadequate patient care was administered. According to the terminal drop hypothesis: - ANSWER-mental function is presumed to decline in the 5 years preceding death.

Common signs and symptoms of acute hyperventilation syndrome include: - ANSWER-cool, clammy skin Functions of the liver include: - ANSWER-secretion of bile and filtration of toxic substances. According to the National EMS Scope of Practice Model, an EMT should be able to: - ANSWER-insert a peripheral intravenous catheter Factors that contribute to a decline in the vital capacity of an elderly patient include all of the following, EXCEPT: - ANSWER-increased surface area available for air exchange As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the: - ANSWER-mouth-to-mouth mask technique with a one way valve. Febrile seizures: - ANSWER-are usually benign but should be evaluated. Common side effects of epinephrine include all of the following, EXCEPT: - ANSWER-drowsiness Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: - ANSWER-slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid. Chronic renal failure is a condition that: - ANSWER-is often caused by hypertension or diabetes. Blood that is ejected from the right ventricle: - ANSWER-flows into the pulmonary arteries. Each ovary produces an ovum in alternating months and releases it into the: - ANSWER-fallopian tube. Cardiac output may decrease if the heart beats too rapidly because: - ANSWER-there is not enough time in between contractions for the heart to refill completely. Activated charcoal may be indicated for a patient who ingested: - ANSWER-aspirin

The eyeball itself is referred to as the: - ANSWER-globe Before giving activated charcoal, you should: - ANSWER-obtain approval from medical control. A 25 year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardia. He has track marks on both arms. The EMT should: - ANSWER-insert a nasal airway and ventilate with a BVM. Nerve agents, a class of chemicals called organophosphates, were first discovered while in search of a superior: - ANSWER-pesticide. An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. - ANSWER-100 mL In contrast to AMI, a dissecting aortic aneurysm: - ANSWER-often presents with pain that is maximal from the onset Shortly after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct? - ANSWER-A mentally competent adult can withdraw his or her consent to treat at any time Fetal complications associated with drug-or alcohol- addicted mothers include all of the following, EXCEPT: - ANSWER-profound tachycardia The mental status of a patient who has experienced a generalized seizure: - ANSWER-is likely to improve over a period of 5 to 30 minutes In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: - ANSWER-self-supporting and lives by himself or herself.

adequately; however, he is restless and his skin is diaphoretic. You should: - ANSWER-apply direct pressure to the wound. _______ pressure is the pressure exerted by a liquid that occurs when blood moves through an artery at relatively high pressures. - ANSWER-Hydrostatic A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has MOST likely experienced: - ANSWER-a detached retina A Patient in respiratory arrest at the scene of a multiple casualty incident would typically be classified as a fourth priority (black tag; expectant) patient, unless: - ANSWER-there are enough resources to provide care for him or her. Most medical models base a pregnant woman's due date: - ANSWER-on the first day of her last menstrual cycle. The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: - ANSWER-brain stem. Acute coronary syndrome (ACD) is a term used to describe: - ANSWER-a group of symptoms that are caused by myocardial ischemia Anterior to the knee is a specialized bone called the: - ANSWER-patella The cricoid cartilage: - ANSWER-is the only complete circular cartilage of the trachea. Airborne substances should be diluted with: - ANSWER-oxygen A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: - ANSWER-a wheel

A 75 year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should: - ANSWER-retreat and notify law enforcement personnel In contrast to the sympathetic nervous system, the parasympathetic nervous system: - ANSWER-slows the heart and respiratory rates Symptoms of both inhaled and ingested ricing include: - ANSWER-fever and headache If a newborn's heart rate is less than 60 beats/min following delivery, you should: - ANSWER-provide ventilations for 30 seconds A patient with high blood pressure would be expected to have skin that is: - ANSWER-flushed and red Which of the following MOST accurately describes septic shock? - ANSWER-Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation Botulinum is: - ANSWER-a potent bacterial neurotoxin An EMS provider who has extensive training in various aspects of advanced life support (ALS) is called a(n): - ANSWER-advanced EMT (AMET) At the scene of a motor vehicle crash, you determine that these are two critically injured patients and that another ambulance is needed. You attempt to contract the dispatcher with your portable radio but are unsuccessful. You should: - ANSWER-use the mobile radio in the ambulance to contact dispatch. All critical life functions are coordinated in which part of the brain? - ANSWER-brain stem A 51 year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: - ANSWER-administer oxygen via a non-rebreathing mask

A patient's refusal of EMS treatment and/or transport be: - ANSWER-an informed refusal A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9- 1 - 1. The MOST likely cause of this patient's present condition is: - ANSWER-cardiogenic hypoperfusion A laceration: - ANSWER-is a jagged cut caused by a sharp object or blunt force trauma. Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine funds and allowing the mother to breastfeed, the bleeding stops. This occurs because: - ANSWER-these actions simulate the production of oxytocin and cause uterine contraction A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first: - ANSWER-follow appropriate standard precautions Which of the following statements regarding anaphylactic shock is correct? - ANSWER-Subsequent exposure after sensitization often produced a more severe reaction. A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious, and has a patent airway and adequate breathing. You should: - ANSWER-ask the daughter how her father normally behaves. An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the MOST appropriate method of immobilizing this patient? - ANSWER- Leave her on her side and use blanket rolls to immobilize her to the long backboard. Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should: - ANSWER-explain to her that you will assist her ventilations. A person's ability to shiver is lost when his or her body temperature falls below: - ANSWER-90F (32C)

Phosgene (CG) has an odor that resembles: - ANSWER-cut grass According to the National EMS Scope of Practice Model, an EMT should be able to: - ANSWER-assist a patient with certain prescribed medications A crackling sound produced by air bubbles under the skin is called: - ANSWER-subcutaneous emphysema An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than: - ANSWER-500 psi An EMT may administer aspirin to a patient if: - ANSWER-authorization from medical control has been obtained Heat loss from the body through respiration occurs when: - ANSWER-warm air is exhaled into the atmosphere. A female is unresponsive due to being hit in the head with a board. She has a large hematoma on her forehead. You should Assess her airway Check for a pulse Obtain consent to treat Manually stabilize the spine - ANSWER-Manually stabilize the spine Which is the BEST way to assess breathing in an unconscious patient? Watch for chest rise