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Emergency Medical Procedures and Protocols, Exams of Advanced Education

A range of emergency medical procedures and protocols that emts and first responders need to be familiar with. It includes information on managing patients with infectious diseases like hiv, tb, and hepatitis b, as well as guidelines for assessing and treating patients with various medical and traumatic conditions. Proper use of equipment like hepa respirators, aeds, and oxygen delivery devices. It also covers assessment techniques, such as checking for pulses, evaluating mental status, and monitoring vital signs. Additionally, the document provides guidance on specific interventions like cpr, wound care, and airway management. This comprehensive overview of emergency medical practices and decision-making processes would be valuable for students in healthcare fields, particularly those training to become emts, paramedics, or other first responders.

Typology: Exams

2024/2025

Available from 10/20/2024

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EMT BASIC PRACTICE EXAM 1

EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact with contact with patients who have which of the following? A. HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome) B. Tuberculosis (TB) C. Open Wounds D. Hepatitis B - B. Tuberculosis HEPA respirators are worn when in contact with patients airborne infections such as TB. HIV/AIDS and Hepatitis B are both blood-borne pathogens. Contaminants from open wounds would also be blood-borne. You are called to assist a 60-year-old female who complains of a severe headache. Upon entering the home, you smell a strong odor of natural gas. What is your first reaction? A. Check the patient's airway, breathing, and circulation. B. Insert a nasopharyngeal airway and assess vital signs. C. Remove the patient from the house to your ambulance. D. Open all windows and determine the source of the gas leak. - C. Remove the patient from the house to your ambulance. Your first action should be to remove your crew and the patient from the possible noxious gas and to notify the gas company of the leak. You may also be required to alert hazardous material response team. Treatment for the patient will begin with an ABC assessment and management of any problems you might encounter. The most common electrical rhythm disturbance that results in sudden cardiac arrest. A. Pulseless Electrical Activity B. Ventricular Fibrillation C. Ventricular Tachycardia D. Asystole - B. Ventricular Fibrillation Because ventricular fibrillation is the most common cause of sudden cardiac arrest., it is critical to apply an AED on an unconscious apneic and pulseless patient as quickly as possible. The other rhythms can also cause a patient to be in cardiac arrest, but they do not occur as frequently as "V-fib". Which of the following is the highest priority patient? A. 57-year-old male with chest pain and systolic blood pressure of 80. B. 40-year-old female with moderate pain from a leg injury. C. 75-year-old male who appears confused but responds to commands. D. 25-year-old female in labor with contractions six minutes apart. - A. 57-year-old male with chest pain and systolic blood pressure of 80.

The patient with chest pain and systolic blood pressure less than 100 is the highest priority patient of the four. A leg injury may be life-threatening if the femoral artery is injured, but most often, a single extremity injury is not a threat to life. The elderly gentleman may be exhibiting his normal mental status, or he may be having problems due to an ongoing health problem. You need more information before you can make that determination, but he is not in any imminent danger right now. Labor with contractions 6 minutes apart is not considered imminent delivery. If you have any questions, however, you should continue assessing this patient as well by asking pertinent questions and checking for crowning. Of the following, which body fluid has the most potential to transmit blood-borne diseases? A. Nasal Discharge B. Vomitus C. Amniotic Fluid D. Feces - C. Amniotic Fluid Fluids containing blood have the highest potential for disease transmission. Your patient is an 11-month-old female. How can you determine if she has a decreased mental status and is responsive to verbal stimuli? A. She will be upset when you take her from her mother's arms. B. She will be unable to tell you how old she is if you ask her. C. She will attempt to locate her parents' voices when they speak. D. She will try to pull away from a painful stimulus on her toe. - C. She will attempt to locate her parents' voices when they speak. An infant who is alert to verbal stimuli will still try to locate the parents' voices; choice A describes an alert infant; choice D describes an infant who is responsive to painful stimuli; choice B is incorrect because infants of this age are not developed enough to tell you their age regardless of their mental status. What is the best method to assess circulation in an infant? A. Palpate the carotid pulse. B. Palpate the brachial pulse. C. Palpate the radial pulse. D. Observe capillary refill time. - B. Palpate the brachial pulse. Assess circulation in an infant by palpating the brachial pulse in the upper arm. The carotid and radial pulses are difficult to locate in infants. Capillary refill time shows that the patient has impaired circulation, but it is not the first tool to use in assessing circulation because it is affected by external factors (like the environment) as well as internal factors like poor perfusion.

A 45-year-old male is experiencing chest discomfort. After placing him in his position of comfort, your next action should be? A. Ventilate the patient with a nonrebreather mask at 15 L/min. B. Ventilate the patient with the bag-valve mask at 15 L/min. C. Administer oxygen by rebreather mask at 15 L/min. D. Administer oxygen by the nasal cannula at 6 L/min. - C. Administer oxygen by rebreather mask at 15 L/min. There is no information to indicate that the patient requires ventilatory support. Any patient experiencing chest discomfort should receive the highest possible concentration of oxygen. Which patient should receive a rapid trauma survey to determine hidden injuries? A. Alert 2-year-old child in a car seat who was in a medium speed crash. B.Alert 20-year-old male who fell 10 feet off of a ladder. C. Alert 65-year-old female who fell in the bathtub and is complaining of wrist pain. D. Alert 11-year-old female who tripped while roller skating and fell down three steps. - A. Alert 2-year-old child in a car seat who was in a medium speed crash. The rapid trauma survey is used when you are unsure of the presence of hidden injuries or f the mechanism of injury (MOI) is unclear or severe enough to suggest the need for a rapid assessment. A 2-year-old child could be severely injured by a medium speed collision, even if he or she appears alert and was properly restrained. The other choices do not represent MOIs considered to be high risk for hidden injury. Which of the following is a sign of increased pressure in the circulatory system? A. Flat neck veins B. Palpable carotid pulse C. Distended jugular veins D. Decreased radial pulse - C. Distended jugular veins A supine patient may or may not have jugular veins that are prominent enough to palpate. However, even if the neck veins are normally present when an individual is supine, they will not be engorged with blood and overly firm to the touch. This is what is meant by the phrase distended neck veins. Distended neck veins (in any position) are a sign of increased circulatory pressure. The carotid pulse should always be palpable. A decreased radial pulse may indicate hypovolemic shock or an injured extremity. An automated external defibrillator (AED) will shock which if the following rhythms? A. Sinus Rhythm B. Asystole C. Ventricular Fibrillation D. Pulseless Electrical Activity - C. Ventricular Fibrillation The other rhythms do not benefit from an electrical shock. The purpose of early defibrillation is to stop a highly chaotic, disorganized electrical rhythm such as

ventricular fibrillation, with the hope that an organized rhythm will begin and generate a pulse. To assess the motor function in the lower extremities of a responsive patient, you would... A. Ask the patient to bend his knee B. Ask the patient to wiggle his toes C. Carefully move the patient's leg D. Touch the skin of the patient's foot - B. Ask the patient to wiggle his toes Assess the motor function by asking the patient to wiggle his toes; moving the leg or having the patient bend the knee can compromise spinal stability; option D describes assessment of sensation, not motor function. Which patient can safely receive only a focused physical examination rather than a rapid trauma survey? A. 10-year-old male with a deformed right lower leg who is responsive after falling off his bicycle. B. 20-year-old female who complains of severe pain in her ankle after stepping off a curb. C. 70-year-old male who complains of neck pain after a medium speed collision. D. 30-year-old male who is unresponsive but has only minor cuts on the extremities. - B. 20-year-old female who complains of severe pain in her ankle after stepping off a curb. Patient B is the only one both responsive and who has no significant MOI. You are using the OPQRST acronym to assess a responsive medical patient. What question would you ask to assess the P component? A. What were you doing when the pain started? B. Can you describe the character of the pain for me? C. What makes the pain worse or better? D. On a scale of 1-10, how would rank the pain? - C. What makes the pain worse or better? The P component of OPQRST acronym refers to provocation or palliation, or what makes the pain feel worse or better. What is the first step in the physical assessment of an unresponsive medical patient? A. Perform the initial assessment B. Assess a complete set of vital signs C. Position the patient to protect the airway D. Obtain SAMPLE history from a family member - A. Perform the initial assessment You should perform the initial assessment first because the unresponsive patient cannot direct you to the specific complaint. Vital signs are completed during your second phase of patient assessment after you determine treatment priority and have a baseline ABC

assessment. You cannot determine the appropriate course of treatment of any airway problem (including the need for positioning - chocie C until you have first assessed the airway. The SAMPLE is important information to gather, but it should never come before any treatment that may be needed to correct an ABC abnormality. Which patient needs a detailed physical examination? A. 48-year-old male with a history of heart disease who is complaining of chest pain B. 35-year-old female who has been in a single car collision and who briefly lost consciousness C. 28-year-old full-term pregnant woman whose water has broken and who is having contractions every 2 minutes D. 53-year-old female with a history of smoking who is distressed and short of breath - B. 35-year-old female who has been in a single car collision and who briefly lost consciousness Trauma and medical patients who are unresponsive and all patients who have an altered mental status should receive a detailed physical examination. It is easy to overlook something when the patient is not conscious enough to tell what hurts or if the MOI and nature of illness (NOI) are unclear. Where is a detailed physical exam typically performed? A. At the scene of the accident or injury B. In the hospital emergency department C. In the ambulance during transport D. In the triage area of the trauma center - C. In the ambulance during transport The detailed physical assessment is usually performed in the back of the ambulance during transport; its purpose is to reveal hidden injuries that escaped the initial rapid assessment. The purpose of the ongoing assessment is to re-evaluate the patient's condition and to... A. Find any injuries missed during the initial assessment B. Reassure the patient that you are still caring for him or her C. Check the adequacy of each intervention performed D. Protect the EMT against liability malpractice - C. Check the adequacy of each intervention performed The purpose of the ongoing assessment is to check the adequacy of your initial interventions. The detailed examination is designed to find missed injuries. Immediately after delivering a shock with an AED to a patient in cardiac arrest, you should A. Check for a pulse B. Check for breathing and provide rescue breaths as necessary C. Analyze with the AED and shock again if needed

D. Do CPR - D. Do CPR American Heart Association guidelines advise that even if there is an organized rhythm, a pulse will not be palpable immediately after a shock. CPR is crucial to maintaining blood flow and ventilation during this time. You should apply an AED to A. Adult patients experiencing chest discomfort B. Adult patients with significant traumatic injuries C. Adult patients without respirations or a pulse D. Adult patients with low blood pressure - C. Adult patients without respirations or a pulse Only those patients that are unresponsive, pulseless, and apneic should have the AED applied. In which of the following situations should you call for immediate assistance? A. You must care for two critical patients with gunshot wounds. B. You patient is a 26-year-old female in active labor. C. Your patient is a child with fever who has had a brief seizure. D. Your partner is needed to stabilize the cervical spine. - A. You must care for two critical patients wih gunshot wounds. You could make the argument that you need additional help in the management og each of these situations; however, the one with the most critical need is when you must care for more than one critical patient. Both patietns with gun shot wounds need immediate attention, so you should call for backup. In the other three situations, you should not require assistance unless some complicating factor presents itself. Patient B may or may not require ALS assistance, but most (over 80%) deliveries are simple and uncomplicated and can easily be managed by basic life support (BLS) providers. PAtient C is having a febrile seizure, which i managed by stabiloizing the ABCs and transporting. In patient D, even if your partner is required to stabilize the ncervial spine, you should bw able to manage the patient for the time being until other assistnce arrives to assist with packing and and moving the patient. What is the structure that prevents food and liquid from entering the trachea during swallowing? A. Larynx B. Cricoid Cartilage C. Epiglottis D. Diaphragm - C. Epiglottis The epiglottis is the leaf-shaped structure that closes off the trachea during swallowing. The larynx is the voice box, the structure that produces speech vibrations; the cricoid cartilage forms the lower portion of the larynx; the diaphragm is a large muscle that contracts to initiate inhalation.

The air sacs in the lungs where oxygen-carbon dioxide exchange occurs are the... A. Bronchioles B. Bronchi C. Epiglottis D. Alveoli - D. Alveoli The alveoli are the numerous minute air sacs that make up the lungs; bronchioles are small branches of the bronchi, which are the two main tubes branching from the trachea; the epiglottis is the leaf-shaped structure that closes off the trachea during swallowing. Pink or bloody sputum is often seen in patients with... A. Pulmonary Edema B. Anaphylaxis C. Allergic Reaction D. Flu - A. Pulmonary Edema Other symptoms of pulmonary edema may include difficulty breathing, excessive sweating, anxiety, and pale skin. Which occurs during capillary-cellular exchange? A. Oxygen enters the capillaries as carbon dioxide enters the alveoli. B. Oxygen-poor blood from the capillaries passes into the alveoli. C. Body cells give up carbon dioxide and capillaries give up oxygen. D. Body cells obtain nourishment from the capillaries. - C. Body cells give up carbon dioxide and capillaries give up oxygen. During capillary-cellular exchange, oxygen enters the body cells and carbon dioxide enters the capillaries; choices A and B describe alveolar-capillary exchange; choice D describes cellular digestion. Which of the following is a sign of inadequate breathing? A. Warm, dry skin B. No audible sounds C. Equal chest expansion D. Accessory muscle use - D. Accessory muscle use Accessory muscles may be seen in use in the neck and as retractions above the clavicles and/or between the ribs. These muscles are used when greater than normal inspiratory and/or expiratory pressures are needed to move air. Normal breathing does not produce any audible sounds, but it will produce ausculatory sounds (heard witha stethoscope). Warm, dry skin and equal chest expansion are both sign of adequate breathing.

A patient complaining of facial paralysis on one side of his face with tearing, localized pain, and sensitivity may be suffering from the most common form of facial paralysis called __________. A. Dystonia B. Muscular dystrophy C. Amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) D. Bell's palsy - D. Bell's Palsy Bell's palsy is the most common form of facial paralysis. Muscular dystrophy is a degenerative disease characterized by the weakening of skeletal muscles. ALS, a.k.a Lou Gehrig's disease affects the nerve cells that control voluntary movement. Dystonia describes repetitive motions or abnormal posturing. A gurgling sound heard with artificial ventilation is a sign that... A. The patient must suctioned immediately. B. Supplemental oxygen should be added to the gas-valve mask. C. The airway is most likely open, patent, and clear. D. The patient is trying to communicate with you. - A. The patient must be suctioned immediately. A gurgling sound means that the patient needs to be suctioned immediately; ventilation cannot be adequate when the airway is blocked from mucous, blood, or other secretions. The first step in artificial ventilation with a bag-valve-mask unit in patients with no suspected trauma is to... A. Position the mask correctly on the face using both hands. B. Place the patient's head in a hyper-extended, sniffing position. C. Insert an airway adjunct and select the correct mask size. D. Have an assistant squeeze the bag until the patient's chest rises. - B. Place the patient's head in a hyper-extended, sniffing position. The correct order of steps is B, C, A, D. You take a report from a first responder who describes a patient as postictal; based on this report, you would expect to find to find the patient... A. Alert and oriented B. Confused C. Unresponsive D. Hallucinating - B. Confused The seizure event is referred to as -ictal, hence postictal refers to the period after the seizure wherein a patient is often confused for a period of time. When suctioning a patient, how far should you insert a soft suction catheter? A. As far as you can see

B. As far as the base of the tongue C. Until resistance is encountered D. Past the vocal cords - B. As far as the base of the tongue Choice B is the correct procedure. Choice A is correct for a rigid catheter, choice C is the correct method for inserting an oropharyngeal airway, and choice D is applicable only to endotracheal intubation. What is the correct procedure for a patient who has secretions or emesis that suctioning cannot easily remove? A. Insert an oropharyngeal or nasopharyngeal airway immediately. B. Suction for 15 seconds, ventilate for 2 minutes, and then repeat. C. Logroll the patient and clear the oropharynx and nasopharynx. D. Hyperventilate the patient with a bag-valve mask unit. - C. Logroll the patient and clear the oropharynx and nasopharynx. Choice C is the correct procedure for clearing the airway when simple suctioning is not working. Choice B is appropriate for a patient with copious frothy secretions like the kind produced with pulmonary edema. Choices A and D are inappropriate without first clearing the airway. What is the purpose of the head tilt/chin-lift technique? A. To position the patient for insertion of an airway adjunct. B. To remove foreign bodies from the upper airway. C. To help the rescuer better visualize the larynx and vocal cords. D. To lift the tongue and epiglottis out of their obstructing position. - D. To lift the tongue and epiglottis out of their obstructing position. The purpose of the head-tilt/chin-lift is to lift the tongue and the epiglottis out of the airway; it is not useful for intubation (use the sniffing position), to remove foreign bodies, or to visualize the larynx. After opening the airway, the next step in patient management is to... A. Insert an endotracheal tube. B. Assess adequacy of respirations. C. Begin mouth-to-mouth ventilations. D. Apply bag-valve mask ventilation. - B. Assess adequacy of respirations. After opening the airway, the EMT should assess the rate and depth of ventilations; choices A, C, and/or D would occur only after respiratory adequacy has been assessed and they are appropriate to use. A patient should receive high-flow oxygen if he or she exhibits ______. A. Fever B. Anxiety C. Dehydration

D. Cyanosis - D. Cyanosis Cyanosis, or a bluish coloration of the mucous membranes and skin, which is caused by inadequate oxygen supply to the body's tissues; the other choices are unrelated to oxygen supply. The first step in the delivery of high-flow oxygen via a nonrebreather mask is to... A. Select the correct mask size. B. Regulate the flow of oxygen. C. Inflate the reservior bag with oxygen. D. Turn on the oxygen source. - A. Select the correct size mask. Masks come in adult and pediatric sizes. In order to deliver the highest possible concentration of oxygen to the patient, you must have a properly fitting mask. Steps D, B, C must then be completed (in that order) before placing the mask on the patient's face. When providing mouth-to-mask ventilation with supplementary oxygen, what is the first step after sealing the mask to the patient's face? A.Follow body substnce precautions before touching the patient. B. Connect the one-way valve and filter (if available) to the mask. C. Exhale over the ventilation port for 1.5-2 seconds. D. Attach oxygen tubing to the mask and set the flow rate at 15-30mL/min. - C. Exhale over the ventilation port for 1.5-2 seconds. After sealing the mask to the patient's face, you should begin mouth-to-mask ventilation with a long, slow breath; steps A, B, and D should be done before applying the mask. The correct rate of artificial ventilations for an adult is _______. A. 3 ventilations per minute. B. 5 ventilations per minute. C. 10 ventilations per minute. D. 12 ventilations per minute. - D. 12 ventilations per minute. The correct rate is 12 ventilations per minute for an adult (one breath every five seconds), and the correct rate for a child is 20 ventilations per minute. When using the two-person bag-valve mask procedure, one EMT ventilates the patient while the other ______________. A. Suctions the patient and administers CPR. B. Administers mouth-to-mask ventilation. C. Insert the oral or nasopharyngeal airway. D. Maintains the mask seal and monitors chest rise. - D. Maintains the mask seal and monitors chest rise.

During a two person bag-valve mask procedure, one EMT ventilates the patient while the other maintains the airway and monitors the patient's chest rise. Where is the cricoid cartilage located? A. Inferior to the larynx. B. Superior to the epiglottis. C. At the carina. D. In the oropharynx. - A. The cricoid cartilage forms a ring of firm cartilage and is located inferior to (below) the larynx. Your patient is awake, confused, and disoriented. How would you grade her using the AVPU scale? A. A B. V C. P D. U - A. A A means alert. The other letters in the acronym stand for verbal, pain, and unresponsive. A bulb syringe is used to suction infants up to the age of __. A. 1 month. B. 3-4 months. C. 6-8 months. D. 1 year - B. 3-4 months. A bulb syringe is used to suction an infant's nasal passage or mouth and is generally used with infants up to age 3-4 months. If you are using mechanical or hand-powered suction equipment in infants of this age, be very careful to use the lowest possible pressure needed to accomplish the job. The right ventricle pumps blood into the _______. A. Body via the aorta. B. Lungs via the pulmonary vein. C. Lungs via the pulmonary artery. D. Left atrium. - C. Lungs via the pulmonary vein. The right ventricle receives oxygen-poor blood from the right atrium. It then pumps the blood to the lungs via the pulmonary artery, where it receives oxygen and releases carbon dioxide. A 56-year-old female patient complains of mild chest discomfort. You should... A. Decide what type of heart problem it might be. B. Decide whether the patient has a heart problem.

C. Maintain a high index of suspicion for cardiac compromise. D. Apply the AED. - C. Maintain a high index of suspicion for cardiac compromise. The role of the EMT-Basic is not to diagnose the exact cause of the patient's chief complaint. Maintaining a high suspicion for a cardiac emergency will guide your next step in managing this patient appropriately. Your patient is a 62-year-old male with a history of heart disease. He is experiencing chest pain. Your first action should be to... A. Place the pads for the AED on his chest. B. Begin CPR while preparing the AED. C. Ask him if he has taken his nitroglycerin, and if not, offer to assist him. D. Place him in a comfortable position and administer high-flow oxygen. - D. Place him in a comfortable position and administer high-flow oxygen. Your first action would be to administer oxygen and place the patient in a comfortable position; next, if not contraindicated, you would request permission to administer nitroglycerin. You should first obtain a set of vital signs to ensure he is not in cardiogenic shock. Never put defibrillator pads onto a conscious patient with a pulse; this procedure is contraindicated. AED pads are not serving the same function as the electrodes used by ALS providers to monitor the heart rhythm. The EMT-Basic should request the prehospital ACLS for the care of the cardiac arrest patient because... A. ACLS intervention provides higher survival rates. B. EMT-Basics must have prehospital ACLS present to perform defibrillation. C. Only paramedics can transport cardiac arrest patients. D. The EMT-Basic is not adequately trained to manage cardiac arrest. - A. ACLS intervention provides higher survival rates. Prehospital ACLS provides additional medications and other therapies that may help either terminate the cardiac arrest state or help prevent the patient who has regained a pulse from going back into cardiac arrest. You patient is a 29-year-old who has fallen off a ladder. He is bleeding profusely from a wound on his right forearm and has severe pain in his left thigh. Which of the following is an appropriate initial treatment for this patient? A. Perform a quick initial assessment to assess his ABCs. B. Stop the bleeding by applying a tourniquet near the elbow. C. Maintain an open airway and ventilate the patient with a gas-valve mask. D. Elevate the patient's legs 20-30 cm to treat him for shock. - A. Perform a quick initial assessment to assess his ABCs. Although you note several injuries, you still need to perform a rapid initial assessment to determine if any problems with the ABCs that you have not noted may be more life- threatening than what you can obviously see. Stop the bleeding (do not use a

tourniquet) and treat the patient for shock, but do not elevate the patient's legs if there is an injury to the legs, pelvis, head, neck, chest, abdomen, or spine. There is no indication that this patient needs ventilation at this time. Touching the patient when the semiautomatic external defibrillator (SAED) is analyzing the rhythm... A. is acceptable with today's modern defibrillators. B. is indicated to maintain cardiac compressions. C. is indicated to maintain artificial ventilation. D. Can cause the SAED to misinterpret a rhythm. - D. Can cause the SAED to misinterpret a rhythm. When the SAED is attempting to analyze the patient's electrical rhythm, any movement of the patient or the unit could cause the machine to misinterpret the signal. What should you do the for cardiac arrest patient found in the rain? A. Perform one rapid defibrillation then move the patient inside. B. Defibrillate 3 times then move the patient inside. C. Move the patient inside away from the rain. D. Perform one rapid defibrillation, then start CPR if pulseless. - C. Move the patient inside away from the rain. Safety is critical when performing defibrillation. Any defibrillation attempt in the rain may possibly harm anyone near the patient during the discharge of the unit. Your patient is bleeding profusely from a wound on her right forearm. Where is the pressure point for this injury? A. Carotid artery B. Ulnar artery C. Brachial artery D. Femoral artery - C. Brachial artery The pressure point for wounds of the forearm is the brachial artery. Kinetic energy is described as the... A. energy an object has while in motion. B. measure of matter. C. capacity to do work. D. tendency for an object to stay in motion. - A. Energy an object has while in motion. Kinetic energy is the energy an object has while in motion. Choice B describes mass, choice C describes energy, and choice D describes inertia. A bystander is performing CPR when you arrive. You evaluate the scene, practice body substance isolation, and begin your initial assessment by having the bystander... A. verify pulselessness

B. continue CPR C. stop CPR D. provide a history of cardiac aresst. - C Stop CPR. Having the bystander stop CPR will allow you to reassess the patient's ventilatory and circulatory status. This will tell you whether you need to continue CPR or whether the patient has regained a pulse or is breathing. Your patient is bleeding from a wound to the forearm. The blood flows in a steady, dark- red stream. what type of bleeding should you suspect? A. Venous B. Arterial C. Capillary D. Internal - A. Venous Venous bleeding flows in a steady, dark-red stream. Arterial bleeding is bright red and spurts from the wound, while capillary bleeding oozes. Internal bleeding may or may not be present externally recognizable sign or symptoms. Your patient is restless, anxious, and complaining of thirst. She exhibits increased heart rate and pale, clammy skin. You should do all the following EXCEPT... A. Maintain an open airway and provide oxygen. B. Evaluate her legs if not contraindicated. C. Cover the patient with a blanket to keep her warm. D. Give the patient small amounts of liquid to drink. - D. Give the patient small amounts of liquid to drink. This patient has the classic signs and symptoms of shock. Do not offer anything to eat or drink to a patient you suspect of being in shock, since surgery may be necessary later. If a person was hit by an object described in the following, which would have the potential to cause the most damage? A. 1 pound object traveling at 10 mph. B. 2 pound object traveling at 20 mph. C. 1 pound object traveling at 30 mph. D. 1 pound object traveling at 20 mph. - C. 1 pound object traveling at 30 mph. Speed is squared in the calculation of kinetic energy. A one-pound object traveling at 30 mph is nine times more injurious than a one-pound object traveling at 10 mph. Which heart rhythm often converts o ventricular fibrillation? A. Asystole B. Ventricular tachycardia C. Atrial fibrillation D. Atrial tachycardia - B. Ventricular tachycardia

Ventricular tachycardia often converts to ventricular fibrillation, a life-threatening heart rhythm that the AED is designed to correct. What is the reason for stopping CPR before applying the AED? A. To give the patient a chance to breathe on his/her own. B. To allow the ACLS system to take over patient care. C. To allow the EMT to verify pulselessness and apnea. D. To allow other rescuers to get out of the way. - C. To allow the EMT to verify pulselessness and apnea. Stop CPR briefly to verify pulselessness an apnea. Once you have the leads ready for placement on the chest wall, you should stop CPR, clear away from the patient, attach the AED leads, and perform the initial analysis. Resume CPR after the first round of shocks if they were unsuccessful and the patient persists in pulselessness. Stop CPR again every time you deliver shocks. After receiving three consecutive "no shock indicated" messages on the AED, you should do which of the following? A. Consult medical control for direction. B. Check the AED battery/power supply. C. Check for a pulse and begin CPR. D. Begin transporting to the hospital. - D Begin transporting to the hospital. After three consecutive "no shock indicated" messages, you should make sure to begin transporting the patient while continuing CPR. Some jurisdictions may adopt a protocol or standing order that requires you to consider transporting following the first or second set of AED rounds, regardless of whether you shock. At the minimum, you should begin your transport by the third time you perform an analysis. You are transporting a patient who has been resuscitated but is still unresponsive. You should check the patient's pulse every... A. 30 seconds B. 1 minute C. 5 minutes D. 10 minutes - A. 30 seconds If the patient has been resuscitated but is still unresponsive, check the pulse every 30 seconds during transport and keep the AED leads attached to the patient. The medical direction physician orders you to deliver additional shocks to a patient in cardiac arrest while en route to the hospital. What is the correct procedure to follow? A. Wait for the arrival of the ACLS team. B. Deliver the shocks without stopping CPR. C. Stop the vehicle before reanalyzing the rhythm.

D. Refuse to defibrillate the patient while en route. - C. Stop the vehicle before reanalyzing the rhythm. If it becomes necessary to shocks while en route with the patient, the proper procedure is to stop the vehicle before reanalyzing the rhythm because the AED has a motion detector sensor in a place that will not allow the unit to operate in the presence of motion. What is the primary action of nitroglycerin? A. Lower the blood pressure. B. Contract the heart muscles. C. Slow down the heart rate. D. Dilate the coronary vessels. - D. Dilate the coronary vessels. The primary action of nitroglycerin is to dilate the myocardial (coronary) arteries, therefore easing the heart's workload by increasing the blood flow. Lowering of blood pressure is a secondary effect seen with vessel dilation. Reflex tachycardia, not bradycardia, may occur as a result of nitroglycerin administration. It does not have any direct effects on the muscles of the heart. Patients commonly describe heart attack pain as which of the following characteristics? A. Like pins and needles. B. Crushing or squeezing. C. Intermittent (comes and goes). D. Less severe than indigestion. - B. Crushing or squeezing. Myocardial pain is often difficult to determine because it can take on many different characters; however, patients most commonly (over 40% of the time) describe the pain of myocardial infarction as a crushing, squeezing pressure that radiates outward to the arms and upper back. In pedestrian versus automobile impacts, which of the following is always true? A. Children often turn towards the impact and are often thrown down and under the vehicle. B. Adults tend to turn toward the vehicle before impact. C. Children often turn toward the impact and are often scooped and thrown over the vehicle. D. There tends to be no difference in the way adults and children respond in these situations. - A. Children often turn towards the impact and are often thrown down and under the vehicle. Children often turn toward the impact and are often thrown down and under the vehicle. Your patient has profuse bleeding from a wound on her lower leg but no signs of skeletal injury. The steps you should take to stop the bleeding, in the correct order, are...

A. Direct pressure, elevation, pressure dressing, and pressure point. B. Pressure point, tourniquet, and concentrated or diffuse direct pressure. C. Pneumatic anti-shock garments (PASG), lower extremity elevation, and diffuse direct pressure. D. Elevation, pressure point, pressure dressing, and PASG. - A. Direct pressure, elevation, pressure dressing, and pressure point. The combination of direct pressure, pressure dressing, and pressure point pressure is almost always successful in stopping bleeding in the extremities. Tourniquets are seldom needed. PASG use is performed cautiously under direct medical control, and it is never the first line of treatment. Where should place your hands when using the head-tilt/chin-lift maneuver to open an unconscious patient's airway? A. On the nose, with fingertips pinching it closed, and under the neck. B. On the nose, with the fingertips pinching it closed, and on the forehead. C. On the forehead, with the other hand under the neck. D. On the forehead, with the fingertips of the other hand under the lower jaw. - D. On the forehead, with the fingertips of the other hand under the lower jaw. Lifting the jaw is necessary to dislodge the tongue from the back of the throat and provide a patent airway. Your patient is found lying on the ground after falling off a roof. He is unconscious and apneic. Which method should you use to open the patient's airway? A. Head-tilt/Chin-lift B. Modified jaw thrust C. Head-tilt only D. Head-tilt/Neck-lift - B. Modified jaw thrust The head-tilt/chin-lift may jeopardize the patient's cervical spine. The other two procedures will not adequately open the airway. Following an explosion, a patient is trapped in a collapsed structure and suffers crush injuries to both lower extremities. How would the injuries be classified based on the blast-injury phase? A. Primary blast injury B. Secondary blast injury C. Tertiary blast injury D. None of the above - C. Tertiary blast injury Tertiary blast injury includes those injuries resulting from structural collapse. When splinting an injured limb, you should assess the pulse, motor function, and sensation distal to the injury... A. After applying the splint.

B. Before applying the splint. C. While applying the splint. D. Before and after applying the splint. - D. Before and after applying the splint. Assess pulse, motor function, and sensation distal to a splint both before and after applying the splint to ensure that the splint is not adversely affecting the limb. When performing the modified jaw thrust maneuver to open your patient's airway, which of the following steps in NOT correct? A. Stabilize the patient's cervical spine with your forearms. B. Rest your elbows on the same surface as the patient. C. Tilt the head by applying gentle pressure to the forehead. D. Use your index finger to push the angles of the lower jaw forward. - C. Tilt the head by applying gentle pressure to the forehead. Tilting the head may compromise the stabilization of the cervical spine when using the modified jaw thrust. The GOLDEN HOUR in emergency medicine refers to the first 60 minutes after the... A. Arrival of EMS. B. Occurrence of multisystem trauma. C. Arrival at the emergency room. D. Start of surgery. - B. Occurrence of multisystem trauma. The first 60 minutes after the occurrence of multisystem trauma is the golden hour. Your unconscious patient has blood in his airway. You should... A. Use a suction unit to immediately clear the airway. B. Apply oxygen using a nonrebreather mask at 15 L/min. C. Use a bag-valve mask to clear the airway. D. Perform a finger sweep to remove the blockage. - A. Use a suction unit to immediately clear the airway. Blood is too fluid to be cleared up adequately by a finger sweep. The other answers are not appropriate unless the airway was cleared by suction. Your patient is behaving abnormally but refuses treatment after falling down a flight of stairs. Before transporting the patient without consent you should... A. Document the presence of any injury. B. Ask bystanders to serve as witnesses. C. Ask bystanders to help talk him into care. D. Contact medical direction for advice. - D. Contact medical direction for advice. Before transporting a patient without consent, it is best to always seek medical direction You should not suction a patient's airway for more than 15 seconds because...

A. the patient's tongue may be injured. B. The suction unit's battery may drain too quickly. C. The patient will become hypoxic during this time. D. You may cause the pateint to vomit. - C. The patient will become hypoxic during this time. While the other answers may be true, they may occur regardless of the time interval. Which of the following is true regarding using a pocket mask to ventilate a nonbreathing patient? A. There is direct contact between the rescuer and the patient's mouth. B. Oxygen cannot be connected to the mask. C. A one-way valve prevents exhaled air from contacting the rescuer. D. Oxygen levels of 100% may be achieved. - C. A one-way valve prevents exhaled air from contacting the rescuer. The one-way valve minimizes potential cross-exposure of the patient's secretions and exhaled breath to the rescuer. To which patient should you administer oral glucose? A. 60-year-old female behaving as if she is intoxicated, and whose daughter informs you that she takes insulin by injection. B. 45-year-old male with a history of diabetes behaving erratically after falling and hitting his head in the bathtub. C. 70-year-old male with a long history of diabetes who is unconscious and cannot swallow. D. 52-year-old female who tells you that she is dizzy and has low blood sugar. - A. 60- year-old female behaving as if she is intoxicated, and whose daughter informs you that she takes insulin by injection. Administer oral glucose on medical direction (through protocol or standing order) only to patients with altered mental status and history of diabetes. Patient B should first be treated as a trauma patient, and because research shows poor outcomes following brain injuries and glucose administration, it is best to withhold its use until blood sugar can be checked (which is an ALS-provider skill in many areas). Patient C is not appropriate because of an inability to swallow properly; ALS should be called to provide IV dextrose to this patient. Glucose should be withheld until you can better determine if patient D is actually diabetic or not. (A blood glucose reading would be helpful with this patient as well.) The focused history for patients with altered mental status should include questions about a history of trauma, diabetes, seizures, and which of the following? A. Heart disease B. Pregnancy C. Fever D. Stress - C. Fever

Common causes of altered mental status are trauma, diabetes, seizures, and infectious disease. Asking about fever helps determine if there is a history of recent infection. All of the may be signs of allergic reaction EXCEPT... A. Headache and dizziness B. Rapid, labored breathing C. Decreased blood pressure D. Decreased heart rate - D. Decreased heart rate Signs of allergic reactions include increased heart rate, as the heart attempts to compensate for hypoperfusion. The two primary life-threatening events that occur during an allergic reaction are are profound vasoconstrictions (resulting in shock) and compromised airway due to swelling, constriction, or mucous production. Under medical direction, the EMT-Basic may administer epinephrine to a patient with respiratory distress or hypoperfusion resulting from an allergic reaction if... A. Patient has no history of heart disease. B. Patient is in severe respiratory distress or arrest. C. Medication has been prescribed for this patient. D. Medication has been storeed in the refrigerator. - C. Medication has been prescribed to this patient. EMTs can administer epinephrine under medical direction only if the medication was previously prescribed for the patient. The patient will be prescribed the correct dosage by the physician, and you are only allowed to administer the patient's own medications. Ethics is best described as... A. the principles of conduct; concerns for what is right and what is wrong and what is right, good or bad. B. A code of conduct put forward by a society or some other group such as religion. C. The principle of doing good for the patient. D. The obligation to treat all patients fairly. - A. The principle of conduct; concerns for what is wrong and what is right, good or bad. This is the principle of conduct; concerns for what is wrong and what is right, good or bad. Choice B describes morals, choice C is a better description of bioethics, and choice describes justice for the patient. Your patient is a 25-year-old female who is severely hypothermic after having plunged into an icy river. Although she was rescued after only a few minutes in the water, she is showing a diminished level of responsiveness. Your care should include... A. Encouraging the patient to walk in order to improve her circulation. B. Covering the patient in blankets and turning up the heat in the ambulance. C. Giving her hot coffee or tea to drink and massaging her extremities.

D. Beginning active rewarming measures under direct medical direction. - B. Covering the patient in blankets and turning up the heat in the ambulance. Care for a hypothermic patient with a diminished level of responsiveness should include passive rewarming (blankets and heated room) only; active rewarming should take place only in the hospital environment, and hypothermic patients should not be allowed to excerise or take stimulants, such as coffee or tea. However, your protocols may allow you to give warmed liquids that are not alcoholic or caffinated to slightly hypothermic patients with normal mental status. A sign of a generalized cold emergency, or hypothermia, is cool skin on the... A. Feet or hands B. Ears C. Face D. Abdomen - D. Abdomen Cool skin on the abdomen is a reliable sign of hypothermia in a patient because the abdomen is the central core of the body and is usually covered under layers of clothing. Two important principles in the emergency treatment of local cold injuries are to remove the patient from the cold environment and to... A. Rewarm the cold extremity quickly. B. Warm the whole body as soon as possible. C. Prevent further tissue damage. D. Prevent or treat pain. - C. Prevent further tissue damage. The goal of care in cases of localized cold damage is to prevent further damage by removing the patient from the cold environment and protecting the damaged tissues from further injury. Rewarming is best accomplished in the hospital setting, where pain medication can be administered and the danger of reinjury due to recooling is diminished. Which of the following indicates that a patient with hyperthermia is in serious danger? A. Hot skin B. Moist skin C. Muscle cramps D. Dizziness - A. Hot skin. A hypothermic patient with hot skin must be treated aggressively before permanent organ damage sets in. When the skin is hot and dry, the normal sweating mechanisms have stopped functioning and the patient in danger of brain damage due to excessive high body temperatures. your patient has been stung by a bee, and the stinger is present in the wound. You should attempt to remove it by... A. Grabbing it with sterile tweezers.

B. Cutting around it with a knife. C. Scraping it away with a rigid object. D. Grabbing it with your fingers. - C. Scraping it away with a rigid object. Grabbing a stinger with tweezers or your fingers can squeeze more venom into the wound (also, there is a personal risk of accidental exposure to the venom if you use your hands). Instead, scrape the stinger out with a piece of cardboard or rigid plastic (a credit card is ideal). Cutting around the stinger causes more tissue damage. In legal terms, a TORT is a(n)... A. Civil wrong committed by one individual against another. B. Criminal wrongdoing C. Action by an employee for a workers' compensation claim. D. Breach of contract. - A. Civil wrong committed by one individual against another. A tort is a civil wrong committed by one individual against another. Improper or negligent patient care would be considered a tort. Which of the following are the signs of early respiratory in children and infants? A. Breathing rate of less than 10 per minute, limp muscle tone, slow or absent heart rate, weak or absent distal pulses. B. Increased rate of breathing, nasal flaring, intercostal or supraclavicular retractions, mottled skin color, abdominal muscle use. C. Altered mental status, respiratory rate of over 60 or under 20 breaths per minute, severe retractions, severe use of accessory muscles. D. Inability to cough, crying with tears but no sounds, cyanosis, abdominal or chest-wall movements with absent breath sounds. - B. Increased rate of breathing, nasal flaring, intercostal or supraclavicular retractions, mottled skin color, abdominal muscle use. Choice B describes early respiratory distress. Choice A describes the signs of impending respiratory arrest from insufficiency, choice C describes respiratory failure, and choice D describes airway obstruction Your patient is an 8-year-old female who had a single, brief seizure at school. Her mother arrives at the same time you do and reports that her daughter has seizures often and is under medical treatment. What should you do? A. Request advanced life support (ALS) and law enforcement backup so you can transport the child. B. Administer a dose of the child's prescribed seizure-control medication. C. Maintain ABCs, monitor vital signs, and transport the patient immediately. D. Ensure a patent airway and request medical direction regarding transport. - D. Ensure a patent airway and request medical direction regarding transport. For patients who have routine seizures and whose condition returns to normal quickly after a seizure, you should request medical direction about whether to transport.

All of the following are signs of possible child abuse EXCEPT... A. the presence of multiple bruises in various stages of healing. B. A single, severe traumatic event that occurred for no reason. C. Injuries inconsistent with the mechanism described. D. Conflicting histories of the injury from the guardians/parents. - B. A single, severe traumatic event that occurred for no reason. Multiple injuries, conflicting stories of the cause, and repeated calls to the same address are characteristics of child abuse. The head of a newborn infant has just delivered. You should... A. Suction the baby's mouth and nostrils with a bulb syringe. B. Push own on the baby's upper shoulder to facilitate the rest of the delivery. C. Push up on the baby's lower shoulder to facilitate the rest of the delivery. D. Ventilate the baby with a pediatric bag-valve mask and high-flow oxygen. - A. Suction the baby's mouth and nostrils with a bulb syringe. Suctioning the baby's mouth and nose will help to open the airway while the baby has not yet begun breathing. You should not force any part of the delivery process. Emergency care for a responsive 7-year-old child with a foreign-body airway obstruction includes... A. Holding the child on your knee and performing back blows. B. Standing behind the child and performing sub-diaphragmatic thrusts. C. Placing the child supine on the floor and attempting to see the obstruction. D. Placing the child supine on the floor and performing abdominal thrusts. - B. Standing behind the child and performing sub-diaphragmatic thrusts. Care for a responsive child consists of standing behind the child and attempting to relieve the obstruction with a series of subdiaphragmatic thrusts. A 2-year-old male is in respiratory failure when he has... A. Altered mental status and breathing rate of 68 per minute. B. Limp muscle tone and weak or absent distal pulse. C. Nasal flaring and mottled skin color. D. Breathing rate of 6 per minute and heart rate of 50 per minute. - A. Altered mental status and breathing rate of 68 per minute. Signs of respiratory failure include altered mental status and a slow or fast breathing rate with fatigue. There is not enough information to determine if patients B and C are in respiratory insufficiency, respiratory failure, or impending respiratory arrest. Patient D is in impending respiratory arrest. A sign or symptom of a predelivery emergency is... A. The mother's dry skin. B. Profuse vaginal bleeding.

C. The presence of bloody show. D. A contraction every 20 minutes. - B. Profuse vaginal bleeding. Profuse vaginal bleeding may indicate a true obstetrical emergency such as uterine rupture or torn placenta. Select the correct size oral airway for a small child by measuring from the corner of the patient's mouth to what structure? A. Central incisor B. Angle of the jaw C. Tip of the nose D. Pinnea of the ear - B. Angle of the jaw. Select the correct size oral airway for an infant or child by measuring from the corner of the patient's mouth to the angle of the jaw. Vitreous humor is found... A. Behind the lens of the eye. B. In the bone marrow of the upper arm. C. In front of the lens of the eye. D. In the joint lubrication of the upper arm. - A. Behind the lens of the eye. Vitreous humor is found behind the lens of the eye. It is the clear gel that fills the space between the lens and the retina. Aqueous humor is a thick, watery substance that fills the space between the lens and the cornea. You are assisting with childbirth in the field. As the infant's head is delivered, you discover that the umbilical cord is wrapped tightly around the neck. You should immediately... A. Place the mother on her side and transport rapidly. B. Deliver the infant with the cord wrapped around its neck. C. Clamp the cord in two places and cut it between the clamps. D. Suction the infant's mouth and nose to clear secretions. - C. Clamp the cord in two places and cut it between the clamps. If the cord is wrapped around the infant's neck and you cannot easily loosen and remove it, you should clamp it in two places and cut the cord. You have just assisted in delivering an infant with a pink body, pulse rate of 106 per minute, and good muscle tone. How should you care for this infant? A. Wrap the newborn in clean towels and give her to the mother to hold during transport. B. Provide positive pressure ventilations at the rate of 60 per minute with a bag-valve mask. C. Monitor the infant for one minute and reassess vital signs to see if the heart rate increases.

D. Administer free-flow oxygen by holding an oxygen mask or tubing over the newborn's face. - A. Wrap the newborn in clean towels and give her to the mother to hold during transport. This newborn has a high Apgar score; there is no need for respiratory support unless the condition changes. You should always follow the steps in the inverted pyramid for neonatal resuscitation by drying and warming, positioning the head down for drainage, suctioning the airway and nose as needed, and providing tactile stimulation to stimulate breathing. The presence of a bloody show during the first stage of labor is a sign that... A. The delivery of the infant is imminent. B. The newborn is in danger of respiratory distress. C. Labor is progressing normally. D. The second stage of labor has begun. - C. Labor is progressing normally. The presence of a bloody show (which is the expulsion of the mucus plug from the mouth of the cervix) occurs during the first stage of labor. It is normal and indicates that the cervix is beginning to open or dilate and may occur several hours prior to delivery. The second stage of labor continues until the baby is born. Your patient has experienced a spontaneous abortion or miscarriage. You should... A. Remove any tissues from the vagina. B. Discard any expelled tissues. C. Place a sanitary napkin in the vagina. D. Treat the patient for shock. - D. Treat the patient for shock. There can be large blood loss suffered by the mother during a miscarriage. The EMT- Basic should treat the patient for possible shock as well as provide emotional care. What is the first treatment when a mother bleeds excessively from her vagina after delivery? A. Massage her abdomen gently. B. Administer oxygen. C. Transport her immediately. D. Treat her for shock. - A. Massage her abdomen gently. More than 500 mL of blood loss after delivery is excessive; massage the mother's abdomen by rubbing firmly in one direction from the sympahsis pubis bone to the umbilicus. This will help the uterus contract and stop the bleeding. Oxygen administration, shock treatment, and rapid transport will follow uterine massage. Emergency care for an infant when meconium is present in the amniotic fluid includes... A. Stimulating the infant to cough to expel the meconium. B. Performing bag-valve mask ventilations to improve lung compliance. C. Performing back blows and chest thrusts to remove the meconium.