Emergency Medical Procedures and Techniques, Exams of Nursing

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Jones and Bartlett EMT Test prep

Questions and Answers

the active, muscular part of breathing is called: - Answer- inhalation A 22-year-old man crashed his motorcycle into a tree. He is found approximately 20 feet away from his bike and is responsive to pain only. He is not wearing a helmet. You are unable to effectively open his airway using the jaw-thrust maneuver. What should you do? - Answer- Carefully tilt his head back and lift up on his chin. what is the function of pulmonary surfactant? - Answer- it lubricates the alveolar walls and allows them to expand and recoil. which of the following devices is contraindicated in patients with blunt thoracic trauma? - Answer- Oxygen-powered ventilator. You are performing abdominal thrusts on a 19-year-old male with a severe airway obstruction when he becomes unresponsive. After lowering him to the ground and placing him in a supine position, you should: - Answer- begin CPR, starting with chest compressions. As you begin ventilating an unresponsive apneic man, you hear gurgling in his upper airway. Your MOST immediate action should be to - Answer- quickly turn the patient onto his side so secretions can drain Which of the following injuries or conditions should be managed FIRST - Answer- Bleeding within the oral cavity You are assessing a 66-year-old man who has emphysema and complains of worsened shortness of breath. He is confused, has a heart rate of 120 beats/min, and an oxygen saturation of 89%. Which of the following assessment findings should concern you the MOST? - Answer- Confusion An inaccurate pulse oximetry reading may be caused by: - Answer- severe peripheral vasoconstriction.

A patient who is breathing with reduced tidal volume would MOST likely have - Answer- shallow respirations During your assessment of an unresponsive adult female, you determine that she is apneic. You should: - Answer- assess for a carotid pulse. In which of the following situations would you MOST likely encounter agonal gasps? - Answer- Shortly after becoming unresponsive and pulseless A patient overdosed on heroin and is unresponsive. He is cyanotic; he has slow, shallow breathing; and his oxygen saturation is 80%. The primary cause of this patient's condition is inadequate - Answer- ventilation which of the following statements regarding the head tilt-chin lift maneuver is correct? - Answer- it should be used in conjunction with an appropriate airway adjunct. Hypoxia is defined as: - Answer- inadequate oxygen to the body's cells and tissues. Which of the following signs or symptoms is indicative of cerebral hypoxia - Answer- decreased level of consciousness Clinically, reduced tidal volume would MOST likely present with respirations that are: - Answer- shallow To obtain the most reliable assessment of a patient's tidal volume, you should - Answer- look at the rise of the chest A patient overdosed on several drugs and is unresponsive with shallow breathing and facial cyanosis. As you continue your assessment, the patient suddenly vomits. You should: - Answer- turn the patient onto his side A properly placed oropharyngeal airway - Answer- keeps the tongue off of the posterior pharynx. An elderly woman with COPD is semiconscious with labored breathing. Her face is cyanotic, her pulse is rapid and weak, and her oxygen saturation is 75%. You should - Answer- ventilate her with a bag-valve-mask device and high-flow oxygen. Shallow breathing is an indication of: - Answer- decreased tidal volume. During your initial attempt to ventilate an unresponsive apneic patient, you meet resistance and do not see the patient's chest rise. You should - Answer- reposition the head and reattempt to ventilate If an adult patient presents with a respiratory rate of 26 breaths/min, your initial action should be to - Answer- Evaluate his mental status and the depth of his respirations

To ensure you deliver the highest concentration of oxygen with a nonrebreathing mask, you should: - Answer- make sure the reservoir bag is pre-inflated The lower airway begins at the - Answer- larynx Which of the following yields the lowest minute volume? - Answer- Respiratory rate of 14 breaths/min; tidal volume of 300 mL. When attaching an oxygen regulator to a D cylinder and preparing it for use, you should recall that: - Answer- oxygen supports combustion and should not be used where sparks are easily generated. All of the following would cause an increased level of carbon dioxide in the arterial blood, EXCEPT: - Answer- deep, rapid breathing an unresponsive patients respirations are 28 breaths/min and shallow. The MOST appropriate treatment includes: - Answer- assisted ventilations with 100% oxygen. Which of the following is the MOST correct technique for ventilating an apneic adult who has a pulse? - Answer- Deliver each breath over 1 second at a rate of 12 breaths/min. Agonal respirations are not adequate because they are: - Answer- infrequent, gasping respiratory efforts. When ventilating an apneic patient with a bag-valve-mask device, each breath should be delivered over: - Answer- 1 second After an initial attempt to ventilate an unresponsive apneic patient fails, you reposition the patient's head and reattempt ventilation without success. You should next - Answer- perform chest compressions, open the airway, and look in the mouth While providing initial ventilations to an apneic adult with a bag-valve-mask device, you note minimal rise of the chest despite an adequate mask-to-face seal. You should: - Answer- increase the volume of your ventilations. The MOST effective way to determine if you are providing adequate volume during artificial ventilation is: - Answer- assessing the chest for adequate rise. When suctioning copious secretions from a semiconscious adult's airway, you should: - Answer- avoid touching the back of the airway with the suction catheter. While managing a patient with acute shortness of breath, you attempt to apply a nonrebreathing mask set at 12 L/min. The patient pulls the mask away from his face, stating that it is smothering him. You should: - Answer- reassure the patient and apply a nasal cannula instead.

The MOST appropriate treatment for a semiconscious patient with slow, shallow respirations includes: - Answer- a nasopharyngeal airway and assisted ventilation with a bag-valve-mask device. An unresponsive man has shallow, gurgling respirations at a rate of 8 breaths/min. Initial treatment should include: - Answer- suctioning of the oropharynx. Which of the following processes occurs during cellular/capillary gas exchange? - Answer- The capillaries give up oxygen to the cells. A patient with a mild foreign body airway obstruction: - Answer- is typically not cyanotic. An elderly man is found lying unresponsive next to his bed. The patient's wife did not witness the events that led to his unresponsiveness. You should immediately: - Answer- grasp the angles of the lower jaw and lift. The tidal volume of an unresponsive patient is rapidly assessed by: - Answer- observing for chest rise during inhalation. Medications such as Albuterol (Ventolin) relieve respiratory distress by: - Answer- relaxing the smooth muscle of the bronchioles. A 22-year-old male has a shard of glass impaled in his cheek. You look inside his mouth and see minor bleeding. - Answer- carefully stabilize the shard of glass and allow him to suction his own mouth. Which of the following processes occurs during inhalation? - Answer- The intercostal muscles and diaphragm both contract. Which of the following statements regarding artificial ventilation of an apneic patient who has dentures is correct? - Answer- Tight-fitting dentures should be left in place because they facilitate the delivery of adequate tidal volume. After an adult cardiac arrest patient has been intubated by a paramedic, you are providing ventilations as your partner performs chest compressions. When ventilating the patient, you should: - Answer- deliver each breath over 1 second at a rate of 10 breaths/min. A 60-year-old woman has severe respiratory distress. She is conscious, but confused, and can only say two words at a time. Which of the following would be the MOST appropriate treatment for her? - Answer- Ventilation with a bag-valve-mask device. In which position would you place an uninjured, unresponsive patient with a respiratory rate of 14 breaths/min and adequate tidal volume? - Answer- Lateral Recumbent

Which of the following airway sounds indicates a lower airway obstruction? - Answer- Wheezing A 50-year-old woman presents with acute shortness of breath. Her skin is pale and she is anxious. You should: - Answer- administer high-flow oxygen and assess the adequacy of her breathing. Ventilation is defined as the: - Answer- Movement of air into and out of the lungs You are assessing a middle-aged male who is experiencing respiratory distress. The patient has a history of emphysema and hypertension. He appears fatigued; has weak retractions; and demonstrates labored, shallow breathing. Your MOST immediate action should be to: - Answer- ventilate him with a bag-valve-mask device. Tidal volume is defined as the: - Answer- volume of air inhaled or exhaled per breath. Prior to your arrival, a woman experiencing an asthma attack took two puffs from her prescribed inhaler without relief. After administering supplemental oxygen, you should: - Answer- contact medical control for further advice. A 50-year-old man, who fell approximately 20 feet and landed on a hard surface, is semiconscious. You should: - Answer- stabilize his head while performing the jaw-thrust maneuver. A 60-year-old woman presents with acute respiratory distress. She is conscious and alert, but restless. Her respiratory rate is 26 breaths/ min with adequate chest expansion, her breath sounds are clear to auscultation bilaterally, and her oxygen saturation is 84%. Which of the following is the MOST appropriate treatment for this patient? - Answer- Supplemental oxygen with a nonrebreathing mask. In which of the following situations should the jaw-thrust maneuver be used? - Answer- When the mechanism of injury is unknown. You are assessing an elderly man with respiratory distress. He is coughing up bloody sputum and has an oxygen saturation of 85%. You auscultate his breath sounds and hear coarse crackles in all lung fields. This patient MOST likely has: - Answer- congestive heart failure. Snoring respirations in an unresponsive patient are MOST often the result of - Answer- upper airway obstruction by the tongue. The method by which you administer supplemental oxygen to a hypoxemic patient depends MOSTLY on the: - Answer- severity of hypoxemia and adequacy of breathing.

Which of the following patients obviously needs positive-pressure ventilation assistance? - Answer- Responsive to pain only; respiratory rate of 8 breaths/min and shallow An unresponsive 60-year-old male is apneic and has a weak, rapid pulse. His oxygen saturation reads 79%. You should: - Answer- deliver one breath over 1 second every 5 to 6 seconds. Which of the following clinical findings is MOST consistent with a chronic respiratory disease? - Answer- A barrel-shaped chest Occasional, irregular breaths that may be observed in a cardiac arrest patient are called: - Answer- agonal gasps. An apneic patient has severe facial trauma and bleeding in the oropharynx. How should this situation be managed? - Answer- Alternate suctioning for 15 seconds and ventilations for 2 minutes. Oxygen that is administered through a nasal cannula would be of LEAST benefit to a patient who: - Answer- breathes through his or her mouth. Which of the following occurs during positive-pressure ventilation? - Answer- Intrathoracic pressure increases. A 60-year-old female is found unresponsive. She is cyanotic, is making a snoring sound, and has a slow respiratory rate. You should: - Answer- manually open her airway An unresponsive apneic patient's chest fails to rise after two ventilation attempts. You should: - Answer- immediately proceed to chest compressions. Which of the following would MOST likely occur if an adult patient is breathing at a rate of 45 breaths/min with shallow depth? - Answer- Most of his or her inahled air will not go beyond the anatomic dead space. At the peak of the inspiratory phase, the alveoli in the lungs contain: - Answer- more oxygen than carbon dioxide. You are ventilating an apneic adult with a bag-valve-mask device and high-flow oxygen. Her pulse rate is 130 beats/min and she has cyanosis to her face and chest. The MOST reliable indicator of adequately performed ventilations in this patient is: - Answer- a decrease in her heart rate to 90 beats/min. A 56-year-old man has labored, shallow breathing at a rate of 28 breaths/min. He is responsive to pain only. You should: - Answer- insert a nasopharyngeal airway and begin assisting his ventilations.

You are ventilating an apneic 50-year-old woman with a bag-valve-mask device. After squeezing the bag and noting visible chest rise, you should. - Answer- allow the patient to completely exhale If the level of carbon dioxide in the arterial blood increases: - Answer- the respiratory rate and depth increase A patient's skin will MOST likely become cyanotic if he or she has: - Answer- a decrease in the amount of arterial oxygen. Which of the following patients has signs of inadequate breathing? - Answer- 41-year- old woman with shallow respirations of 14 breaths/min. When ventilating an unresponsive apneic adult with a bag-valve-mask device, you should ensure that: - Answer- an airway adjunct has been inserted. Signs of inadequate breathing in an unresponsive patient include: - Answer- cyanotic oral mucosa. Which of the following describes the correct technique for inserting a nasopharyngeal airway? - Answer- Insert the device with the bevel facing the septum The respiratory system functions by: - Answer- bringing oxygen into the lungs and eliminating carbon dioxide. A young female experienced massive facial trauma and is unresponsive. After several attempts, you are unable to adequately open her airway with the jaw-thrust maneuver. You should: - Answer- carefully tilt her head back and lift up on her chin. The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream is called: - Answer- oxygenation Patients with a hypoxic drive: - Answer- are stimulated to breathe by low oxygen levels in the blood. A young woman overdosed on heroin and is unresponsive with slow, shallow breathing. She begins to gag after you insert an oropharyngeal airway. You should: - Answer- remove the oropharyngeal airway and be prepared to suction her mouth. You are dispatched to a residence for an elderly female who has possibly suffered a stroke. You find her lying supine in her bed. She is semiconscious; has vomited; and has slow, irregular breathing. You should: - Answer- manually open her airway and suction her oropharynx.

A nonrebreathing mask is MOST appropriate to use on patients who: - Answer- have an adequate rate and depth of breathing. During the inhalation phase of breathing: - Answer- pressure within the thorax decreases and air is drawn into the lungs. When ventilating an apneic patient, you note decreased ventilatory compliance. This means that: - Answer- the lungs are difficult to ventilate. Which of the following would most likely cause a reduction in tidal volume? - Answer- Unequal chest expansion. A 40-year-old man is conscious, but has an increased rate of breathing. You should - Answer- assess the regularity and quality of breathing. In which position would you expect a patient with severe dyspnea to be found? - Answer- Fowlers Sonorous respirations are MOST rapidly corrected by: - Answer- Manually positioning the head. You receive a call for a 49-year-old woman who passed out. The patients husband tells you that they were watching TV when the incident occured. No trauma was involved. The patient is semiconscious and has cyanosis to her lips. After opening her airway with the head tilt-chin lift manuever, you should: - Answer- insert a nasopharyngeal airway. Prior to applying a nonrebreathing mask on a patient with difficulty breathing and sings of hypoxemia, you should: - Answer- prefill the reservoir bag to ensure a high oxygen concentration. A 33-year-old female presents with acute respiratory distress. She is conscious but anxious, and tells you that she has a history of asthma. She took two puffs of her albuterol inhaler prior to your arrival, but states that it did not help. Her oxygen saturation reads 89% and you hear diffuse wheezing while auscultating her lungs. You should: - Answer- administer high-flow oxygen, contact medical control to request permission to assist her with another albuterol treatment, and prepare for transport. A 35-year-old patient complains of shortness of breath. He is conscious and alert and is able to speak in complete sentences, although with slight difficulty. Assessment reveals diffuse wheezing to auscultation, a respiratory rate of 24 breaths /min, a heart rate of 110 beats/ min, and an oxygen saturation of 96%. Which of the following interventions would be of most benefit to this patient? - Answer- Inhaled bronchodilator. Which of the following patients is the BEST candidate for an oropharyngeal airway - Answer- an unresponsive trauma patient with blood draining from the nose.

Assessment of a 40-year-old patient reveals respiratory distress, tachycardia, audbile expiratory wheezing, and an oxygen saturation of 88%. The EMT should suspect: - Answer- diffuse bronchoconstriction. During your assessment of a trauma patient, you note massive facial injuries, weak radial pulses, and clammy skin. What should be your MOST immediate concern? - Answer- Potential obstruction of the airway. Which of the following ventilation techniques will enable you to provide the greatest tidal volume AND allow you to effectively assess lung compliance? - Answer- One-rescuer mouth-to-mask ventilation. You are administering oxygen at 15 L/min to a patient with respiratory distress. If you are using a D cylinder (cylinder constant, 0.16), which reads 1500 psi, how long will it take before you need to replace the oxygen cylinder? - Answer- 14 minutes. While you are inside a crashed vehicle assessing a patient who is entrapped, the rescue team should be: - Answer- assessing exactly how the patient is trapped and determining the safest way to extricate him or her. The set of regulations and ethical considerations that define the extent or limits of an EMT's job is called: - Answer- the scope of practice. Which of the following is the MOST practical method of standard precautions when treating multiple patients during a mass-casualty incident? - Answer- Changing your gloves in between contact with different patients. The EMT should avoid focusing all of his or her attention on a single critical patient during the triage process because: - Answer- other patients may die from causes that could have been prevented. You are called to transport a patient with terminal lung cancer from a skilled nursing facility to the emergency department for evaluation of possible pneumonia. As you are reviewing the transfer paperwork, you see that the patient has a valid "do not attempt resuscitation" order. During transport, you should: - Answer- provide supportive care, such as oxygen, and keep the patient comfortable. A patient presents with severe bradycardia, hypersalivation, vomiting, and excessive tearing. Which of the following agents would MOST likely cause his signs and symptoms? - Answer- Soman. You are called to treat a 55-year-old man who is experiencing difficulty breathing. After making contact with your patient, he extends his arm out to allow you to take his blood pressure. This is an example of: - Answer- actual consent

During the triage process, which of the following injuries or conditions would classify a patient as a high priority? - Answer- A large avulsion to the arm and altered mental status. While you are caring for an emotionally disturbed 30-year-old male, he suddenly becomes violent and needs to be physically restrained. During the restraint procedure, you should: - Answer- maintain close communication with him and closely manage his airway. You are giving a presentation to a group of laypeople on the importance of calling EMS immediately for cardiac arrest patients. Which point should you emphasize the MOST? - Answer- CPR and defibrillation are key factors in patient survival. How does a unified incident command system differ from a single incident command system? - Answer- In a unified incident command system, plans are made in advance by all agencies that assume a shared responsibility for decision making. The safest emergency vehicle operator is one who: - Answer- drives with due regard. Failure of the EMT to obtain consent from a responsive patient before taking his or her blood pressure may constitute: - Answer- battery. While functioning at a large-scale terrorist incident, it is important for the EMT to: - Answer- use triage and base patient care on available resources. Following a call in which a 6-week-old infant in cardiac arrest did not survive, your partner is exhibiting significant anxiety and irritability. How can you MOST effectively help him? - Answer- Allow him to voice his feelings to you. You receive a call at 3:00 a.m. for a patient who is slumped over the steering wheel of his car, which is parked on the shoulder of the road. Your unit and a police officer arrive at the scene at the same time. You should: - Answer- stay in your unit until the police officer checks the patient. Which of the following statements BEST describes a mass-casualty incident? - Answer- The number of patients overwhelms your resources. Which of the following situations presents the greatest risk for suicide? - Answer- A man who was recently diagnosed with stage 4 lung cancer. At the scene of a mass-casualty incident, you notice a bystander who is emotionally upset. An appropriate action to take would be to: - Answer- assign the bystander a simple, non-patient-care task. Which of the following vaccinations is NOT currently recommended by the Centers for Disease Control and Prevention (CDC)? - Answer- Smallpox.

Which of the following statements regarding the high-efficiency particulate air (HEPA) respirator is correct? - Answer- Long sideburns or a beard will prevent the proper fit of a HEPA respirator. You are caring for a 6-year-old child with a swollen, painful deformity to the left forearm. As you communicate with the parents of this child, you should: - Answer- make sure that they remain aware of what you are doing. As soon as you begin transport of a patient to the hospital, you should: - Answer- advise dispatch of your status. You arrive at the scene of a traffic accident in which multiple vehicles are involved. You see at least two patients who are lying on the road and are not moving. You should: - Answer- request additional ambulances. While en route to the scene of an injured person, dispatch advises you that law enforcement personnel are at the scene. This indicates that: - Answer- The scene is potentially unsafe. Which of the following situations is an example of abandonment? - Answer- A paramedic transfers care to an advanced EMT. When using the power lift to lift a stretcher, you should: - Answer- ensure that you lift with your palms facing up. In most states, the EMT is required to report which of the following occurrences? - Answer- Animal bite. The primary clinical feature associated with exposure to a vesicant agent is: - Answer- skin blistering. The technique of rapid extrication from a vehicle involves: - Answer- manually stabilizing the head, applying a cervical collar, and removing the patient from the vehicle onto a long backboard. Which of the following statements regarding the use of an escort vehicle when en route to an emergency call is correct? - Answer- An escort vehicle should be used only if you are unfamiliar with the patient's location. Which of the following practices will provide you with the highest degree of safety when responding to an emergency call? - Answer- Wearing your seat belt and shoulder harness. You arrive at the scene where a man fell approximately 40 feet and landed on his head. He is unresponsive, has agonal gasps, and has a weak carotid pulse. Further

assessment reveals an open head injury with exposed brain matter. Upon identifying this patient as an organ donor, you should: - Answer- manage the patient aggressively and provide rapid transport. When called to the scene of a structural fire to stand by in case any injuries occur at the scene, you should: - Answer- ensure that your ambulance does not block or hinder other arriving fire apparatus. The scene size-up includes all of the following components, EXCEPT: - Answer- donning personal protective gear. Upon arriving at the scene of a crash involving a large truck, you immediately note the presence of an orange placard on the side of the tank that the truck is pulling. This indicates that the vehicle is carrying a/an ___________ agent. - Answer- explosive. Proper body mechanics when lifting and moving a patient include: - Answer- keeping the weight as close to you as possible. Medical control has ordered you to administer one tube of oral glucose to a hypoglycemic patient. After receiving this order, you should: - Answer- repeat the order back to medical control word for word. As you step out of the ambulance at the scene of a nighttime motor-vehicle crash on the highway, your MOST immediate concern should be: - Answer- the presence of oncoming traffic. Which of the following actions demonstrates an EMT's knowledge of crime scene preservation? - Answer- Advising a law enforcement officer after moving a coffee table to access a critically injured patient You are dispatched to a call for an unresponsive patient. Which of the following is the MOST important information that you should initially obtain from the dispatcher? - Answer- The exact location of the patient. Proper guidelines for safe reaching include all of the following, EXCEPT: - Answer- reaching no more than 30 inches in front of your body. Which of the following patients has the highest priority at the scene of a mass-casualty incident? - Answer- 35-year-old unresponsive woman with snoring respirations and severe burns. The MOST effective means of preventing the spread of disease is: - Answer- effective handwashing. When is it MOST appropriate to complete your patient care report for a critically ill or injured patient? - Answer- As soon as all patient care activities are completed.

Upon arriving at a scene in which a tanker truck overturned and is spilling an unknown liquid on the ground, you should: - Answer- park upwind from the scene, Which of the following is an example of the EMT providing care based on standing orders? - Answer- The EMT defibrillates a patient with the automated external defibrillator, directs immediate resumption of CPR, and then contacts medical control for further guidance. When driving in emergency mode on a multilane highway, the emergency vehicle operator should keep to the: - Answer- extreme left lane so motorists can yield to the right. Upon returning to the quarters after working a major car accident involving an entire family, a member of the press calls and requests information regarding the call. Which of the following would be the EMT's MOST appropriate action? - Answer- Inform him that the patients were transported to the hospital, but you cannot disclose the extent of their injuries. While caring for an injured patient, you remove blood-soaked clothing to treat his injuries. You should dispose of the clothing by: - Answer- placing it in a biohazard bag. Which of the following situations is an emergency move of a patient from his or her wrecked vehicle clearly indicated? - Answer- Gas is leaking from the vehicle and there is a small fire in the engine compartment. While caring for a trauma patient, blood splashes into an EMT's eyes. This is an example of: - Answer- exposure. When calling in your radio report to the receiving hospital, you should: - Answer- be brief, concise, and factual. The immobilization device MOST appropriate to use for a patient with multiple injuries and unstable vital signs is the: - Answer- long spine board immobilization device. A man armed with a shotgun has taken two people hostage and has shot one of them. Upon arriving at the scene, you should: - Answer- have the incident commander guide you to a shielded staging area and wait for the tactical team to bring the patient to you. A 10-year-old child was struck by a car while crossing the street. He has bilateral femur fractures and a head injury. His father has been notified and is 20 minutes away from the scene. The EMT should: - Answer- begin immediate transport and have law enforcement update the father.

You and your partner have secured a trauma patient to a long backboard and are preparing to lift the backboard onto the stretcher. When doing so, you should: - Answer- ensure that the strongest EMT is positioned at the head of the backboard. While triaging patients at a mass-casualty incident, you encounter a responsive middle- aged female with a respiratory rate of 26 breaths/ min. What should you do next? - Answer- Assess for bilateral radial pulses. Most crashes involving ambulances occur: - Answer- at intersections Which of the following scene size-up findings is LEAST suggestive of an unsafe environment? - Answer- A large man standing in his yard awaiting your arrival A 70-year-old man with a history of emphysema and congestive heart failure is in cardiac arrest. His wife tells you that he collapsed about 5 minutes before your arrival. Your partner begins one-rescuer CPR as you prepare the AED. As you are applying the AED pads, the man's wife tells you that she wants you to let him die in peace. You should: - Answer- continue performing CPR and ask her if he has a living will. You are called to a local state park where a hiker fell from a cliff into a thick, wooded area with rough terrain. It is cold and foggy, and a thunderstorm is approaching. You will MOST likely move the patient to the ambulance by: - Answer- placing the patient in a basket stretcher and using at least four people to carry him to the ambulance. Who has ultimate authority for all issues regarding patient care at the scene of a mass- casualty incident? - Answer- EMS medical director. Following an apparent terrorist attack, numerous patients present with shortness of breath and persistent coughing. A green haze is noted in the area in which the patients are located. Which of the following agents should you suspect they were exposed to? - Answer- Chlorine (CL) EMTs arrive at a one-vehicle crash on the left shoulder of a 3-lane highway. The fire department has parked their apparatus on the left shoulder, behind the crashed vehicle. The ambulance should be parked: - Answer- past the crashed vehicle, on the left shoulder. Your partner, a veteran EMT of 20 years, has been showing up late to work with increasing frequency over the last several shifts. When he arrives, he is in a bad mood and is clearly not interested in being at work. His behavior is MOST consistent with: - Answer- burnout. After arriving at a mass-casualty incident where other ambulances are already present, you should notify the dispatcher and then: - Answer- report to the staging area

You are called to a residence for a woman in cardiac arrest. Shortly after you start CPR, the patient's husband presents you with an unsigned document that states "do not attempt resuscitation." You should: - Answer- continue CPR until you have contacted medical control for guidance. While treating a patient in cardiac arrest, you turn the AED on and attach the pads to the patient. However, when the AED begins to analyze the patient's cardiac rhythm, it signals "low battery" and then shuts off. The patient subsequently dies. Which of the following statements regarding this scenario is MOST correct? - Answer- You and your partner may be held liable for negligence. A 30-year-old woman crashed her car into a tree at a high rate of speed. She is conscious and alert and has stable vital signs. She has some small lacerations and abrasions to her arms and face, but no obviously life-threatening injuries. As you are loading her into the ambulance, she tells you that she does not want to go to the hospital. You should: - Answer- advise the patient that she should be transported to the hospital because of the seriousness of the crash. Upon arriving at a mass-casualty incident, the EMT is assigned to the treatment area. Upon completion of duties in the treatment area, the EMT should: - Answer- report to the treatment officer for further instructions. A patient injured his arm and asks to be transported to a specific hospital because he has been there before. The EMT states that he does not feel the doctors there are competent and recommends a different hospital. The EMTs behavior is: - Answer- legal, but unethical. A 52-year-old woman crashed her minivan into a tree. She is pinned at the legs by the steering wheel and is semiconscious. After gaining access to the patient, you should: - Answer- perform a primary assessment and provide any lifesaving care before extrication. When requesting medical direction for a patient who was involved in a major motor- vehicle accident, you should do all of the following, EXCEPT: - Answer- use radio codes to describe the situation As an EMT, your primary responsibility is to: - Answer- keep yourself as safe as possible. According to the United States Department of Transportation (USDOT), minimum staffing for a basic life support ambulance includes: - Answer- at least one EMT in the patient compartment. All of the following are considered key components at the scene of a mass-casualty incident, EXCEPT: - Answer- an on-scene emergency physician.

You are the first ambulance to arrive at the scene of a motor-vehicle crash. As you approach the scene, you see three patients: two have been ejected from their vehicles and the other is still in his vehicle. You should: - Answer- request additional ambulances to respond to the scene. When the incident command system is activated at the scene, you should expect to: - Answer- report back to your section officer in between assignments. Which of the following components is NOT part of an injury or illness prevention program? - Answer- Training a group of daycare employees on infant and child CPR. If the EMT could initially only take two pieces of equipment to the side of a patient in cardiac arrest, which of the following should he or she select? - Answer- AED and suction device. The ultimate goal of any EMS quality improvement program is to: - Answer- deliver a consistently high standard of care to all patients who are encountered. Upon arriving at the scene of an overturned tanker truck, you see a clear liquid leaking from the rear of the tank. The driver is still in the vehicle, and you can see that his face is covered with blood. You should: - Answer- request fire department assistance if they are not already en route. When providing care to multiple patient at the scene of a mass-casualty incident, your goal should remain focused on: - Answer- transporting patients to the hospital. You arrive at the scene of an 80-year-old woman who is weak and lightheaded. Her son, who called 911, is present and asks you to transport his mother to the hospital. You should: - Answer- assess the woman and determine if she wishes to be treated and transported. You arrive at the scene of a young male who was stabbed when a burglar broke into his house. Law enforcement officers are present. The patient, who is unresponsive with several stab wounds to the chest, is lying in a narrow space between a couch and coffee table. You should: - Answer- move the coffee table, begin patient care, and notify a police officer. A conscious and alert 92-year-old woman with chest pain is refusing EMS treatment and transport to the hospital. Her family insists that you transport her. This situation is MOST appropriately managed by: - Answer- advising the patient of the risks of refusing care. Upon arriving at the scene of a multiple-vehicle crash, you can see that at least two patients have been ejected from their vehicles. You should: - Answer- request at least one more ambulance.

Which of the following is considered minimum personal protective equipment (PPE) when suctioning an unresponsive patient's airway? - Answer- Gloves and full facial protection. When sizing up a motor-vehicle crash in which a small passenger car struck a bridge pillar and sustained severe damage, you should: - Answer- ensure that there are no hazards and then try to open one of the doors. While en route back to your station from the emergency department, you discover that you forgot to include vital patient information on the front of your patient care report (PCR). Having left a copy of your PCR with the emergency department staff, you should: - Answer- include the information on an addendum and furnish it to the hospital. Your actions at the scene of a critically injured patient who was shot during a robbery include: - Answer- caring for the patient while manipulating the scene to a minimal extent. The role of triage officer at a mass-casualty incident should be assumed by the: - Answer- most knowledgeable EMS provider. Which of the following situations would necessitate treatment using implied consent? - Answer- A 65-year-old man who is confused and suspected of having a severe stroke. A 9-year-old girl was struck by a car while she was crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs has MOST likely been injured? - Answer- Spleen Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert, and her vital signs are stable. Treatment for her should include: - Answer- administering oxygen and massaging the uterus. A 30-year-old woman has severe lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect: - Answer- en ectopic pregnancy. A woman who is 39 weeks pregnant is unresponsive, apneic, and pulseless. When treating her, the EMT should: - Answer- manually displace her uterus to the left. Which of the following is the MOST common cause of seizures in children? - Answer- An abrupt rise in body temperature. Which of the following would MOST likely occur in conjunction with a breech presentation? - Answer- Prolapsed umbilical cord.

Which of the following statements regarding two-rescuer child CPR is correct? - Answer- Compress the chest with one or two hands to a depth that is equal to one-third the diameter of the chest. When you begin to assess a woman in labor, she states that her contractions are occurring every 4 to 5 minutes and lasting approximately 30 seconds each. Which of the following questions would be MOST appropriate to ask next? - Answer- At how many weeks' gestation are you? You are responding to a call for a 2-year-old child who fell from a second-story window. With the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's: - Answer- head. A 4-year-old girl fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and is bleeding from her mouth and nose. You should: - Answer- open her airway with the jaw-thrust maneuver while manually stabilizing her head, suction her oropharynx, and assist her ventilations. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5 degrees F. What is the MOST appropriate treatment for this child? - Answer- Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring. Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should: - Answer- make one attempt to gently remove the cord from around its neck. Which of the following is the MOST common cause of shock in infants and children? - Answer- Dehydration. A 29-year-old woman, who is 38 weeks pregnant, presents with heavy vaginal bleeding, a blood pressure of 70/50 mm Hg, and a heart rate of 130 beats/min. She is pale and diaphoretic, and denies abdominal cramping or pain. Her signs and symptoms are MOST consistent with a/an: - Answer- placenta previa. A child typically begins to develop stranger anxiety when he or she is a/an: - Answer- toddler. During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should: - Answer- cover the arm with a sterile towel and transport immediately.

After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should: - Answer- immediately perform CPR. If a woman is having her first child, the first stage of labor: - Answer- is usually the longest and lasts an average of 16 hours. A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should expect: - Answer- foreign body airway obstruction. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment this child includes: - Answer- Offering oxygen and providing transport. Of the following, the MOST detrimental effect of gastric distension in infants and children is: - Answer- decreased ventilatory volume. After drying, warming, and suctioning a newborn's mouth and nose, assessment reveals central cyanosis, a weak cry, and a heart rate of 60 beats/min. The EMT should: - Answer- ventilate with a bag-valve-mask at 40 to 60 breaths/min. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include: - Answer- treating for shock and performing uterine massage during transport. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should: - Answer- lower the extremities and reassess the child. A 3-year-old child experienced a seizure that lasted about 10 minutes. He has a fever of 103 degrees F, his skin is hot to the touch, and he has a rash on his trunk. The EMT should suspect: - Answer- meningitis Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first? - Answer- Begin artificial ventilations. A newborn is considered to be premature if it: - Answer- is born before 37 week's gestation. The appropriate technique for performing two-rescuer CPR on a 4-year-old child includes: - Answer- 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.

To maintain neutral alignment of an 18-month-old child's airway, you should: - Answer- place padding in between the shoulder blades. The MOST important initial steps of assessing and managing a newborn include: - Answer- clearing the airway and keeping the infant warm. A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for: - Answer- convulsions Which of the following is a sign of an altered mental status in a small child? - Answer- Inattention to the EMT's presence. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn? - Answer- Initiate positive-pressure ventilations. Which of the following is an abnormal finding? - Answer- Heart rate of 80 beats/min in a newly born infant. A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury? - Answer- Pelvic injury. Your assessment of a mother in labor reveals that a fetal limb is protruding from the vagina. Management of this situation should include: - Answer- positioning the mother with her hips elevated, administering high-flow oxygen, and providing transport. You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before, but had a miscarriage at 19 weeks. You should document her obstetric history as: - Answer- gravida 2, para 0. Which of the following techniques represents the MOST appropriate method of opening the airway of an infant with no suspected neck injury? - Answer- Tilt the head back without hyperextending the neck. A 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her: - Answer- On her left side. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include: - Answer- examining the child in the parent's arms.

A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is most likely experiencing: - Answer- preeclampsia You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should: - Answer- allow the chest to fully recoil in between compressions. You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation? - Answer- Advise the parents that the child needs to be transported. Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child? - Answer- Systolic blood pressure. When assessing a 30-year-old female who was sexually assaulted, it is MOST important for you to: - Answer- ensure that all life-threatening injuries are treated. A 6-year-old boy presents with a high fever, a headache, and a stiff neck. He is conscious, but is not acting as a normal 6-year-old boy should. His mother told you that he vomited once before your arrival. You should be MOST concerned with: - Answer- the risk of permanent neurologic damage. Which of the following statements regarding pediatric anatomy is correct? - Answer- The occiput is proportionately larger when compared to an adult. When is it MOST appropriate to clamp and cut the umbilical cord? - Answer- As soon as the cord has stopped pulsating The 5-minute Apgar assessment of a newborn reveals a heart rate of 130 beats/min, cyanosis of the hands and feet, and rapid respirations. The infant cries when you flick the soles of its feet and resists attempts to straighten its legs. These findings equate to an Apgar score of: - Answer- 9 Oxygen and other nutrients are transferred to the developing fetus via the: - Answer- umbilical vein. A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should: - Answer- carefully suction the tracheostomy tube. You and your partner are performing CPR on an infant with suspected suddent infant death syndrome (SIDS). An important aspect in dealing with such cases is: - Answer- carefully inspecting the environment in which the infant was found.

A 6-year-old boy complains of pain to the right lower quadrant of his abdomen. Assessment of this child's abdomen should include: - Answer- palpating the left upper quadrant first You receive a call for a 3-year-old girl with respiratory distress. When you enter her residence, you see the mother holding the child, who does not acknowledge your presence. This finding indicates that the child: - Answer- has severe hypoxia. You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should: - Answer- provide supportive care and transport. Which of the following statements regarding crowning is correct? - Answer- Gentle pressure should be applied to the baby's head during crowning. You should assist with the delivery of the baby's head by: - Answer- placing your fingers on the bony part of the skull and applying gentle pressure. A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. The appropriate compression to ventilation ratio for this child is: - Answer- 30:2 Appropriate treatment for an 18-year-old woman with severe vaginal bleeding may include all of the following, EXCEPT: - Answer- placing sterile dressings into the vagina Supplemental oxygen via the blow-by technique is MOST appropriate for a child who presents with respiratory difficulty and: - Answer- is agitated, tachycardic, and clinging to his parent. The MOST effective way to prevent caridopulmonary arrest in a newborn is to: - Answer- ensure effective oxygenation and ventilation. You are called for a local for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred? - Answer- Allergic reaction. Which artery should you palpate when assessing for a pulse in an unresponsive 6- month-old patient? - Answer- Brachial. The MAIN reason why small children should ride in the backseat of a vehicle is because: - Answer- they can experience severe injury or death if the air bag deploys. The function of the uterus is to: - Answer- house the fetus as it grows for 40 weeks.

A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 92%. The MOST effective way of delivering oxygen to her involves: - Answer- asking the mother to hold an oxygen mask near her face. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. You should: - Answer- begin ventilations with a bag-valve-mask Which of the following injuries is MOST indicative of child abuse? - Answer- Bruising to the upper back. In contrast to the contractions associated with true labor, Braxton-Hicks contractions: - Answer- do not increase in intensity and are alleviated by a change in position. Immediately upon delivery of a newborn's head, you should: - Answer- suction the mouth The purpose of the pediatric assessment triangle is to: - Answer- form a general impression of the child without touching him or her. You should suspect physical abuse of a 4-year-old child if you observe: - Answer- purple and yellow bruises to the thighs. A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should: - Answer- contact poison control and give him oxygen. Which of the following signs or symptoms is/are more common in children than in adults following an isolated head injury? - Answer- Nausea and vomiting Which of the following signs is MOST indicative of inadequate breathing in an infant? - Answer- Expiratory grunting. A prolapsed umbilical cord is dangerous because the: - Answer- baby's head may compress the cord, cutting off its supply of oxygen. During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. You should: - Answer- advise your partner to stop the ambulance and assist with the delivery Prevention of cardiac arrest in infants and small children should focus primarily on: - Answer- ensuring adequate ventilation. You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the

past 24 hours. Your MOST immediate concern should be: - Answer- assessing the need for ventilation assistance. After the baby's head delivers, it is usually tilted: - Answer- posteriorly, to one side. Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color, includes: - Answer- supplemental oxygen and transport. Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord? - Answer- Supine with hips elevated. While performing a visual inspection of a 30-year-old woman in labor, you can see the umbilical cord at the vaginal opening. After providing high-flow oxygen, you should: - Answer- relieve pressure from the cord with your gloved fingers. Management for a woman who presents with a prolapsed umbilical cord includes all of the following, EXCEPT: - Answer- relieving pressure off of the cord by gently pulling on it. After clearing the airway of a newborn who is not in distress, it is MOST important for you to: - Answer- keep the newborn warm. You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should: - Answer- keep the newborn warm, give oxygen to the mother if needed, and transport. Which of the following assessment parameters is a more reliable indicator of perfusion in infants than adults? - Answer- Capillary refills. A 5-year-old child in compensated shock secondary to severe vomiting and diarrhea would be expected to have: - Answer- a slow capillary refill time. A sudden onset of respiratory distress in a 5-year-old child with no fever is MOST likely the result of: - Answer- a foreign body airway obstruction The preferred method for inserting an oropharyngeal airway in a small child is to: - Answer- depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of: - Answer- 10 breaths/min.

Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. Initial treatment for this condition should include: - Answer- trying to remove the cord from around the neck. Which of the following statements regarding the length-based resuscitation tape measure is correct? - Answer- The tape measure can be used in children who weigh up to 75 pounds. You are dispatched to a residence for a child having a seizure. When you arrive at the scene, the 4-year-old child's grandfather tells you that he has had several full body seizures over the past 20 minutes, but never woke up in between seizures. The child's skin is hot and flushed. This is MOST indicative of: - Answer- status epilepticus You will know that the third stage of labor has begun when: - Answer- the entire baby has delivered. Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include: - Answer- positive-pressure ventilation, chest compressions, and rapid transport. A 5-year-old child experienced partial-thickness burns to his head, anterior chest, and both upper extremities. What percentage of his total body surface area has been burned? - Answer- 0.45 You are assessing a 5-year-old boy with major trauma. His blood pressure is 70/40 mm Hg and his pulse rate is 140 beats/min. and weak. The child's blood pressure: - Answer- indicates decompensated shock. Which of the following is a more reliable indicator of perfusion in children than it is in adults? - Answer- Capillary refill. In which of the following situations would the EMT MOST likely deliver a baby at the scene? - Answer- A tornado has struck and blocked the only route to the hospital. A 44-year-old man has a traumatic leg amputation just below the knee. He is unresponsive; is breathing rapidly and shallowly; and has pale, cool, clammy skin. He is lying in a large pool of blood and the wound is bleeding profusely. To control this bleeding, you should: - Answer- cover the wound with a trauma dressing and apply a proximal tourniquet. A young male has a large laceration to his lateral neck, directly over his jugular vein. His airway is patent and his breathing is adequate. Your MOST immediate priority should be to: - Answer- keep air out of the wound and control the bleeding.