Emergency Medical Scenarios, Exams of Nursing

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WEST COAST EMT BLOCK 2 EXAM

ACTUAL QUESTIONS AND CORRECT

ANSWERS 202 4 /202 5 , EXAMS OF NURSING

It is especially important to assess pulse, sensation, and movement in all extremities as well as pupillary reactions in patients with a suspected ___________ problem. Select one: A. endocrine B. respiratory C. cardiac D. neurologic Correct Answer D. neurologic Most patients with an infectious disease will have _________. Select one: A. a low blood glucose level B. abdominal pain C. seizures D. a fever Correct Answer D. a fever Most treatments provided in the prehospital setting are intended to _________. Select one: A. reduce the need for transport to the hospital B. confirm the patient's diagnosis C. address the patient's symptoms D. correct the patient's underlying problem Correct Answer C. address the patient's symptoms The BEST way to prevent infection from whooping cough is to: Select one: A. routinely place a surgical mask on all respiratory patients. B. ask all patients if they have recently traveled abroad. C. get vaccinated against diphtheria, tetanus, and pertussis.

D. wear a HEPA mask when treating any respiratory patient. Correct Answer C. get vaccinated against diphtheria, tetanus, and pertussis. The determination of whether a medical patient is a high-priority or low-priority transport is typically made: Select one: A. as soon as the patient voices his or her chief complaint. B. after the primary assessment has been completed. C. upon completion of a detailed secondary assessment. D. once the patient's baseline vital signs are known. Correct Answer B. after the primary assessment has been completed. When assessing a patient with a medical complaint, which of the following would MOST likely reveal the cause of the problem? Select one: A. Baseline vital signs B. Index of suspicion C. Medical history D. Primary assessment Correct Answer C. Medical history When caring for a patient with an altered mental status and signs of circulatory compromise, you should: Select one: A. perform a detailed secondary assessment prior to transporting the patient. B. have a paramedic unit respond to the scene if it is less than 15 minutes away. C. limit your time at the scene to 10 minutes or less, if possible. D. transport immediately and begin all emergency treatment en route to the hospital. Correct Answer C. limit your time at the scene to 10 minutes or less, if possible. When forming your general impression of a patient with a medical complaint, it is important to remember that:

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: Select one: A. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible. B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. C. load him into the ambulance, begin transport, and perform all treatment en route to the hospital. D. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. Correct Answer B. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. You are attending to a 27-year-old male driver of a car. According to his passenger, the patient had been acting strangely while driving, then slumped forward against the steering wheel, apparently unconscious. The car drove off the road and struck a telephone pole. The patient remains unconscious, and physical assessment reveals only a large hematoma on his right forehead with no other physical signs. Your patient is a diabetic who had been under a lot of stress lately and may have missed meals. This is an example of a: Select one: A. combination of a psychiatric and trauma emergency. B. medical emergency. C. trauma emergency. D. combination of a medical and trauma emergency. Correct Answer D. combination of a medical and trauma emergency. "PASTE" is an alternate assessment tool for ___________. Select one:

A. respiratory patients B. seizure patients C. stroke patients D. cardiac patients Correct Answer A. respiratory patients A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/ mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is: Select one: A. epinephrine. B. a beta-antagonist. C. albuterol. D. an antihistamine. Correct Answer A. epinephrine. A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel- shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: A. Spontaneous pneumothorax B. Exacerbation of his COPD C. Acute pulmonary embolism D. Rupture of the diaphragm Correct Answer A. Spontaneous pneumothorax A pleural effusion is MOST accurately defined as: Select one: A. fluid accumulation outside the lung. B. diffuse collapsing of the alveoli.

A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane. D. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. Correct Answer C. oxygen and carbon dioxide must be able to freely diffuse across the alveolar- capillary membrane. In what area of the lungs does respiration occur? Select one: A. Alveoli B. Bronchi C. Trachea D. Capillaries Correct Answer A. Alveoli Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? Select one: A. Pulmonary edema, history of hypertension, and anxiety B. Difficulty breathing, two-word dyspnea, and tachycardia C. Conscious and alert patient with an oxygen saturation of 85% D. Shortness of breath and a blood pressure of 76/56 mm Hg Correct Answer D. Shortness of breath and a blood pressure of 76/56 mm Hg When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: Select one: A. abnormal breath sounds. B. diminished breath sounds. C. normal breath sounds.

D. an absence of breath sounds. Correct Answer A. abnormal breath sounds. Which of the following conditions would be LEAST likely to result in hypoxia? Select one: A. Pleural effusion B. Severe anxiety C. Pulmonary edema D. Narcotic overdose Correct Answer B. Severe anxiety Which of the following is a genetic disorder that predisposes the patient to repeated lung infections? Select one: A. Multiple sclerosis B. Severe acute respiratory syndrome C. Cystic fibrosis D. Celiac sprue Correct Answer C. Cystic fibrosis Which of the following is MOST characteristic of adequate breathing? Select one: A. 22 breaths/min with an irregular pattern of breathing and cyanosis B. 20 breaths/min with shallow movement of the chest wall and pallor C. 24 breaths/min with bilaterally equal breath sounds and pink skin D. 30 breaths/min with supraclavicular retractions and clammy skin Correct Answer C. 24 breaths/min with bilaterally equal breath sounds and pink skin Which of the following must be assessed in every respiratory patient? Select one:

upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from: Select one: A. bacterial infection of the epiglottis. B. viral infection of the upper respiratory tract. C. inflammation of the bronchioles. D. inflammation of the lower respiratory tract and bronchospasm. Correct Answer B. viral infection of the upper respiratory tract. You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from: Select one: A. chronic obstructive pulmonary disease (COPD). B. tuberculosis. C. pneumonia. D. influenza Type A. Correct Answer B. tuberculosis. Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________. Select one: A. alternate drive B. CO2 drive C. hypoxic drive D. COPD drive Correct Answer C. hypoxic drive A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: A. administer up to three doses of nitroglycerin.

B. administer up to 324 mg of baby aspirin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations. Correct Answer D. assess the adequacy of his respirations. A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: Select one: A. give her one nitroglycerin and reassess her systolic blood pressure. B. administer oxygen, give her 324 mg of aspirin, and assess her further. C. obtain a SAMPLE history and contact medical control for advice. D. give her high-flow oxygen, attach the AED, and transport at once. Correct Answer B. administer oxygen, give her 324 mg of aspirin, and assess her further. A dissecting aortic aneurysm occurs when: Select one: A. a weakened area develops in the aortic wall. B. the aorta ruptures, resulting in profound bleeding. C. the inner layers of the aorta become separated. D. all layers of the aorta suddenly contract. Correct Answer C. the inner layers of the aorta become separated. A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one:

B. assess for a carotid pulse. C. immediately resume CPR. D. re-analyze the cardiac rhythm. Correct Answer C. immediately resume CPR. Angina pectoris occurs when: Select one: A. myocardial oxygen demand exceeds supply. B. a coronary artery is totally occluded by plaque. C. myocardial oxygen supply exceeds the demand. D. one or more coronary arteries suddenly spasm. Correct Answer A. myocardial oxygen demand exceeds supply. Deoxygenated blood from the body returns to the: Select one: A. left ventricle. B. right atrium. C. right ventricle. D. left atrium. Correct Answer B. right atrium. Most AEDs are set up to adjust the voltage based on the impedance, which is the: Select one: A. distance between the two AED pads on the chest. B. direction that the electrical flow takes in the body. C. actual amount of energy that the AED will deliver. D. resistance of the body to the flow of electricity. Correct Answer D. resistance of the body to the flow of electricity. Nitroglycerin is contraindicated in patients: Select one: A. who have taken up to two doses. B. who have experienced a head injury. C. with a systolic blood pressure less than 120 mm Hg.

D. with a history of an ischemic stroke. Correct Answer B. who have experienced a head injury. Prior to attaching the AED to a cardiac arrest patient, the EMT should: Select one: A. assess for a pulse for 20 seconds. B. contact medical control. C. dry the chest if it is wet. D. perform CPR for 30 seconds. Correct Answer C. dry the chest if it is wet. Risk factors for AMI that cannot be controlled include: Select one: A. family history. B. lack of exercise. C. hyperglycemia. D. excess stress. Correct Answer A. family history. Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: A. are older than 40 years of age. B. regularly take illegal drugs. C. have chronic hypertension. D. have had a stroke in the past. Correct Answer C. have chronic hypertension. The electrical impulse generated by the heart originates in the: Select one: A. atrioventricular node. B. bundle of His. C. sinoatrial node. D. coronary sinus. Correct Answer C. sinoatrial node.

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: Select one: A. perform two-rescuer CPR for 5 minutes and request ALS backup. B. have your partner perform CPR while you question the bystanders. C. immediately apply the AED pads and analyze his cardiac rhythm. D. begin high-quality CPR and apply the AED as soon as possible. Correct Answer D. begin high-quality CPR and apply the AED as soon as possible. A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: Select one: A. administer high-flow supplemental oxygen. B. apply a tourniquet proximal to the wrist. C. apply pressure to the brachial artery. D. wrap the towel with pressure bandages. Correct Answer B. apply a tourniquet proximal to the wrist. A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? Select one: A. High-flow oxygen administration B. Rapid transport to a trauma center

C. Full immobilization of her spine D. Intravenous fluid administration Correct Answer B. Rapid transport to a trauma center As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be? Select one: A. Check for a pulse. B. Control the bleeding. C. Administer oxygen. D. Open the airway. Correct Answer B. Control the bleeding. Distributive shock occurs when: Select one: A. severe bleeding causes tachycardia in order to distribute blood to the organs faster. B. an injury causes restriction of the heart muscle and impairs its pumping function. C. temporary but severe vasodilation causes a decrease in blood supply to the brain. D. widespread dilation of the blood vessels causes blood to pool in the vascular beds. Correct Answer D. widespread dilation of the blood vessels causes blood to pool in the vascular beds. Foods, medications, and insects are common causes of ________. Select one: A. anaphylactic shock B. septic shock C. neurogenic shock D. psychogenic shock Correct Answer A. anaphylactic shock Hypovolemic shock caused by severe burns is the result of a loss of:

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: Select one: A. the lungs. B. the brain. C. the skin. D. the heart. Correct Answer C. the skin. What are the three components of the "perfusion triangle"? Select one: A. Heart, blood vessels, blood B. Plasma, red blood cells, platelets C. Heart, brain, lungs D. Arteries, veins, capillaries Correct Answer A. Heart, blood vessels, blood When assessing a patient with signs and symptoms of shock, it is important to remember that: Select one: A. irreversible shock often responds well to a prompt blood transfusion. B. multiple fractures are the most common cause of hypovolemic shock. C. blood pressure may be the last measurable factor to change in shock. D. the patient's respirations are deep during the early stages of shock. Correct Answer C. blood pressure may be the last measurable factor to change in shock. When should nonlifesaving interventions be performed for your multisystem trauma patient? Select one: A. En route to the hospital B. During the primary assessment

C. Prior to transport D. Immediately after the injuries are discovered Correct Answer A. En route to the hospital When treating an 80-year-old patient who is in shock, it is important to remember that: Select one: A. the older patient's central nervous system usually reacts more briskly to compensate for shock. B. medications older patients take for hypertension often cause an unusually fast heart rate. C. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting. D. compensation from the respiratory system usually manifests with increased tidal volume. Correct Answer C. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting. Which of the following injuries would MOST likely cause obstructive shock? Select one: A. Spinal cord injury B. Simple pneumothorax C. Liver laceration D. Cardiac tamponade Correct Answer D. Cardiac tamponade Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax? Select one: A. Early administration of high-flow oxygen B. Rapid administration of intravenous fluids C. Decompression of the injured side of the chest D. Positive-pressure ventilation with a bag-valve mask Correct Answer C. Decompression of the injured side of the chest