Identifying and Managing Medical Emergencies: A Comprehensive Guide, Exams of Nursing

Download Identifying and Managing Medical Emergencies: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! NR EMT FINAL EXAM 2023-2024 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT AND VERIFIED ANSWERS) |ALREADY GRADED A+ (BRAND NEW!!) Cushing's reflex includes increased blood pressure, bradycardia, and: (A) irregular respirations. (B) irregular pulse. (C) increased respirations. (D) pupil dilation. - ANSWER- (A) irregular respirations. RATIONALE:Cushing's reflex is indicative of a head injury with increased intracranial pressure (ICP). You delivered a full-term baby in the back of your ambulance and the initial APGAR score is 5. What treatment should you do? (A) CPR. (B) effective ventilation. (C) vascular access. (D) administration of epinephrine. - ANSWER- (B) effective ventilation. RATIONALE:Most newborns respond favorably to warming, drying, suctioning, and stimulation. All of the following are phases of the stress response EXCEPT: (A) alarm reaction. (B) resistance. (C) exhaustion. (D) acceptance. - ANSWER- (D) acceptance. RATIONALE:The 3 phases of the body's response to stress: (1) alarm reaction (fight-or-flight response) (2) resistance: the level of resistance to stress raises (3) exhaustion-as stress continues, coping mechanisms begin to fail Manual maneuvers used to open a patient's airway (A) are contraindicated in most patients. (B) are difficult to perform. (C) include head-tilt/chin-lift and jaw thrust. (D) do not usually work without more extensive intervention. - ANSWER- (C) include head-tilt/chin-lift and jaw thrust. A patient was struck in the head by a large tree branch while trimming a tree. The next day, he complains of dizziness and vomiting. You suspect? (A) an epidural hematoma. (B) a subdural hematoma. (C) a concussion. (D) a contusion. - ANSWER- (b) subdural hematoma. RATIONALE:A subdural hematoma is usually due to rupture of small venous vessels. This type of bleeding is slow and the onset of symptoms may take several hours to develop after the injury. Supine hypotensive syndrome occurs from? (A) reduction of cardiac output due to compression of the aorta. (B) reduction of cardiac output due to compression of the inferior vena cava. (C) reduction of cardiac output due to compression of the superior vena cava. (D) the uterus pushing up on the diaphragm. - ANSWER- (B) reduction of cardiac output due to compression of the inferior vena cava. When caring for a child in respiratory distress, you hear a harsh high-pitched sound with each breath. What do you suspect? (A) stridor. (B) wheezing. (C) crackles. (D) rhonchi. - ANSWER- (A) stridor. The documentation of a baseline neurological status should NOT include which of the following: (A) Pulse oximetry (B) Response to sensory stimulation (C) Pupillary reaction (D) Motor function - ANSWER- (A) Pulse oximetry The chest wall is lined by a layer of smooth, glistening tissue called: (D) placing in a Trendelenburg position. - ANSWER- (A) CPR. RATIONALE: CPR is indicated even if signs of death are present. A hypothermic patient cannot be presumed dead until they are warm and dead. Remember hypothermia can cause Ventricular Fibrillation so rewarming needs to be done in a controlled setting. Injury to which abdominal organ is most likely to cause death in the pediatric patient? (A) Pancreas (B) Liver (C) Spleen (D) Kidney - ANSWER- (B) Liver RATIONALE:The liver is a solid, vascular organ in the RUQ. Rupture or laceration of the liver can cause severe hemorrhage. Injury to the liver is the most common abdominal injury that leads to death in the pediatric patient. Which blood component transports oxygen? (A) plasma. (B) platelets. (C) leukocytes. (D) erythrocytes. - ANSWER- (D) erythrocytes. RATIONALE:Also known as RBC's. Leukocytes are white blood cells and play a role in fighting infection. Platelets play a role in clotting. Plasma is the liquid that carries the cells throughout the body. Your assessment must be thorough when dealing with an intoxicated patient because: (A) alcohol increases pain tolerance. (B) alcohol decreases the patient's judgment. (C) alcohol is a CNS stimulant. (D) alcohol can mask signs and symptoms of injury. - ANSWER- (D) alcohol can mask signs and symptoms of injury. RATIONALE: Alcohol is a central nervous system depressant and, therefore, can mask signs and symptoms of injury. What would you suspect in a 22yo female complaining of severe, stabbing, unilateral pain in the lower abdomen. Vital signs are BP 88/64, HR 128, RR 22. Her skin is cool and she missed her menstrual cycle. (A) a ruptured ectopic pregnancy. (B) endometriosis. (C) pelvic inflammatory disease. (D) amenorrhea. - ANSWER- (A) a ruptured ectopic pregnancy. RATIONALE:The classic triad of symptom includes abdominal pain, vaginal bleeding, and amenorrhea. Other symptoms include referred pain to the shoulder, nausea, vomiting, or syncope. Signs of shock may be present if the ectopic ruptures. An indicator of severe abdominal trauma after an MVC may include: (A) absent bowel sounds. (B) back pain. (C) referred pain to the clavicle. (D) unexplained shock. - ANSWER- (D) unexplained shock. Shaken Baby Syndrome can cause which of the following conditions? (A) Hypoglycemia (B) Abdominal bruising (C) Subdural hematoma (D) Lower extremity fracture - ANSWER- (C) Subdural hematoma Which law protects an EMT if the EMT acts in good faith, is not negligent, acts within the scope of practice, and does not accept payment for service? (A) implied consent laws. (B) Good Samaritan laws. (C) malfeasance laws. (D) absolute immunity laws. - ANSWER- (B) Good Samaritan laws You arrive at a two car accident and the driver of the 1st car is unconscious. Consent for this patient would be? (A) informed. (B) implied. (C) expressed. (D) involuntary. - ANSWER- (B) implied Organ responsible for insulin production. (A) adrenal (B) pancreas (C) thyroid (D) thymus - ANSWER- (B) pancreas Which federal agency regulates telecommunications in the United States? (A) FBI. (B) FDIC. (C) FCC. (D) FACEP. - ANSWER- (C) FCC. What is the rate of chest compressions for a two-year-old in cardiac arrest? (A) 80/minute. (B) 100/minute. (C) 110/minute. (D) 120/minute. - ANSWER- (B) 100/minute. A BVM with a reservoir and oxygen source (at least 15 LPM) delivers an oxygen concentration of (A) 21%. (B) 40% to 60%. (C) 80%. (D) 100%. - ANSWER- (D) 100%. Beck's triad (associated with pericardial tamponade) includes: distant heart tones, JVD, and... (A) pulse deviation. (B) narrowing pulse pressure. (C) wheezing. (D) delayed capillary refill. - ANSWER- (B) narrowing pulse pressure. What happens during inspiration? (A) the diaphragm contracts and the intercostal muscles relax. (B) the diaphragm relaxes and the intercostal muscles contract. (C) the diaphragm relaxes and the intercostal muscles relax. (D) the diaphragm contracts and the intercostal muscles contract. - ANSWER- (D) the diaphragm contracts and the intercostal muscles contract. When assessment of a trauma patient does not reveal significant injury, the presence of unexplained shock should lead you to suspect serious following actions are appropriate EXCEPT to: (A) establish scene command. (B) treat and transport the most critically ill patient. (C) perform a scene size up. (D) control scene hazards. - ANSWER- (B) treat and transport the most critically ill patient. The first unit to arrive on the scene should begin the scene size up which includes establishing command, calling for back-up units, controlling any hazards and locating and triaging patients. It would not be appropriate for the primary unit to locate and transport the most critically injured patient. The large vessel of the body that carries oxygenated blood is the (A) coronary sinus. (B) pulmonary vein. (C) superior vena cava. (D) femoral vein. - ANSWER- (B) pulmonary vein Veins carry blood from the body back to the heart. The pulmonary vein carries oxygen-rich blood from the lungs back to the heart. Where should you place your hands on the chest of an adult victim when you are performing chest compressions? (A) On the top of the sternum (B) On the lower one-third of the sternum (C) On the lower half of the sternum, at the nipple line (D) Over the very bottom of the sternum - ANSWER- (C) On the lower half of the sternum, at the nipple line During your assessment, you find crepitus and instability to the right rib cage. Lung sounds are equal but there is paradoxical chest movement. You suspect: (A) a tension pneumothorax. (B) a massive hemothorax. (C) a flail chest. (D) an abdominal aneurysm. - ANSWER- (C) a flail chest Flail chest is defined as three or more adjacent ribs that are fractured in two or more places. This segment of the chest is free to move with the pressure changes of respirations. A high-pitched noise associated with upper airway constriction is known as (A) wheezes. (B) rhonchi. (C) stridor. (D) rales. - ANSWER- (C) Stridor Stridor is defined as a high-pitched sound associated caused by obstruction in the trachea or larynx. Which statement correctly relates to pediatric seizures? (A) Febrile seizures typically occur on the 1st day of a febrile illness and have tonic-clonic activity. (B) Always suspect a fever to be the cause of a seizure if the temperature is more than 101°F. (C) Infants and children between the ages of 4 months and 8 years commonly suffer from febrile seizures. (D) Febrile seizures do not require transport if the patient can be cooled. - ANSWER- (A) Febrile seizures typically occur on the 1st day of a febrile illness and have tonic-clonic activity. A patient was burned and has blisters to the chest, abdomen, entire right arm, and front of the right leg. According to the rule of nines, what is the percent of burns? (A) 40.5% (B) 36% (C) 45% (D) 31.5% - ANSWER- (B) 36% (chest = 9%, abdomen = 9%, entire arm 9%, front of the leg = 9%) When using the rule of nines for calculating burns, which of the following is a correct modification for a child? (A) The front of each arm for a child is 7% compared to 9% for an adult. (B) The front of each leg for a child is 4% compared to 9% on an adult. (C) The head of a child is 18% compared to 9% on an adult. (D) The entire leg of a child is 9% compared to 18% on an adult. - ANSWER- (C) The head of a child is 18% compared to 9% on an adult. You arrive to find a 6 year old child who is in the tripod position and drooling. The child has a fever and difficulty swallowing. What do you suspect? (A) bronchiolitis. (B) croup. (C) epiglottitis. (D) meningitis. - ANSWER- (C) Epiglottitis Epiglottitis is a bacterial infection causing the acute swelling of the epiglottis and the soft tissues above the glottic opening. Clinical findings include fever, pain on swallowing, typically sitting in tripod position, and drooling. Which of the following is NOT indicative of a tension pneumothorax? (A) Dyspnea (B) Hyperresonance to percussion (C) Distended jugular veins (D) Clear lung sounds - ANSWER- (D) Clear lung sounds. Stimulation of the vagus nerve may result in: (A) vasodilation. (B) an increase in heart rate. (C) a decrease in heart rate. (D) an increase in cardiac output - ANSWER- (C) a decrease in heart rate. You are caring for a female who is 36 weeks pregnant and involved in a car accident. After you fully immobilize her on a long spine board, you would: (A) carefully tilt the board to the left side 10-15 degrees. (B) carefully tilt the board to the right side 10-15 degrees. (C) manually displace the uterus to the right. (D) allow the patient to roll onto her side. - ANSWER- (A) carefully tilt the board to the left side 10-15 degrees...To prevent supine hypotension syndrome. Tilting the board will allow the uterus to displace to the left and prevent compression of the inferior vena cava. A nasal cannula can deliver ____% of oxygen at a flow rate of 6 LPM in optimal conditions. (A) 30% (B) 40% (C) 50% (D) 65% - ANSWER- (B) 40% of oxygen. Which of the following is treatment for a flail chest injury? (A) Position of comfort with O2 per NRB mask (B) Positive pressure ventilation (C) Stabilization of the flail segment with a sandbag A. Equal and reactive pupils B. Pedal edema C. Normal distal sensory and motor function D. Bruising on her forearms - ANSWER- B A 28-year-old female has ingested about 30 unknown pills. She is semiconscious and her vital signs are pulse 128, respiration 12, blood pressure 88/40. Poison control notes that activated charcoal should be administered. In this case charcoal is contraindicated because: A. the pills are unknown. B. she has an altered mental status. C. her blood pressure is too low. D. her breathing is too slow. - ANSWER- B A 17-year-old pregnant female presents with altered mental status. Her boyfriend notes she is 40 weeks pregnant with twins and states, "I can't wake her up." She presents confused and is flushed with obvious swelling in her hands and face. Her vital signs are pulse 90, respiration 28, blood pressure 200/112. What is the most likely immediate complication for this patient? A. Stroke B. Internal bleeding C. Seizures D. Imminent delivery - ANSWER- C A one-year-old male has had a fever for three days and now has developed wheezing and severe respiratory distress. You notice his skin is hot and cyanotic around the lips. The patient suddenly begins to seize. The most likely cause of the seizure in this patient would be: A. fever B. toxic ingestion C. hypoxia D. epilepsy - ANSWER- C An adult female patient was cooking when there was a flare up that resulted in burns to the following areas: entire chest, entire abdomen, and circumferential to lower part (elbow to hands) of both arms. Using the "rule of nines," what percentage of body surface area is burned on this patient? A. 45% B. 18% C. 36% D. 27% - ANSWER- D. The "rule of nines" assigns the following percentages for an adult: head, 9%; chest, 9%; abdomen, 9%; upper back, 9%; lower back, 9%; each arm, 9%; each leg, 18%; and groin, 1%. Applying the rule of nines to this scenario gives us the following: the chest (9%), abdomen (9%), and half of each arm (2 X 4.5% = 9%) for a total of 27% of body surface area burned. An 18-year-old female tells you that she has ingested 48 amitriptyline pills. She notes she was trying to harm herself and took the pills about 20 minutes ago. She is alert and her vital signs are pulse 120, respiration 20, blood pressure 100/60. You should first: A. contact poison control. B. request ALS and await their arrival. C. initiate transport immediately. D. induce vomiting - ANSWER- C The most important benefit of a unified command would be: A. allowing more than one agency to design tactics for dealing with an incident. B. preventing more than one set of tactics at a single incident. C. assigning one overall commander to oversee all agencies. D. allowing different chiefs to make decisions independently. - ANSWER- B An 81-year-old diabetic female presents with altered mental status. She is conversational, but confused as to where she is. She is pale and diaphoretic and her blood glucose is 62 mg/dL. You should first: A. apply high-concentration oxygen via nonrebreather mask. B. administer a tube of oral glucose. C. initiate rapid transport D. complete a detailed assessment to look for potential injuries - ANSWER- B You are caring for a neonate who you suspect is severely depressed and in need of aggressive resuscitation. Which of the below clinical findings would support your suspicion? A. APGAR score of 6 B. Cyanotic extremities with pink core C. Respiratory rate 64/minute D. Heart rate 172/minute - ANSWER- C A 12-year-old male has injured his knee after a minor bicycle crash. He is alert and complains only of knee pain. After completing your primary assessment, you should: A. complete a detailed physical exam. B. initiate rapid transport. C. complete a rapid trauma assessment. D. initiate a focused examination of the patient's knee. - ANSWER- D A 29-year-old male has been involved in a motorcycle crash. He has a large abrasion on his left thigh and lower leg. The most significant threat from this type of injury would be: A. serious bleeding. B. pain. C. nerve damage. D. infection. - ANSWER- D Which one of the following would be considered a significant mechanism of injury? A. 63-year-old female falls and sustains an angulated tibia/fibula fracture B. Motor-vehicle crash at 30 mph with no passenger compartment intrusion C. A three-year-old falls 11 feet without loss of consciousness D. Six-foot male falls eight feet without a loss of consciousness - ANSWER- C Arriving at the home of a patient who has chest pain, you are told that she has an automatic implanted cardiac defibrillator (AICD). After your assessment, you begin to gather a SAMPLE history. Before you finish, the patient loses consciousness. You determine she is apneic and pulseless. Of the following which one is the most appropriate action to take? A. Contact medical control for orders. B. Do CPR only but do not connect an AED. C. Start CPR and attach an AED. D. Wait for the patient's AICS to respond. - ANSWER- C During the interview of a female patient thought to be experiencing a spontaneous abortion, she relays to you a prenatal history of poor nutrition, drug abuse, and smoking. During what stage of the fetal development would these habits have the greatest potential for malformation? A. Embryonic stage B. Fertilization C. Fetal stage D. Implantation - ANSWER- A C. The windpipe is soft and pliable in pediatric patients. D. The mouth is much smaller in pediatric patients. - ANSWER- A During your pre-shift ambulance inspection, you notice that one of the box warning flashers has burnt out. You should: A. notify your relief of the problem and let them handle it. B. remove the light because it is not necessary. C. keep the ambulance in service and make an appointment with maintenance as soon as possible. D. immediately take the ambulance out of service and notify maintenance. - ANSWER- C After a particularly bad call involving a pediatric trauma arrest, you notice your partner to be extremely agitated, sweating, verbally aggressive, and pacing about the station muttering to himself. These findings may be indicative of what kind of stress reaction? A. Acute B. Delayed C. Progressive D. Cumulative - ANSWER- A There are multiple tasks the EMT is responsible for on each EMS run. If the EMT must coordinate the rescue of a patient who is entrapped under rubble from a building collapse, this is an example of which EMT role? A. Maintenance of medical and legal standards B. Maintaining vehicle readiness C. Provision of scene leadership D. Provision of rescue services - ANSWER- C A patient presents to you with dyspnea, accessory muscle use, a diminishing pulse ox reading on oxygen, chest pain, inspiratory rales, and tripod positioning. He states that the trouble breathing started before the chest pain. He has a history of heart failure and hypertension. This patient is likely experiencing what respiratory emergency? A. Pulmonary edema B. Cardiogenic shock C. Bronchitis D. Asthma - ANSWER- A Given the history and presentation, the patient is likely going into pulmonary edema secondary to heart failure. The fact the dyspnea started prior to the chest pain suggests that poor oxygenation is now stressing the heart. Asthma and bronchitis are both pulmonary conditions, but typically do not present with rales. Finally, the patient may go into cardiogenic shock, but this is not a respiratory type emergency - it is a cardiac emergency. After finishing a radio report detailing your chest-pain patient, the medical control physician instructs you to administer nitroglycerin. The patient does not take this medication and in your state EMTs do not administer it. However, the medication is carried on your ambulance for use by paramedics. In this case administering nitroglycerin would be: A. a violation of your scope of practice. B. allowable if the patient agreed. C. acceptable because your were directed by a physician. D. appropriate only if the patient had clear indications. - ANSWER- A Which one of the following is a sign of left-sided heart failure? A. Abdominal edema B. Pedal edema C. Sacral edema D. Pulmonary edema - ANSWER- D As the result of damage to the left side of the heart, blood backs up into the lungs. This may be auscultated as crackles or rales in the lungs. When the right side of the heart is in failure and not pumping properly, then fluid backs up in the abdomen, lower extremities (pedal edema), and lower back (sacral edema). A 45 year olf male was thrown off a motorcycle when it struck a car. The patient was not wearing a helmet. He opens his eyes and pulls away when you stimulate him. When you ask him questions he provides inappropriate responses to your questions. His Glascow Coma Scale score is A. 5 B. 11 C. 9 D. 7 - ANSWER- C The Glascow Coma Scale score is based on the patient's best eye, verbal and motor response. He should receive a 2 for opening his eyes to pain; a 3 for using inappropriate words to respond to questions; and a 4 for withdrawing from painful stimuli. EMT'S should wear high efficiency particulate air respirators when they are in contact with patients who have which of the following?? - ANSWER- B . Tuberculosis 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 action? - ANSWER- C. remove patient from the house and to your ambulance. The most common electrical rhythm disturbance that results in sudden cardiac arrest is called? - ANSWER- b. ventricular fibrillation Which of the following is the highest priority patient? - ANSWER- a. 57 year old male with chest pain and systolic blood pressure of 80 OPQRST - ANSWER- O-onset P-Provocation Q-quality R-Radiation S-Severity T-Time DCAP-BTLS - ANSWER- D- DEFORMITIES C-CONFUSIONS A-ABRASIONS P-PUNCTURES B-BURNS T-TENDERNESS L-LACERATIONS S-SWELLING SAMPLE - ANSWER- S-SIGNS AND SYMPTOMS A-ALLERGIES M-MEDICATION P-PAST PERTINENT HISTORY L-LAST ORAL INTAKE E-EVENTS LEADING TO INJURY AVPU scale - ANSWER- A-Alert V-Voice P-Pain U-Unresponsive Ecchymosis - ANSWER- bruising or discoloration The valve between right atrium and right ventricle is the ? - ANSWER- Tricuspid valve - ANSWER- This patient's symptoms are consistent with preeclampsia. Symptoms of a miscarriage include severe menstrual cramping and vaginal bleeding. Symptoms of an ectopic pregnancy include fatigue, abdominal and back pain, and spotting. This patient shows no signs of respiratory-related symptoms and has no complaints of difficulty breathing. Calculate the APGAR score for the following newborn: - Appearance: pink - Pulse: 120 - Grimace: sneeze - Activity: active - Respiratory: vigorous cry - ANSWER- A: 2. P: 2. G: 2. A: 2. R: 2. Total = 10 You are managing a patient who is in the process of delivering her full-term baby. When the baby's head emerges, you notice that the amniotic sac is still intact. What should you do? - ANSWER- You need to rupture the amniotic sac immediately. Do so gently with your fingers to avoid harm to the baby and then suction the airway. Having just arrived on the scene of a motor vehicle crash, which of the following is the most appropriate piece of safety/personal protective equipment to do immediately? - ANSWER- While gloves and eye protection are necessary for patient care, ensuring your own safety is the number one priority on any call. Wearing a high visibility reflective traffic vest will make you easier to see for approaching traffic. Which of the following is not a component of the water rescue model? - ANSWER- The water rescue model is intended to save a patient who is drowning. It includes calling out to the patient to have them move towards you. Reach for the patient, throw them a rope, row out to them, or swim to them if all else fails. You are the incident commander at a mass casualty incident. Two passenger trains have collided inside a tunnel that is one mile in length. Initial casualty reports are in the hundreds. What type of incident is this? - ANSWER- A closed incident is an incident that is limited by the physical structures surrounding it. The physical limitations reduce the ability of emergency responders to easily access, treat, and transport patients. An assessment of the scene and surroundings that will provide valuable information to the first responder and will help ensure their well being is a definition of which of the following terms? - ANSWER- Scene safety is the assessment of the scene, your surroundings, and any threats to your well-being. If the scene isn't safe, you need to stay away until it is. Your 19-year-old male patient is complaining of a "thunder-clap" headache after a motor vehicle collision with intrusion to the driver's side. The patient is conscious but altered, and is speaking inappropriate words. While assessing your patient, he vomits violently and begins seizing. What type of head injury has this patient likely sustained? - ANSWER- The best answer is A. The "thunder-clap" headache is associated with a Sub-arachnoid hemorrhage. Epidural and Subdural hematoma have a similar presentation but do not present with this type of headache. An intravetricular hemorrhage is usually seen in pediatric patients of non-traumatic etiology. Which artery is best to palpate for a pulse in small children? - ANSWER- Brachial--Upper Arm Preeclampsia - ANSWER- a condition that occurs in late pregnancies that is characterized by hypertension, severe headache, blurry vision, and fluid retention. Major deprestion - ANSWER- Typical signs of depression include, loss of interest in things once enjoyed, lack of sleep, decreased appetite, change in activity or energy, and thoughts of suicide. A complete breech presentation is when the baby is in which position? - ANSWER- The buttocks present first, with the baby having its knees and hips flexed Respiratory syncytial virus - ANSWER- Respiratory syncytial virus is a common pediatric illness that occurs during winter and early spring. It is characterized by cold-like symptoms early on that progress to moderate-to-severe respiratory symptoms including increased respiratory rate, wheezing, and respiratory distress. You are managing a patient who is in the process of delivering her full-term baby. When the baby's head emerges, you notice that the amniotic sac is still intact. What should you do? - ANSWER- You need to rupture the amniotic sac immediately. Do so gently with your fingers to avoid harm to the baby and then suction the airway. How does activated charcoal eliminate ingested poisons? - ANSWER- Through adsorption Which of the following changes would you most likely NOT see with a pregnant adult female? - ANSWER- Decrease in heart rate The fetus' umbilical cord is made up of how many arteries and how many veins? - ANSWER- 2 arteries and 1 vein Acrocyanosis refers to which of the following? - ANSWER- Pink core and cyanotic extremities Acro = extremity Cyano = blue Osis = condition of Your patient is a 5-year-old male who hit his head on a rock after falling from a tree. Compared to an adult with head trauma, he is more likely to exhibit which of the following signs or symptoms? - ANSWER- It is relatively common for children to experience nausea and vomiting after head trauma. In adults, it usually only occurs in cases of severe trauma. The last stage of labor is called? - ANSWER- The placental stage Begins after the fetus is delivered and ends with the delivery of the placenta. Which of the following events occurs during the luteal phase of the menstrual cycle? - ANSWER- Menstruation You are called to a 36-year-old female who is having labor pains. She appears to be in active labor and as you inspect the vagina, she begins to bleed excessively prior to crowning. You should immediately? - ANSWER- Treat with high-flow O2 and rapid transportation. Place a sanitary napkin over the vaginal opening. Due to the potential for life-threatening hemorrhage, patients presenting with possible placenta previa should be treated for? - ANSWER- Patients with active hemorrhage should always be treated for shock. Which of the following is not an anatomically correct difference between adult and pediatric patients? - ANSWER- The trachea is more flexible in adults Respiratory Syncytial Virus - ANSWER- common pediatric illness that occurs during winter and early spring. It is characterized by cold-like symptoms early on that progress to moderate-to-severe respiratory symptoms including increased respiratory rate, wheezing, and respiratory distress. You are on scene with a 28-year-old female patient involved in a head-on motor vehicle crash. She is 34 weeks pregnant. The engine company has placed your patient in full C-spine precautions and she is ready to be transported. In what position should you transport your patient? - ANSWER- Pregnant women should be transported the left lateral recumbent position. If you place a pregnant woman on her back, you risk causing supine hypotension (the weight of the fetus rests on the vena cava which prevents blood return to the heart). If your patient is immobilized, slightly elevate the right side of the spinal board 4-6" above the left side. The second stage of labor begins after what has occurred? - ANSWER- Full dilation of cervix The most common reason for bradycardia in a newborn is? - ANSWER- Hypoxia In newborns, bradycardia is almost always an event secondary to hypoxia. In most You respond to a serious motor-vehicle crash where it is apparent that a young woman has been killed. Her family arrives on scene. When speaking with them, you should tell them: A. you know how they feel B. crews are doing everything they can C. their daughter has died D. everything will be okay - ANSWER- C A 22-year-old, 38-week pregnant female requires transport to the hospital after a fall. There is no indication of spine injury. The most appropriate position to transport her in would be: A. left lateral recumbent. B. knee-chest position. C. semi-Fowler's position. D. supine - ANSWER- A A patient is found in his apartment sitting in a chair in the tripod position, manifesting noisy respirations, cyanosis around the lips, and restlessness. Vital signs are: respirations 28 (working to breathe), pulse 100 (slightly irregular), and blood pressure 140/90. Oxygen should be provided to this patient by way of: A. bag-valve mask. B. oxygen-powered ventilation device. C. nasal cannula. D. nonrebreather mask. - ANSWER- D A 66-year-old male patient with a stoma is found in respiratory arrest. Which one of the following would be the most appropriate method for delivering positive pressure ventilations to this patient? A. Use a pediatric mask to ventilate the stoma directly. B. Use a traditional face mask to ventilate, leaving the stoma open. C. Use a traditional face mask to ventilate the stoma directly. D. Seal the stoma and ventilate, using a traditional face mask. - ANSWER- A Early signs of hypoperfusion in a pregnant female patient may be lost due the physiological changes caused by pregnancy. Which of the following vital signs is one such example of this? A. Heart rate B. Respiratory rate C. Pulse oximeter D. Blood pressure - ANSWER- D You and your partner are checking your ambulance prior to your shift. Which one of the following oxygen cylinder pressures would be the minimum safe residual pressure for operational use? A. 2000 psi B. 1000 psi C. 500 psi D. 200 psi - ANSWER- D You are departing the scene of a 2 car MVC from which you are transporting a critical trauma patient. Your partner is in the back and you are going to drive the ambulance to the hospital. As you conceptualize the route you wish to take to the hospital, which of the factors below is LEAST important to the actual route you'll take? A. Traffic patterns B. Freeway versus city road C. Road surface D. Travel time - ANSWER- B A mother states her seven-week-old infant has not been feeding well and may have had a fever over the last four days. The baby is listless, and when you examine his head, you notice its fontanels are sunken. What does this finding most likely indicate? A. Rising intracranial pressure B. Hypovolemia C. Traumatic brain injury D. Meningitis - ANSWER- B A 21-year-old male has been involved in a serious motor-vehicle crash. You begin your primary assessment in the vehicle as rescue crews prepare for mechanical extrication. After checking airway and breathing, you find spurting blood coming from a laceration on his leg. Your jump kit is outside the car. You should: A. wait for the patient to be extricated to initiate bleeding control. B. immediately apply the tourniquet you carry in your pocket. C. use your gloved hand to initiate direct pressure. D. wait for a crew member to bring you a sterile dressing. - ANSWER- C You are addressing a person who is angry at you because his wife was pronounced dead on scene and he thinks you should have started treatment and transport. You are trying to gather specific patient information from him so you can contact appropriate authorities. During this exchange, what patient communication strategy could you possibly employ? A. Reflection B. Confrontation C. Anger D. Clarification - ANSWER- A A 31-year-old female has been found unconscious by the side of the road. Bystanders state that they do not know what happened. The patient does not appear to be breathing. After ensuring scene safety, you should next: A. interview bystanders for further information. B. check her carotid pulse C. open her airway using a jaw-thrust maneuver. D. obtain a blood glucose level. - ANSWER- B Alveolar ventilation refers to the amount of: A. air that does not reach the alveoli during normal inhalation. B. carbon dioxide transferred from the blood to the alveoli each minute. C. air moved in and out of the alveoli per minute. D. oxygen transferred to the blood from the alveoli each minute. - ANSWER- C You and your partner are on a lunch break when you hear a scream from across the room: "My child is choking!" You immediately go to help. The mother quickly tells you she thinks the 10-month-old swallowed a coin. You note that the baby is cyanotic with no cough. What is the appropriate way to clear the obstruction? A. Try a blind finger sweep to dislodge the coin. B. Immediately attempt artificial ventilation. C. Use back slaps and chest thrusts. D. Deliver abdominal thrusts and back blows. - ANSWER- C You are caring for a 19 year old female who is complaining of an acute onset of abdominal pain with dizziness. You find the patient to be tachypneic, tachycardic, nervous, and very scared. Skin is pale and diaphoretic. She admits to being sexually active, but "always" uses some type of prophylactic. Her last menstrual cycle was 25 days previously. Abdominal assessment is benign other than slight tenderness to palpation. The most likely reason for the patient's pain is? safety as an EMT? A. Wearing protective eyewear B. Hand washing C. Donning a moisture resistant gown D. Use of non-latex exam gloves - ANSWER- B A 20-year-old female has been involved in a minor motor-vehicle crash. She is ambulatory on arrival and complains of difficulty breathing. She is alert and vitals are pulse 110, respiration 40, and blood pressure 122/80. Her skin is flushed. Considering her respiratory status, you should: A. do nothing because her respiratory status is fine. B. begin positive pressure ventilations. C. apply a nonrebreather mask. D. ask her to breathe into a paper bag. - ANSWER- C A 16-year-old male has been struck by a car. He is confused and complains of abdominal pain. His vital signs are pulse 120, respiration 30, blood pressure 100/72. A detailed assessment should be completed on this patient: A. before administering high-flow oxygen. B. only if there are obvious additional injuries. C. immediately following the primary assessment. D. only after transport has been initiated. - ANSWER- D A 20-year-old female complains of severe headache and photophobia. She notes she has had a fever and a stiff neck for the last two days. To manage this patient you should first: A. complete a Cincinnati Prehospital Stroke Scale B. administer 324 mg of aspirin. C. turn down the lights in the ambulance D. don gloves and respiratory protection - ANSWER- D A 15-year-old male has been stabbed in the abdomen. As you examine the patient's abdomen, you see a small loop of intestine protruding from the wound. After completing your patient assessment, you should next: A. push the intestine back into the wound. B. cover the exposed intestine with moistened sterile dressing. C. apply an occlusive dressing over the wound. D. initiate rapid transport. - ANSWER- D A 21-year-old female states that she has taken 25 Librium capsules approximately 30 minutes ago. After completing a primary assessment and initiating transport, you should next: A. contact poison control. B. complete a detailed assessment. C. induce vomiting. D. administer activated charcoal. - ANSWER- A A 48-year-old female was recently prescribed an antibiotic. Upon taking her first pill, she noted watery eyes, itching, and now complains of shortness of breath. She is alert, her skin is flushed, and you hear wheezes bilaterally. Her vital signs are: pulse 110, respiration 30, blood pressure 112/74. You should first: A. conduct a detailed assessment. B. arrange for ALS to meet you en route to the hospital. C. contact poison control for further instructions. D. identify the type of pill she took. - ANSWER- B Given any type of cellular, digital, or radio communication between the EMS providers and dispatch, what is one consistent limitation across these technologies the EMT must be aware of and try to avoid in order to assure smooth communication occurs? A. Language barriers B. Dead batteries C. Dead spots D. High costs - ANSWER- C