Neurogenic Shock and Emergency Medical Care, Exams of Nursing

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FSSD NREMT Review Questions

You should assess CMS at what time(s) when applying a traction splint to a closed femur fracture? - Both before and after traction splint application You arrive at a nightclub to find an unconscious 24-year-old female lying on her back. During which part of your assessment would you discover a small caliber gunshot wound to the back? - Rapid Trauma Assessment While completing your head-to-toe assessment, which of the following are you not looking for when examining the pupils? A)Shape B)Clarity C)Reaction to light D)Size - B) Clarity You respond to a local elementary school gym for a report of a 12 y/o student w/ a broken right arm. As you approach the pt from across the room, you can see angulation and gross deformity to the right humerus. Which joints will you immobilize to prepare the pt for transport? - Shoulder and Elbow You are treating a 6 y/o female pt. Her parents called because she fell off a play structure earlier in the day and when they tried to wake her from her nap, she was not alert. She is bradycardic, blood pressure is 70/40, she has an altered mentation and her skin is warm to the touch. You suspect? - Neurogenic Shock When describing a pt's alertness, which of the following would you not use? A) Oriented B)Active

C)Disoriented D) Alert - B) Active Who is responsible for sorting pt's based on severity of injury in an MCI? - Triage Officer After an adult cardiac arrest pt has been intubated by your paramedic partner, you are tasked with providing ventilation's as another member of your crew performs chest compressions. When ventilating the pt, you should? - Deliver each breath over roughly 1 second at a rate of 8-10 breaths per min You notice that your 10 month-old patient is performing belly breathing. This signifies which of the following? A) Labored Breathing B) Rapid Breathing C) Normal Breathing D) Loud Breathing - C) Normal Breathing When inserting an oropharyngeal airway in an adult patient, you should be sure it is inserted so that?

• The airway is initially inserted upside down and then rotated 180 degrees Which of the following is usually the most dangerous? A) Venous Bleed B) Capillary Bleed C) Arterial Bleed D) Dark red Bleed - Arterial Bleed

With regards to blood pressure, which of the following statements is true? A) Blood pressure has a direct affect on the perfusion of the body's tissues B) Blood pressure is the single most important sign during the initial assessment - A) Blood pressure has a direct affect on the perfusion of the body's tissues You are called to a home where a 91 year old man has had a syncopal episode and is vomiting. The caregiver who called 911 stated that the patient's bowel movements have been bright red since yesterday. The patient has not complained of any pain, but is nauseated. What is most likely wrong with this man and which choice includes appropriate treatment steps? - He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported in a position of comfort while treating for shock If a patient was feeling nauseated this would likely be a_______________response. If a person was tachycardic it would likely be a___________________ response. - Parasympathetic / sympathetic One pupil dilated and the other constricted would suggest what type of injury? - Cerebral After the baby's head has delivered you should? - Suction the mouth and nose then check if the cord is wrapped around the infant's neck Why does Nitroglycerin lower the blood pressure? - Because it dilates the vessels reducing the preload on the heart You have just arrived on scene of a single vehicle accident involving a truck that has slid off the road and rolled. Your patient was driving about 40 MPH when he hit an icy spot and went off the road rolling the vehicle one time. After completing your scene size up, which of the following treatment choices would be the most appropriate? - Perform a rapid trauma assessment

Cells that die during a stroke are called? - Infarcted cells Assault is used to describe behavior that? - -Is threatening -Causes fear of offensive physical contact -Attempts offensive physical contact You are called to the scene of a man down. Dispatch reports the man is pulseless and bystanders are doing CPR. According to the NREMT Cardiac Arrest Management/AED skill sheet, which of the following sequences is appropriate? A) Check for responsiveness, Assess for breathing, Check carotid pulse , put your gloves on B)Question the bystanders, direct them to stop CPR , check for pulse and then attach the AED, Begin chest compressions C) Turn on power to AED, open the patient's airway, insert an adjunct and then analyze the rhythm D) Complete one cycle of CPR, Attach the AED, Have everyone stand clear during rhythm check - D) Complete one cycle of CPR, Attach the AED, Have everyone stand clear during rhythm check Which of the following choices is a normal systolic blood pressure in a child? A) Less than 80 mm Hg B) 70 mm Hg C) Greater than 70 mm Hg D) Greater than 120 mm Hg - C) Greater than 70 mmHg A Transient Ischemic Attack (TIA) will usually stop after: - 10-15 Minutes

During an assessment of a 78 year old woman you find her skin to be cool, moist, and pale. What would you suspect? - Hypoperfusion A 57 year old woman is complaining of chest pain. Her blood pressure is 109/88 and her respirations are at 22 per minute. What condition does the patient's blood pressure indicate? - Low pulse pressure Upon assessment of a 55 year old male, you find his blood pressure to be 124/75 his pulse is 122 and his respirations are 18. It would be stated that this man is? - Tachycardic EMTs are required to contact medical control to administer Epinephrine? (True or False) - True What is the dosage of for an albuterol treatment? - 2.5 mg Is approval from medical control required for the administration of oral glucose? - No When assembling a nebulizer, which flow rate should you set the O2 bottle too? - 6 LPM When administering Narcan, what dosage is sprayed in each of the nares? - 0.5 mg What route is epinephrine administered? - Intramuscular When should you specifically ask the pt if they are taking Brillnta? -

When preparing to administer Aspirin Administering nitroglycerin to a pt may cause? - Hypotension How long should you hold the epinephrine twin-injector for? - 10 seconds What are the 6 rights to Medication Administration? - Right Patient Right Medication Right Dose Right Time Right Route Right Documentaion The primary assessment of an adult with chest pain includes: - Determine the transport priority You are caring for a six-year-old patient with respiratory distress. The pulse oximeter (Sa02) reads 93%. Your management of the patient should include: - Administer sufficient oxygen to maintain a pulse oximeter reading of at least 94%. Which of the following interventions should be performed first for an unresponsive patient with a suspected spinal cord injury? - Jaw thrust maneuver You are caring for a 22-year-old female who complains of respiratory distress after exercising. She is alert, speaking full sentences, and has a persistent cough. She is most likely experiencing: - Respiratory distress with adequate breathing

Your 5-year-old patient is unresponsive. A carotid pulse is present at 40 beats per minute. Breaths are shallow at six per minute. You should immediately: - Begin chest compressions Which of the following medications is intended to decrease myocardial workload and increase myocardial blood flow? - Nitroglycerin You are caring for a multi-system trauma patient with possible internal bleeding. Select the correct statement about the rapid scan for a multi-system trauma patient: - The rapid scan is used to identify life-threatening conditions. Life-threatening bleeding should be found and treated during the: - Primary assessment Your patient is unresponsive following blunt trauma to the head. Which of the following is the EMT's first priority for an unresponsive patient? - Determine if CPR is indicated You are called for a drowning victim at a family barbecue. Upon arrival, two family members approach you yelling, swearing, and demanding to know what took so long. One of the family members pushes you. You should: - retreat and request immediate assistance from law enforcement. Your 6-year-old patient jumped from a swing and injured his right leg. You note deformity to the right leg above the ankle. The patient most likely has a fracture to the: - Distal tibia The foramen magnum: - is an opening at the base of the skull. Which of the following is the most frequent cause of airway obstruction? - the tongue

Continuous positive airway pressure (CPAP) can reduce respiratory distress by: - helping to keep the alveoli open Which of the following is true during inhalation of a spontaneously breathing patient? - There is a drop in pressure within the thorax You are first on the scene of a motor vehicle collision involving multiple vehicles. Which of the following should you do first: - Request additional resources Which of the following is the first priority at a hazardous material incident? - ensure your own safety. Carbon monoxide exposure is dangerous because it: - reduces delivery of oxygen. You are caring for an apneic patient with a suspected overdose. You have loaded the patient into the ambulance and entered the patient compartment. You should first: - put on your seat belt You are called for a 6-month-old infant with respiratory distress. Which of the following is true about patients in this age group? - infants are obligate nose breathers. Which of the following signs of hypoxia is more commonly found in pediatric patients? - seesaw respirations You are treating a patient with respiratory distress. He has a history of multiple myocardial infarctions. Lung sounds indicate pulmonary edema. You note the patient does NOT have any JVD or pedal edema. The patient is most likely experiencing: - left heart failure

The left side of the heart receives oxygenated blood from the: - pulmonary veins Which of the following provides oxygenated blood directly to the heart? - coronary arteries Which of the following vessels carries deoxygenated blood? - pulmonary arteries. Your patient has been exposed to a chemical that over-stimulates the parasympathetic nervous system. You would expect this patient to exhibit: - vomiting You are considering administration of oral glucose to your diabetic patient. This drug is contraindicated when it: - poses a significant risk of harm. Nerve agents and choking agents are examples of: - chemical agents. Which of the following describes the purpose of administering aspirin to a suspected myocardial infarction patient? - Aspirin reduces platelet aggregation in the coronary arteries. You are dispatched to a soccer game for a 12-year-old female with signs and symptoms of an allergic reaction. Upon arrival, the patient's mother hands you an epinephrine auto-injector. You should: - Begin the primary assessment You are dispatched for a possible CVA. Upon arrival, you determine the patient is responsive to painful stimuli. Which of the following should be assessed first for this patient? - Airway Treatment should begin at a mass casualty incident: -

After triage has been completed You are caring for a patient who was ejected during a single vehicle rollover. The patient responds incoherently to verbal commands. You should first: - Assess the patient's airway How should you open the airway of an unresponsive patient with an unknown mechanism of injury?

• jaw-thrust maneuver Your patient is a construction worker who fell from a residential rooftop. He is responsive to pain. Breaths are shallow and irregular. You should: - provide artificial ventilations with a bag-mask device and high flow oxygen. Your pediatric patient has spontaneous respirations. This means the patient is breathing: - without assistance A nonrebreather mask should be administered to patients who: - are breathing adequately with signs of hypoxia You are dispatched to the local jail for a prisoner found unresponsive in her cell. Her airway is clear. Respirations are rapid and shallow. The pulse oximeter (SaO2) reads 90%. Your first action should be to: - begin positive pressure ventilations Which of the following findings indicates partial obstruction of the upper airway? - stridor To determine if CPR is indicated for an unresponsive patient less than one year of age, you should assess the: - brachial pulse

You respond to a preschool facility for an ill child. Upon arrival, you find an unresponsive 8-month- old. The infant has a palpable pulse of 50 beats per minute. Your next action should be to: - begin chest compressions During a hazardous materials incident, you should take standard precautions: - before making contact with the patient A 19-year-old female is found unconscious in her apartment living room. While surveying the apartment, your partner yells from the patient's bedroom "she has an SVN machine in here". This suggests the patient has a history of: - respiratory problems You are treating a 35-year-old man who was stung by a bee. He is allergic to bees and has a prescribed epinephrine auto-injector. His breath sounds are clear and non-labored. His BP is 130/82. How should you manage this patient? - Assess the patient for signs of hypoxia, administer oxygen as needed, and transport. An elderly patient reportedly collapsed on a golf course almost 10 minutes ago. You assess her level of consciousness and determine she is unresponsive. Which of the following should you do first: - Assess pulse and begin CPR if needed You are treating an unresponsive patient with slow, shallow respirations and pinpoint pupils. Which of the following conditions is most likely? - Narcotic overdose You are caring for a 3-year-old patient in cardiac arrest. What is the correct compression to ventilation ratio for two-person CPR on this patient? - 15 compressions to 2 ventilations You are caring for a 12-year-old who was injured at the neighborhood skate park. He was not wearing a helmet and is responsive to pain. You note snoring respirations and deformity to the left ankle. You should: - open the airway using a jaw-thrust maneuver

Shallow respirations and bradypnea will likely cause: - a decrease in minute volume The most common weapon of mass destruction used by terrorists is: - explosive weapons You are conducting a primary assessment on an elderly fall victim who complains of hip pain. While assessing circulation, you should check: - pulses, external bleeding and skin condition. In unresponsive patients over one year of age, you should palpate the: - carotid pulse Coordinating efforts through a unified command system at a mass casualty incident will likely: - reduce duplication of effort and freelancing. Inadequate oxygen delivery to the body's tissues is called: - hypoxia Which of the following signs of hypoxia is more common in pediatric patients? - bradycardia Which of the following adult patients is breathing adequately? - a patient with respirations at 16 per minute and equal chest rise and fall. An oropharyngeal airway is indicated for which of the following patients? - a 44-year-old unconscious patient. A 16-year-old male is unconscious following an assault. When you insert an OPA, the patient begins gagging. You should: - remove the airway and prepare to suction as needed.

An elderly female reportedly had a severe headache for the last 24 hours. She was recently found unconscious in bed. Her family reports she has a history of hypertension and transient ischemic attacks (TIAs). The patient's current condition is most likely due to: - a hemorrhagic stroke. The rapid extrication technique should be used at a motor vehicle accident when: - the patient has life-threating injuries When a pulse oximeter is available, how should oxygen be administered to a patient experiencing chest pain? - Administer oxygen to maintain a pulse oximeter reading of at least 94%. When there are signs and symptoms that your patient is hypoxic, you should: - Administer oxygen at 15 lpm via nonrebreather mask A 36-year-old female presents with a sudden onset of difficulty breathing. She is anxious, has intercostal retractions and nasal flaring. Her respiratory rate is 24 breaths per minute. You do not have a pulse oximeter. You should: - administer oxygen via nonrebreather mask at 15 lpm. Your 67-year-old patient recently began taking a new medication. He is complaining of a sudden onset of severe respiratory distress. He quickly becomes semi-conscious and unable to follow verbal commands. His pulse oximeter (SaO2) is 89%. You should: - assist ventilations with a BVM. You are on the scene of a motor vehicle accident. The driver is trapped in a vehicle that is leaking an unknown fluid. When is it appropriate to enter the vehicle and begin patient care? - do not enter until trained rescuers determine the vehicle is safe to enter. While working out at the gym, you witness someone collapse. The patient is apneic with a pulse. You begin performing mouth-to-mask ventilations. What percentage of oxygen is your patient receiving?

• 16%

You are caring for an unresponsive diabetic patient with deep, rapid respirations. The patient's blood glucose is 480 mg/dL. What is the most likely cause of this patient's hyperventilations? - This patient is likely hyperventilating due to severe acidosis. Your 8-year-old patient has blunt chest trauma after being struck by a car. The patient is alert. His airway is clear, breathing is adequate, and pulses are present but weak at 110 beats per minute. Which of the following should you do next? - perform a rapid scan Your adult patient reportedly smoked an unknown substance and passed out. The patient has inadequate ventilations and your partner begins ventilating with the BVM. Which of the following is the best indicator your patient is being ventilated adequately? - adequate bilateral chest rise and fall during BVM ventilation. Which of the following is true regarding the Emergency Response Guide (ERG): - The ERG helps identify the evacuation distance for specific hazardous materials. You are dispatched to a neighborhood park on a warm day for an 8-year-old with difficulty breathing. You find the patient breathing adequately but with some accessory muscle use. You note expiratory wheezes and a persistent cough. You suspect the patient is experiencing: - an asthma attack. You are ventilating a patient with a stoma. You note air is escaping from the mouth and nose with each breath. You should: - manually seal the mouth and nose. The hypoxic respiratory drive works by monitoring: - oxygen levels. You are dispatched for a homeless person found unresponsive. You find the patient prone on the sidewalk unresponsive to pain. You should first: - log roll the patient into a supine position.

You are first on the scene of an overturned container truck. You note a placard, but do not recognize the ID number. There is fluid leaking from the vehicle. You should: - notify your dispatcher a hazardous materials team is needed You are the first ambulance on the scene of a motor vehicle accident. Your first action upon arrival should be to: - Assess the scene for hazards You and your partner are preparing to lift the stretcher into the ambulance with a 300-pount patient. To protect yourself from injury, you should: - keep your back straight and bend at the knees. While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He is unable to speak, has a faint inspiratory stridor and cyanosis around the lips. You should: - stand behind him and administer abdominal thrusts You are transporting a pregnant patient from an urgent care center to a high-risk OB facility. The transferring physician tells you the patient may have an abruptio placenta. This means: - the placenta is prematurely separating from the uterine wall. Which of the following accurately describes supine hypotensive syndrome? - compression of the inferior vena cava by the uterus. You are called for a 40-year-old female with a severe headache. She is 32 weeks pregnant. The patient history reveals she also has nausea, blurred vision and sudden edema in her face and hands. Her blood pressure is 156/96. The patient is most likely experiencing: - preeclampsia. Shock is caused by: - inadequate tissue perfusion. Epinephrine stimulates which of the following physiological effects? - tachycardia.

Which of the following statements about distributive shock is correct? - Distributive shock is caused by widespread vasodilation. While attempting to restrain a combative patient, your partner was bitten on the arm. Which of the following is true of bite wounds? - Human bites pose a high risk of infection. Your patient has a partial thickness burn to his anterior chest. It is about the size of the palm of his hand. What is the approximate total body surface area of the burn? - 1% Which of the following patients should be your highest transport priority? - a partial-thickness burn with respiratory compromise. Which of the following conditions would most likely cause hypovolemic shock? - laceration of the liver. Your patient has partial-thickness burns over a large surface area. You should: - apply a dry, sterile burn sheet. Your patient has severe bleeding to her forearm. If direct pressure does not control the bleeding, you should immediately: - apply a tourniquet. Your patient was injured during an industrial accident. He has an abdominal laceration with internal organs protruding. You should apply: - a moist, sterile dressing. Which of the following is considered a normal capillary refill time for infants and children? - Less than 2 seconds

Which of the following physiological responses helps protect the body from overheating: - peripheral vasodilation. Your patient exhibits crepitus to the thorax, paradoxical motion and signs of hypoxia. You should suspect: - a flail chest. A 30-year-old male was stabbed in the abdomen during an assault. The knife is impaled in his the right lower abdominal quadrant. It is important to: - stabilize the knife in place. You are caring for a confused and restless 16-year-old female with blunt chest trauma following a single vehicle accident. She complains of dyspnea and orthopnea. You note a reduced tidal volume, cyanosis and tachycardia. Which of the following should be done first? - Begin positive pressure ventilations. While assessing an unresponsive patient, you discover a penetrating wound to the anterior chest. You should first: - applying an occlusive dressing You arrive at a residence for an ill person. A child opens the door and says his dad is locked in the bedroom with his gun. You should: - retreat to safety and request law enforcement When caring for a patient with a behavioral emergency, remember: - the behavior may be caused by a physiological condition. A patient with an isolated concussion injury will likely: - progressively improve over time Which of the following is a common cause of seizures? - poisoning

Which of the following statements about use of the automated external defibrillator (AED) is correct? - Adult AED pads can be used on pediatric patients if pediatric pads are not available. Which of the following is a component of the Cincinnati Prehospital Stroke Scale? - Arm drift Select the patient condition that is most likely to require transport to a specialized facility. - Cerebrovascular accident You are caring for a trauma patient with a closed head injury. The patient is responsive to painful stimuli. The BP is 160/100, pulse is 60 beats/min and respirations are 8 per minute. You should: - stabilize life-threatening conditions and limit your on-scene time to 10 minutes. Your female patient complains of vaginal bleeding. She is alert, denies trauma, and states she is not pregnant. You should: - assess the patient for signs of hypoperfusion You are on the scene of a patient who was sexually assaulted. The scene is safe, but law enforcement officials are still responding. You should: - attempt get at least one EMS provider of the same sex Recommendations for an EMS call involving a behavioral patient include: - not lying to the patient when answering his questions. You are called for a man wandering in the street and yelling at passing cars. Upon arrival, your first priority is: - the safety of you and other rescuers. Which of the following is the normal range for a blood glucose level? - 80 and 120 mg/dL

You are called for a child with an altered level of consciousness. Her parents report a recent history of increased appetite, thirst, and frequent urination. The child's blood glucose is 350 mg/dL. The child is most likely experiencing: - diabetic ketoacidosis. Esophageal varices typically occurs in patients with a history of: - alcohol abuse Severe internal bleeding is most likely following an injury to which of the following organs? - The spleen You are called for a 24-year-old female who is 28 weeks pregnant. You find the patient supine in bed complaining of severe weakness, dizziness, and nausea. Which of the following is your first priority? - place the patient on her left side Acute hypoglycemia typically causes: - a sudden loss of consciousness Which of the following statements regarding febrile seizures is correct? - Febrile seizures pose little risk of permanent injury. You are called to a doctor's office for a patient who reportedly experienced a brief seizure. Upon arrival, the staff tells you the patient is in a postical state. This means the patient: - has an altered but improving level of consciousness. You are dispatched to an assisted living center for a 70-year-old male with an altered level of consciousness. The patient's wife states he has been confused for the last several hours. The patient has slurred speech and left-sided weakness. You should suspect: - a stroke Stimulation of the sympathetic nervous system causes: - increased cardiac output.

You are caring for a 10-year-old child who was an unrestrained passenger in a vehicle that was struck from the rear. The child complains of neck pain. Which of the following should be done first? - manual cervical spine precautions.