NREMT Cognitive Exam Preparation Questions and Answers 2024, Exams of Nursing

Download NREMT Cognitive Exam Preparation Questions and Answers 2024 and more Exams Nursing in PDF only on Docsity! NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Where does the modern EMS system have its origin? - correct answer ✅The modern EMS system has its origins in funeral homes, which often operated ambulances. However, funeral home operators were often serving competing business interests and patients received little trained care until the hospital. What is considered the "birth" of EMS? - correct answer ✅In 1966, a paper titled "Accidental Death and Disability: The Neglected Disease of Modern Society" is published by the National Academy of Sciences. This paper is widely known in the EMS profession as the White Paper. The White Paper is widely considered the birth of modern EMS. It spotlighted inadequacies of prehospital care in the United States, particularly related to trauma. Who developed the first EMT National Standard Curriculum? - correct answer ✅Early in the 1970s, the US Department of Transportation developed the first EMT National Standard Curriculum. What are the levels of EMS training? - correct answer ✅Emergency Medical Responder (EMR): NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. provides basic, immediate care including bleeding control, CPR, AED and emergency childbirth. Emergency Medical Technician (EMT): includes all EMR skills, advanced oxygen and ventilation skills, pulse oximetry, noninvasive blood pressure monitoring, and administration of certain medications. Advanced Emergency Medical Technician (AEMT): includes all EMT skills, advanced airway devices, intravenous and intraosseous access, blood glucose monitoring, and administration of additional medications. Paramedic: includes all preceding training levels, advanced assessment and management skills, various invasive skills, and extensive pharmacology interventions. This is the highest level of prehospital care outlined in the National EMS Education Standards. What are EMT roles and responsibilities? - correct answer ✅Equipment preparedness Emergency vehicle operations NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Bargaining Depression Acceptance How can you prevent the risk of infection? - correct answer ✅Immediately report exposures to the designated infection control officer. Handwashing is the single most important way to prevent the spread of infection. Hand sanitizers can be effective, but soap and water is preferred when available. What are the two types of PPE? - correct answer ✅Minimum PPE: gloves and eye protection should be used during any patient contact situation. Expanded PPE: use disposable gown and mask for significant contact with any body fluid--for example, during childbirth. Use a high-efficiency particulate air (HEPA) mask o N-95 respirator for suspected airborne disease exposure, such as tuberculosis. What are emergency moves? - correct answer ✅These are used when the scene is dangerous NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. and the patient must be moved before providing patient care. Types of emergency moves include the armpit-forearm drag, shirt drag, and blanket drag. What is an urgent move? - correct answer ✅Used when the patient has potentially life- threatening injuries or illness and must be moved quickly for evaluation and transport. Rapid extrication: an urgent move used for patients in a motor vehicle; it requires multiple rescuers and a long backboard. The patient is rotated onto a backboard with manual cervical spine precautions and removed from the vehicle. What are non-urgent moves? - correct answer ✅Used when there are no hazards and no life- threatening conditions are apparent. Types of non-urgent moves include direct ground lift, extremity lift, direct carry method, and draw sheet method. What is the log roll technique? - correct answer ✅Commonly used to place a patient on a backboard or assess the posterior. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Can be done while maintaining manual cervical spine precautions. Should have at least three trained personnel. The person controlling manual cervical spine protection should direct the log roll. What are special considerations for bariatric patients? - correct answer ✅Obese patients pose additional challenges and risks to providers during lifting and movement. Some EMS systems have special bariatric ambulances with specialized equipment, automated lifting systems, and wider stretchers capable of a greater weight capacity. What is supine hypotensive syndrome? - correct answer ✅Patients in the later stages of pregnancy should not be placed supine due to the risk of supine hypotensive syndrome. Place the pregnant patient on her left side. If patient has potential cervical spine trauma, tilt backboard to the left about 20 degrees. When can patients be restrained? - correct answer ✅In general, patients may be forcibly restrained NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. State protocols and guidelines Medical direction EMS agency's policies and procedures Reputable textbooks Care considered acceptable by similarly trained providers in the same community. What is informed consent? - correct answer ✅Informed consent is required from all patients who are alert and competent. -Patient must be informed of your carer plan and associated risks of accepting or refusing care and transport. -Patient must be informed of, and understand, all information that would impact a reasonable person's decision to accept or refuse care and transport. What is expressed consent? - correct answer ✅Expressed consent also requires that the patient be alert and competent to give expressed consent. Expressed consent can be given verbally or nonverbally. -Expressed consent is similar to informed consent, but not usually as in-depth as informed consent. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Expressed consent is often used to obtain consent for more basic assessments or procedures. What is implied consent? - correct answer ✅Implied consent allows assumption of consent for emergency care from an unresponsive or incompetent patient. -Patients might be incompetent for many reasons, such as alcohol, drugs, head injury, hypoxia, hypoglycemia, or mental incompetency. -Implied consent can be used to treat a patient who initially refused care but later loses consciousness or becomes otherwise incapacitated. What is minor consent? - correct answer ✅Minors are not competent to accept or refuse care. -Consent is required from a parent or legal guardian. Implied consent can be used when unable to reach a parent or guardian and treatment is needed. -Minor consent is not required for emancipated minors. Criteria for emancipation varies but usually includes minors who are NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. married or pregnant, already a parent, a member of the armed forces, financially independent, or emancipated by the courts. What is involuntary consent? - correct answer ✅Involuntary consent is used for mentally incompetent adults or those in custody of law enforcement. Consent must be obtained from the entity with the appropriate legal authority. What are advance directives? - correct answer ✅Advance directives are written instructions, signed by the patient, specifying the patient's wishes regarding treatment and resuscitative efforts. There are several types of advance directives. -Do Not Resuscitate (DNR): DNRs are specific to resuscitation efforts and do not affect treatment prior to the patient entering cardiac arrest. -Living will: Living wills are broader than DNRs. They address health care wishes prior to entering cardiac arrest. This may include use of advanced airways, ventilators, feeding tubes, etc. How do Good Samaritan Laws affect EMTs? - correct answer ✅Good Samaritan laws are designed to protect NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is abandonment? - correct answer ✅Once care is initiated, EMS providers cannot terminate care without the patient's consent. Some patient encounters may also require direct contact with medical direction prior to terminating care. Most EMS agencies have written protocols for terminating care without transporting the patient to a higher level of care. Abandonment is the termination of care without transferring the patient to an equal or higher medical authority. Transfer of care must include a verbal report to an equal or higher medical authority. Most EMS systems allow EMTs to accept care from a paramedic or advanced EMT for transport if an advanced-level assessment or advanced care is not needed. What is false imprisonment? - correct answer ✅You may be guilty of false imprisonment if you transport a competent patient without consent. What factors influence hospital determination? - correct answer ✅Destination factors include: -The patient's request or medical direction -The closest appropriate facility or specialty facility -Written protocols or triage guidelines NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Hospital diversion or bypass A patient's ability to pay should NOT factor into where a patient is transported. When in doubt, consult medical direction. Thoroughly document why the destination was chosen. This is especially true if you bypass a closer hospital capable of managing your patient. What are patient refusals? - correct answer ✅Competent patients may refuse treatment regardless of the severity of their condition. -Refusals present high liability risk for EMS providers. -Negligence or abandonment can be much easier to provide if the patient is not transport. -Consider requesting advanced life support personnel or contacting medical direction per local protocols. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -During a refusal, the patient must be fully informed of the treatment recommended and the possible consequences of refusing treatment. -The patient is rarely, if ever, fully informed the first time he or she conveys the intent to refuse treatment. Documentation should reflect both the initial refusal and the second refusal after being fully informed. What factors determine whether a patient is competent or not? - correct answer ✅Typically, competency requires awareness of at least four things: -Person: the patient knows his or her name. -Place: the patient knows where he or she is. -Time: the patient is aware of the date and time. -Event: the patient is aware of his or her present circumstances. How can an EMT reduce liability on patient refusal? - correct answer ✅1) The EMTs best protection from liability is to provide excellent care and convince the patient to accept transport. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Decapitation On what kind of scenes must law enforcement be notified? - correct answer ✅1. Any scene where the patient is dead on arival 2. Suicide attempts 3. Assault or sexual assault 4. Child abuse or elder abuse 5. Suspected crime scene 6. Childbirth How should EMT's operate in crime scenes? - correct answer ✅1. Ensure scene safety 2. Provide patient care as needed 3. Avoid any unnecessary disturbance of scene 4. Remember and note the position of patient(s) 5. Remember and report everything you touched at the scene 6. Cut around (not through) holes in clothing when exposing the patient 7. Note anything or anyone suspicious on or near the scene NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. 8. Discourage sexual assault patients from changing clothes or showering 9. Try to get a same-sex provider to assist with sexual assault patients 10. Leave once you are no longer needed at the scene What are therapeutic communications? - correct answer ✅Therapeutic communications typically refers to your interaction with the patient and ability to obtain clinical information. What are portable and mobile radios? - correct answer ✅Portable radios: hand-held transmitter/receiver with a very limited range, unless used with a repeater. Mobile radios: vehicle-mounted transmitters and receivers. These have a greater range than portable radios, but distance is still limited unless used with a repeater. What is a repeater? - correct answer ✅A type of base station that receives low-power NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. transmissions from portable or mobile radios and rebroadcasts at higher power to improve range. What is a base station? - correct answer ✅A transmitter/receiver in a fixed location that is in contact with all other components in the radio system. Who regulates all radio operations in the US? - correct answer ✅The Federal Communications Commission (FCC) regulates all radio operations in the US and has allocated specific frequencies for EMS use only. How should you communicate with dispatch? - correct answer ✅1. Confirm receipt of dispatch. 2. Notify dispatch when en route to the call,on scene, en route to the hospital, and at the hospital. A. Identify who you are talking to first, then who you are. B. Use "affirmative" or "negative," not "yes" or "no." C. Use "copy" to confirm receipt of a transmission. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Time en route to hospital -Arrival time at hospital -Time transfer of care was completed Patient information: -The patient's age, sex, and chief complaint -The patient's level of consciousness -Minimum of two sets of vital signs -All assessments completed on the patient -All treatments provided and response to treatment Administrative information: -The address of the call -Date of the call -Your unit designation -The name or identifying number and certification level of all EMS providers on the call Narrative NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. How many bones are there in the human body? - correct answer ✅There are 206 bones in the human body. How many vertebrae are in the spinal column? - correct answer ✅33 vertebrae -7 cervical -12 thoracic -5 lumbar -5 sacral -4 coccygeal What are the components of the upper airway? - correct answer ✅Components of the upper airway include: -Nose and mouth -Nasopharynx -Oropharynx -Larynx -Epiglottis NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is the most common cause of upper airway obstruction? - correct answer ✅The tongue. What are the components of the lower airway? - correct answer ✅Components of the lower airway include: -Trachea -Carina -Left and right mainstem bronchi -Broncioles -Alveoli How is lung expansion achieved? - correct answer ✅During inhalation, as the chest expands, the parietal pleura pull the visceral pleura, which pull the lungs. What is the diaphragm? - correct answer ✅The diaphragm is the primary muscle of respiration. It separates the thoracic cavity from the abdominal cavity. It is usually under involuntary control but can be controlled voluntarily. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Low oxygen levels will stimulate breathing. The hypoxic drive is less effective than carbon dioxide drive. What is the minute volume? - correct answer ✅Respiratory rate times tidal volume. What are normal breathing rates for adults, children and infants? - correct answer ✅Normal adult rate: 12-20 breaths per minute Normal pediatric rate: 15-30 breaths per minute Normal infant rate: 25 to 50 breaths per minute Non-labored Regular rhythm Clear and equal breath sounds bilaterally What are the three layers of heart muscle and pericardium? - correct answer ✅Endocardium: smooth, thin lining on the inside of the heart Myocardium: thick muscular wall of the heart NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Epicardium: outermost layer of the heart and innermost layer of the pericardium Pericardium: fibrous sac surrounding the heart What is the heart's electrical conduction system? - correct answer ✅The primary power plant, the sinoatrial (SA) node, normally generates impulses between 60 and 100 times per minute in the adult. The atrioventricular (AV) junction is the backup pacemaker and generates electrical impulses at about 40 to 60 per minute. The bundle of His is the final pacemaker for the heart. It generates impulses only at about 20 to 40 per minute. What is preload? - correct answer ✅Preload is the precontracting pressure based on the amount of blood coming back to the heart. Increased preload leads to increased stretching of the ventricles and increased myocardial contractility. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is afterload? - correct answer ✅Afterload is the resistance the heartm ust overcome during ventricular contraction. Increased afterload leads to decreased cardiac output. What are the components of blood? - correct answer ✅Plasma: the liquid component of blood, made mostly of water Red blood cells: the oxygen-carrying component of blood White blood cells: fight infection by defending against invading organisms Platelets: essential for clot formation to stop bleeding What is perfusion? - correct answer ✅Perfusion is the flow of blood throughout the body. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. The newborn's fontanelles (soft spots on the skull) will be fully fused by about 18 months. Depressed fontanelles may indicate hypovolemia. Infants are often nose breathers and can develop respiratory distress easily. Rapid breathing can lead to fluid loss and loss of body heat. Hyperventilation of infants presents significant risk of barotrauma. What are the reflexes that infants have? - correct answer ✅Startle reflex, grip reflex, rooting reflex, sucking reflex What are the age ranges of toddlers and preschoolers? - correct answer ✅Toddlers: 1 to 3 years old Preschoolers: 3 to 6 years old NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What are normal vital signs of toddlers and preschoolers? - correct answer ✅Toddlers: -Respirations: about 20-30 breaths per minute -Heart rate: 90-140 bpm -Blood pressure: 80-90 systolic Preschoolers: -Respirations: about 20-25 breaths/minute -Heart rate: 80-130 bpm -Blood pressure: about 90-110 systolic What is the physiology of toddlers and preschoolers? - correct answer ✅As the immune system develops, children at this age typically experience a number of minor colds, viruses, flu-like symptoms, respiratory infections, etc. Fine motor skills improve and the brain grows rapidly in size. Toddlers: typically walk, climb, distinguish basic shapes and colors and are potty trained. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Preschoolers: typically are physically coordinated and communicate well verbally, know their name and address and can dress themselves, can count to 10 or beyond. What developments you should know about school-age children? - correct answer ✅Vital signs: -Respirations: about 15 to 20 breaths/minute -Heart rate: 70-110 bpm -Blood pressure: 90-120 systolic Physiology: -Permanent teeth replace baby teeth -The musculoskeletal system is growing rapidly School-age children typically: -Read and write -Develop problem-solving skills -Are establishing their self-image and morals -Have a large social circle due to school NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Women typically experience menopause during middle adulthood -Continued physical and mental decline is common in late adulthood -Older adults frequently have extensive medical histories and are on multiple medications What is ventilation? - correct answer ✅Ventilation is the moving of air in and out of the lungs. What is hypoxia? - correct answer ✅Inadequate delivery of oxygen to the cells. Early indications of hypoxia: restlessness, anxiety, irritability, dyspnea, tachycardia. Late indications of hypoxia: altered or decreased level of consciousness. How long quickly does hypoxia damage the heart and brain? - correct answer ✅The heart and brain become irritable due to lack of oxygen almost immediately. Brain damage begins within about 4 minutes. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Permanent brain damage is likely within 6 minutes. Irrecoverable injury is likely within 10 minutes. What is notable about suction units? - correct answer ✅Portable and fixed suction units should be able to generate a vacuum of 300 mmHg when tubing is clamped. What is proper suctioning technique? - correct answer ✅Suction time cannot exceed: -15 seconds for adults -10 seconds for children -5 seconds for infants The recovery position reduces risk of aspiration. Unresponsive patients with adequate breathing and no c-spine injury should be placed in the recovery position. When is supplemental oxygen needed? - correct answer ✅The goal of supplemental oxygen is to maintain a pulse oximetry reading of at least 94%. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Supplemental oxygen is not needed if there are no signs of symptoms of respiratory distress and the pulse oximetry is at least 94%. -When oxygen is administered, it should be titrated to maintain a pulse oximeter reading of at least 94%. Indications: -Any patient in cardiac arrest -Any patient receiving artificial ventilation -Any patient with suspected hypoxia -Any patient with signs of shock -Any patient with a pulse oximetry below 94% -Any patient that may benefit from it -Any patient with an altered or decreased LOC What is notable about oxygen cylinders? - correct answer ✅A full cylinder is about 2000 psi. The cylinder should be taken out of service and refilled if below 200 psi. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Oxygen delivered: 40-60% What are Venturi masks? - correct answer ✅A mask that delivers precise concentration of low-flow oxygen. Rarely used in the prehospital environment. How do you administer supplemental oxygen in patients with a tracheostomy or stoma? - correct answer ✅Patients with a tracheostomy ventilate thorugh their stoma, not the mouth or nose. Supplemental oxygen should be applied over the stoma using a tracheostomy mask or a nonrebreather mask. What are the hazards of oxygen administration? - correct answer ✅Oxygen is highly combustible Pressurized gas Oxygen toxicity: the alveoli can collapse due to a long-term exposure to high concentrations of oxygen Respiratory depression: a risk for COPD patients on the hypoxic drive NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Retinal damage: can occur in newborns with long-term exposure to high-concentration oxygen When is artificial ventilation indicated? - correct answer ✅Artificial ventilations are indicated for any patient with *inadequate spontaneous breathing* leading to severe respiratory distress or respiratory failure. This could be caused by: -CNS injury, disease or impairment -Foreign-body airway obstruction -Chest trauma, such as a flail chest or a sucking chest wound -Increased airway resistance due to bronchoconstriction, pulmonary edema or inflammation Consider providing artificial ventilations for any patient breathing less than 8 times per minute or for any adult patient breathing more than 24 times per minute. Any unresponsive patient receiving artificial ventilations should have an airway adjunct in place to prevent the tongue from obstructing the airway. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What are the risks of artificial ventilation? - correct answer ✅Artificial ventilations are accomplished through positive pressure ventilations (PPV) whereas normal spontaneous breathing is done through negative pressure. Complications of PPV: -Increased intrathoracic pressure, which reduces circulatory efficiency -Gastric distension, which increases the risk of vomiting and can compromise ventilatory efficiency -Hyperventilation How do you know you're performing correct artificial ventilations? - correct answer ✅The best way to determine appropriate tidal volume is rise and fall of the chest. -Artificial ventilations should cause gentle rise and fall. -It should take at least one second to inflate the chest. Correct rates of artificial ventilation for apneic patients with a pulse: NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is notable about the pediatric airway? - correct answer ✅The pediatric airway is more easily obstructed (smaller nose and mouth; larger tongue). The pediatric head is larger in proportion to the body. Padding should be placed behind the shoulders in a supine patient to maintain alignment of the airway. Signs of respiratory failure in pediatric patients: -Bradycardia and poor muscle tone -Altered LOC -Head bobbing and grunting on exhalation -Seesaw breathing How is a foreign body airway obstruction managed in conscious patients? - correct answer ✅Adults and children: administer conscious abdominal thrusts until the obstruction is relieved or until the patient loses consciousness. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Infants: Administer a series of five back blows and five chest thrusts until the obstruction is relieved or until the patient loses consciousness. How is a foreign body airway obstruction managed in unconscious patients? - correct answer ✅Initiate CPR. Before attempting ventilations, inspect the airway for visible foreign bodies. Remove if able. What are open-ended vs. closed-ended questions? - correct answer ✅Open-ended questions require the patient to respond with more than just "yes" or "no." These questions require a descriptive response. When you want the patient to describe things in his or her own words, open-ended questions are preferred. Open-ended questions take longer to answer but provide more information from the patient's perspective. Closed-ended questions can be answered much faster and typically require only a "yes" or "no" response. Closed-ended questions may be preferred when time is critical. They can also NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. be useful if the patient is only able to speak short sentences due to severe pain or respiratory distress. What are the standard vital signs? - correct answer ✅Respiration: rate, rhythm, quality Pulse: rate, rhythm, quality Blood Pressure Pupils: size, equality, reactivity Skin: color, temperature, condition and capillary refill Pulse oximetry What is pulse pressure? - correct answer ✅SBP - DBP Normal pulse pressure should be greater than 25% but less than 50% of systolic blood pressure. A widened pulse pressure above 50% of systolic indicates a possible head injury. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. MOA: adheres many drugs and chemical, preventing their absorption into the GI tract Indication: recently ingested poision Contraindications: decreased LOC, inability to swallow, ingestion of acids, alkalis or hydrocarbons, expired medication or lack of medical direction Dose and route: -Adult: 1 g/kg of body weight -Pediatric dose: 25-50 grams -Administered orally Side effects: Nausea, vomiting, dark and tarry stool Considerations: -Shake before administering -Use caution if you suspect patient's LOC will change NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Have suction ready What information do you need to know about aspirin? - correct answer ✅Names: acetylsalicylic acid Class: anti-inflammatory, anti-platelet aggregate, antipyretic MOA: reduces inflammation, decreases platelet aggregation, reduces fever Indication: chest pain Contraindications: allergy, decreased LOC, inability to swallow, recent bleeding or active ulcer, pediatric, expired medication, lack of medication Dose and route: -324 mg orally NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Side effects: nausea, vomiting, stomach pain, bleeding, allergic reaction, Reye's syndrome in pediatric patients What information do you need to know about a metered dose inhaler? - correct answer ✅Names: albuterol, ipratropium bromide Class: bronchodilator MOA: relaxes bronchial smooth muscle, improving air exchange Indications: dyspnea, wheezing, asthma , reactive airway disease Contraindications: allergy, patient unable to follow commands, expired medication, medication not prescribed to patient, lack of medical direction Dose and route: one to two inhalations NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. MOA: increases blood glucose levels Indication: hypoglycemia Contraindications: -Decreased LOC -Inability to swallow -Expired medication -Lack of medical direction Dose and route: one tube administered orally Side effects: nausea and vomiting What are the components of the scene size-up? - correct answer ✅1. Scene safety 2. Standard precautions (PPE) 3. Number of patients/additional resources NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. 4. Mechanism of injury/nature of illness What are the components of the primary assessment? - correct answer ✅1. Manual cervical spine stabilization 2. General impression 3. Level of consciousness (AVPU and orientation; person, place, time and event) 4. Airway, Breathing, Circulation 5. Transport priority What are the appropriate managements for life-threatening conditions associated with breathing? - correct answer ✅Flail chest: initiate artificial ventilations Sucking chest wound: apply an occlusive dressing What are the stages of shock? - correct answer ✅Compensated shock: the early stage of shock. The body is still able to compensate for the hypovolemic state through defense mechanisms, such as increased heart rate and peripheral vasoconstriction. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Tachycardia -Peripheral vasoconstriction -Increased respirations Decompensated shock: late or "progressive" shock. The body can no longer compensate for the hypovolemic state, and blood pressure starts to fall. -Falling BP Irreversible shock: the final stage of shock. The patient will not survive once entering irreversible shock. What are the types of shock? - correct answer ✅1. Cardiogenic shock 2. Obstructive shock 3. Distributive shock 4. Hypovolemic shock NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is hypovolemic shock? - correct answer ✅Hypovolemic shock is a fluid problem. It may be caused by hemorrhage or by dehydration or burns. What are early signs and symptoms of shock? - correct answer ✅Altered LOC Tachycardia Pale, cool skin: due to peripheral vasoconstriction Weak peripheral pulses Increased respiratory rate Thirst Delayed capillary refill NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What are late signs and symptoms of shock? - correct answer ✅Falling BP Irregular breathing Mottling or cyanosis Absent peripheral pulses How should shock be managed? - correct answer ✅Control bleeding, high-flow oxygen, Trendelenburg, prevent loss of body heat, rapid transport. What are potential causes of respiratory complaints? - correct answer ✅Airway obstruction Anaphylaxis Asthma Chronic obstructive pulmonary disease (COPD) Congestive heart failure Croup NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Cystic fibrosis Flail chest Pneumonia Pneumothorax Pulmonary edema Pulmonary embolism Respiratory syncytial virus (RSV) Hyperventilation syndrome Sucking chest wound Thoracic trauma Toxic substance exposure What is croup? - correct answer ✅Croup is inflammation of the pharynx, larynx, and trachea. It is highly infectious and usually occurs in children up to about 3 years of age. Signs and symptoms: -Croup is usually preceded by a cold and usually occurs in winter NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is acute myocardial infarction? - correct answer ✅MI is death to an area of the myocardial muscle due to lack of oxygenated blood flow through the coronary arteries. Dead myocardial muscle cells become scar tissue and cannot contribute to cardiac contraction. Time to restoration of blood flow through coronary arteries is critical to minimizing cardiac damage. Signs and symptoms: chest pain or pressure, nausea, weakness or fatigue, dyspnea, diaphoresis, abnormal vital signs, sudden cardiac arrest. Geriatric patients, women, and diabetic patients may have atypical MI presentations. Complications of MI include cardiac dysrhythmias, sudden cardiac arrest, congestive heart failure, and cardiogenic shock. What is congestive heart failure? - correct answer ✅CHF occurs when the ventricles are unable to keep up with the flow of blood coming to them. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Right ventricular failure: if the right ventricle pumps inefficiently, blood backs up into the venous system that feeds into the right heart. Signs include JVD, pedal edema. Left ventricular failure: if the left ventricle pumps inefficiently, blood backs up into the lungs. Signs include pulmonary edema. Signs and symptoms: dyspnea, chest pain, pulmonary edema, JVD, pedal edema, orthopnea What is hypertension? - correct answer ✅Systolic greater than 140 and/or diastolic greater than 90 Signs and symptoms: headache, tinnitus, nausea, dizziness, nosebleed. What are strokes? - correct answer ✅Death to brain tissue due to an interruption in blood flow. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Also called cerebrovascular accident or "brain attack." Modern treatment can dramatically reduce the amount of damage and resulting disability if received in time. Signs and symptoms: severe headache, slurred speech, facial droop or drooling, unilateral numbness or weakness or paralysis, altered LOC, vision problems What are ischemic strokes? - correct answer ✅Blood flow to the brain is compromised due to a blockage. Ischemic strokes are often due to atherosclerosis. Overwhelming majority of strokes are ischemic in nature. What are hemorrhagic strokes? - correct answer ✅Caused by bleeding within the brain. The bleeding robs the brain of oxygen delivery, and can apply pressure to surrounding brain tissue, further compromising oxygenation. Hemorrhagic strokes limit certain interventions and are often fatal. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. 1. Aura phase -Warning stage -Patient may sense onset 2. Tonic phase -Muscle rigidity -Possible incontinence 3. Tonic-clonic phase -Patient experiences uncontrolled muscle contraction and relaxation -Patient may be apneic during the tonic or tonic-clonic phase. 4. Postictal phase -"Recovery" phase -Patient's LOC progressively improves over about 30 minutes What are possible causes of seizures? - correct answer ✅Congenital, traumatic, medical conditions, diabetes, epilepsy, fever, infection, medications, toxin exposure NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Febrile seizures are a common cause of seizures in pediatric patients. Caused by high fevers that develop rapidly, they do not typically present significant risk to the patient. The child should, however, be evaluated by a physician. Why is glucose important? - correct answer ✅Glucose is the body's primary fuel source It is the only fuel source used by the brain In addition to oxygen, the brain must have a continuous supply of glucose The use of glucose as a fuel source is an aerobic function Why are fats and proteins important? - correct answer ✅The brain cannot use these alternate fuel sources, but the rest of the body can. These energy sources are used in an anaerobic environment. Fats and proteins are far less efficient (by about 19 times) than glucose fuel source. Byproducts of anaerobic metabolism (ketones) are dangerous. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is diabetes mellitus? - correct answer ✅Diabetes is a disease caused by an inability to metabolize glucose normally. This is frequently due to a problem with insulin production. Untreated diabetics typically have elevated blood glucose levels due to a lack of insulin or ineffective insulin. -Increased urinary output and dehydration is common. What is Type I Diabetes? - correct answer ✅Also called insulin-dependent diabetes mellitus (IDDM) Type I diabetics must take supplemental insulin Type I diabetes usually develops in pediatric patients and is usually genetically caused. Untreated type I diabetics will appear with the three P's (polyuria, polydipsia, polyphagia) and very high blood glucose levels. Type I diabetics are at high risk for diabetic ketoacidosis if untreated. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is diabetic ketoacidosis (DKA)? - correct answer ✅Occurs more frequently with type I diabetes. With DKA, the blood glucose is frequently above 350 mg/dL. Brain cells are able to utilize glucose, but the rest of the body's cells are starving and begin using alternate fuel sources, which leads to the production of ketones and acidosis. Signs and symptoms of DKA: -High blood glucose, typically above 350 mg/dL -Kussmaul respirations: deep, rapid breaths -Polydipsia, polyuria, polyphagia -Fruity odor on breath -Tachycardia -Coma What is hyperglycemic hyperosmolar nonketotic syndrome? - correct answer ✅Similar to DKA, without the buildup of ketones Occurs more frequently with type II diabetes NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is an allergic reaction? - correct answer ✅An allergic reaction is an excessive immune response to an allergenic. Allergic reactions can be local or systemic. Sensitization: patients can develop sensitivity to a substance that did not previously cause a reaction. Following sensitization, the severity of reactions can get progressively worse each time. What is anaphylaxis? - correct answer ✅Anaphylaxis is a severe, life-threatening form of allergic reaction. Anaphylaxis is always systemic and impairs the airway, respiratory, and cardiovascular systems. Anaphylaxis causes upper and lower airway swelling, bronchoconstriction, vasodilation, hypotension, capillary permeability and increased mucus production. Signs and symptoms: -Skin: flushed, hives, swelling -Respiratory: wheezing, upper airway swollen -Cardiovascular: hypotension NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What causes anaphylaxis? - correct answer ✅Medications Environmental triggers Foods Insect bites and stings Latex What are the routes of exposure to drugs and toxins? - correct answer ✅Ingestion, inhalation, injection and absorption What are ingested toxins? - correct answer ✅*Ingestion is the most common route of exposure.* Ingestion of poisons by children is usually accidental, but most incidences involving adults are intentional. Common accidental overdose medications include cardiac medications, psychiatric medications, and acetaminophen. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. -Decreased LOC, respiratory depression -Pupillary constriction What are absorbed toxins? - correct answer ✅Signs and symptoms include burns to the skin, rash or blister, itching or burning. Interventions: -Decontaminate patient appropriately before initiating care or transport -Most chemicals on the skin or eye should be irrigated with water continuously for about 20 minutes. -When irrigating the eyes, be sure not to irrigate toxin into unaffected eye. What do you need to know about alcohol? - correct answer ✅Alcohol is the most widely abused drug in the US Most long-term alcoholics will develop hepatitis. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Alcohol is a CNS depressant and a sedative hypnotic. Ingestion of alcohol increases risks of vomiting. Alcohol withdrawal may cause delirium tremens (DTs). -Restless, irritable, agitated -Hallucinations, tremors or seizures What do you need to know about narcotics? - correct answer ✅Narcotics are widely abused. They are typically ingested or injected. Narcotics, or opioids, include morphine, codeine, heroin, oxycodone, and many more. Narcotics are CNS depressants that can cause coma and severe respiratory depression. Most ALS providers are able to administer Narcan (naloxone), which rapidly reverses the CNS effects of narcotics. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What do you need to know about sedative hypnotic drugs? - correct answer ✅Sedative hypnotics are CNS depressants. Sedatives have a calming effect, and hypnotics induce sleep. Sedative hypnotics are usually taken orally but can be injected. Barbiturates such as Amytal, Seconal, and Luminal are sedative hypnotics. Benzodiazepines such as Valium, Xanax, and Rohypnol are sedative hypnotics. What do you need to know about inhalants? - correct answer ✅Abused inhalants may include acetones, glues, cleaning chemicals, paints, hydrocarbons, aerosols, and propellants. These chemicals are inhaled to achieve sedative hypnotic effects. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. CO is a silent killer. It is tasteless, colorless, odorless, and completely nonirritating when inhaled. Victims are usually unaware they are being exposed and eventually lose consciousness. What do you need to know about acids and alkalis? - correct answer ✅Both are considered caustic substances. Many household products are acids or alkalis. Acids have a very low pH and burn on contact. Pain is usually immediate. Alkalis have a very high pH and tend to burn deeper than acids. Pain may be delayed. Most caustic ingestion patients are children. Common household caustics include liquid drain openers, bathroom cleaning supplies, ammonia and bleach. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Note that activated charcoal is contraindicated with caustic or hydrocarbon ingestion. What do you need to know about hydrocarbons? - correct answer ✅Hydrocarbons are petroleum-based. Hydrocarbons are found in gasoline, paints, solvents, sunscreen, baby oil, makeup remover, kerosene, lighter fluid, and more. Hydrocarbons can be ingested, inhaled, and absorbed. Most hydrocarbon ingestion patients are children. Note that activated charcoal is contraindicated with caustic or hydrocarbon ingestion. What is acute abdominal pain? - correct answer ✅Acute abdominal pain is usually due to trauma, distension, inflammation, or ischemia. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What are the different types of abdominal pain? - correct answer ✅Note that the level of pain does not necessarily indicate the illness's severity. Patients can have a life- threatening abdominal emergency without severe pain. Visceral pain -Dull, diffuse pain that is difficult to localize -Frequently associated with nausea and vomiting -Often not severe, but may indicate actual organ injury Parietal pain -Severe, localized pain. Usually sharp and constant. -The pain will often cause the patient to curl up with knees to chest. -The patient is often very still and breathing shallowly to diminish pain. Referred pain: causes pain in an area of the body other than the source. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. What is diverticulitis? - correct answer ✅Diverticulitis develops when small pouches (diverticula) along the wall of the intestine fill with feces and become inflamed and infected. Typically affects people over age 40 and is associated with a low-fiber diet. Signs and symptoms: -Usually abdominal pain in the lower left quadrant -Fever -Weakness -Nausea and vomiting -Bleeding NOT common What is GI bleeding? - correct answer ✅Most often occurs in middle-aged patients Most often fatal in geriatric patients NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Upper GI bleeds: often due to ulcers Lower GI bleeds: often due to diverticulitis Signs and symptoms: -Hematemesis: vomiting blood -Hematochezia: bloody stool -Dark, tarry stool -Signs and symptoms of hypovolemic shock What is gastroenteritis? - correct answer ✅Gastroenteritis is an infection with associated diarrhea, nausea and vomiting. It is usually due to contaminated food or water and is not contagious. Prolonged vomiting and diarrhea can lead to hypovolemic shock. NREMT Cognitive Exam Prep Questions And Answers 2024 Latest Update. Gastroenteritis is a common cause of shock in children. What are esophageal varices? - correct answer ✅Esophageal varices are a weakening of the blood vessels lining the esophagus. The condition is frequently associated with alcoholism. Signs and symptoms: -Vomiting large amounts of bright red blood -History of alcohol abuse or liver disease -Signs and symptoms of hypovolemic shock What are ulcers? - correct answer ✅Ulcers are open wounds along the digestive tract, often the stomach. Signs and symptoms: -History of ulcers