NREMT EXAM LATEST ACTUAL EXAM TEST BANK 2025 QUESTIONS AND DETAILED CORRECT ANSWERS, Exams of Nursing

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A 60-year-old man presents with a severe right-sided headache. He is conscious and alert. As you are assessing him, he tells you that the left side of his body feels weak. His blood pressure is 190/100 mm Hg, pulse is 88 beats/min, and respirations are 14 breaths/min. His past medical history includes diabetes, arthritis, and hypertension. You should be MOST concerned with:

• A:his current blood pressure.
• B:the location of his headache.
• C:his blood glucose level.
• D:the presence of hemiparesis. Correct Answer You selected D; This is correct! Reason:Headaches are a common medical complaint and have numerous causes, most of which are not life-threatening. Common causes of a headache include migraine and cluster headaches, sinusitis, and muscle tension, among others. In some patients, however, a headache can signal a serious problem. In this patient, you should be most concerned with his unilateral weakness (hemiparesis); this is not a common finding in patients with otherwise benign headaches and suggests a serious underlying problem (eg, intracranial bleeding, brain tumor). The

fact that his headache is to the right side of his head and his weakness is to the left side of his body suggests that the problem lies in the right side of the brain. It is doubtful that his blood glucose level (BGL) is abnormal; he is conscious and alert. However, it would not be unreasonable to assess his BGL. His blood pressure, which is significantly elevated, could be causing his headache or may be the result of other factors, such as noncompliance with his antihypertensive medication, anxiety, or pain. Which of the following would MOST likely cause a rapid drop in a patient's blood glucose level?

• A:Mild exertion after eating a meal
• B:Forgetting to take prescribed insulin
• C:Taking too much prescribed insulin
• D:Eating a meal after taking insulin Correct Answer You selected C; This is correct! Reason:Compared to diabetic coma (hyperglycemic ketoacidosis, hyperglycemic crisis), insulin shock (hypoglycemia, hypoglycemic crisis) has a rapid onset. It is commonly caused when a patient accidentally takes too much prescribed insulin. Insulin is a fast-acting drug that rapidly causes glucose to exit the bloodstream and enter the cell. Other common causes of hypoglycemia include taking a regular dose of insulin but not eating or taking insulin and exercising heavily. Eating a meal after taking insulin typically does not cause a significant change in the patient's blood glucose level. If a person

fails to take his or her insulin, glucose will not be able to enter the cell and will accumulate in the bloodstream (hyperglycemia). A 44-year-old woman was bitten on the ankle by an unidentified snake while working in her garden. She is conscious and alert, has stable vital signs, and denies shortness of breath. Her only complaint is a burning sensation at the wound site. Your assessment reveals two small puncture wounds, redness, and swelling. You should:

• A:conclude that envenomation likely did not occur, provide reassurance, and allow a friend to take her to the hospital.
• B:give supplemental oxygen, splint her leg to decrease movement, and keep her leg below the level of her heart.
• C:elevate her leg, cover the wound with a dry sterile dressing, and apply an ice pack to reduce pain and swelling.
• D:administer high-flow oxygen, apply a constricting band proximal to the bite, and use ice to prevent venom spread. Correct Answer You selected B; This is correct! Reason:Given the fact that the snake was not identified, you should assume that it was poisonous. Furthermore, the presence of puncture wounds, burning, redness, and swelling are suggestive of envenomation. Therefore, you should provide emergency care and transport the patient to the hospital. Treatment for a snake bite involves keeping the patient calm, administering oxygen, splinting the

affected extremity to decrease movement (helps slow the spread of venom), keeping the extremity below the level of the heart, and transporting the patient to the hospital. Do NOT apply ice to a snake bite; it may constrict the blood vessels and force venom further into the bloodstream. The use of a proximal constricting band is controversial; if one is used, it should be loose, not tight. En route to the hospital, monitor the patient's vital signs and mental status, and be alert for vomiting. A 34-year-old female complains of persistent fever, fatigue, and night sweats. During your assessment, you note that she has purple blotches on her arms and legs. She MOST likely has:

• A:HIV/AIDS.
• B:chickenpox.
• C:tuberculosis.
• D:viral hepatitis. Correct Answer You selected A; This is correct! Reason:Signs of human immunodeficiency virus (HIV) infection include persistent fever, weight loss, fatigue, a cough, and night sweats. The presence of purple skin blotches (malignant lesions called Kaposi's sarcoma) is consistent with acquired immune deficiency syndrome (AIDS), also known as late stage HIV infection. Patients with tuberculosis (TB) also present with fever, fatigue, weight loss, a cough, and night sweats; however, skin lesions are not common. Hepatitis is characterized by right upper quadrant

abdominal pain, fever, nausea and vomiting, and a yellow tint to the skin and sclera (jaundice). Chickenpox is unlikely; the associated rash is characterized by pustules that crust over, not purple blotches. The daughter of an elderly patient states that her mother is acting confused and talking incoherently. This nature of illness is MOST consistent with:

• A:diabetic complications.
• B:altered mental status.
• C:cardiac compromise.
• D:behavioral problems Correct Answer You selected B; This is correct! Reason:The nature of illness is a category in which you place the patient based on his or her chief complaint. A chief complaint of confusion and incoherent speech suggests that altered mental status is the nature of illness. An altered mental status can be caused by a variety of problems, including diabetic and behavioral problems, and in some cases, cardiac problems. Which of the following statements regarding heatstroke is correct?
• A:Heatstroke is caused by a hyperactive sweating mechanism.
• B:Not all patients experiencing heatstroke have dry skin.
• C:As core body temperature rises, the patient becomes more agitated.

• D:Heatstroke is more likely to occur when the humidity is low. Correct Answer You selected B; This is correct! Reason: Heatstroke occurs when the body is exposed to more heat than it can eliminate and normal mechanisms for eliminating heat, such as sweating, are overwhelmed. The core body temperature then rises rapidly to the point where tissues are destroyed. Heatstroke can develop in patients during prolonged vigorous physical activity or when they are in a closed, poorly ventilated, hot and humid space. High humidity impairs a person's ability to eliminate heat via the sweating mechanism. Many patients with heatstroke have hot, dry, flushed skin; however, early in the course of heatstroke, the skin may be moist due to residual perspiration, as with exertional heatstroke. As the core body temperature rises, the patient's level of consciousness decreases. Untreated heatstroke will result in death. Law enforcement requests your assistance to evaluate a young female who they believe has overdosed. The patient is conscious, is displaying bizarre behavior, and is very restless. Her BP is 170/90 mm Hg and her heart rate is 130 beats/min. You see needle tracks on both of her arms. She is MOST likely under the influence of a:
• A:benzodiazepine.
• B:sedative-hypnotic.
• C:powerful narcotic.
• D:methamphetamine. Correct Answer You selected D; This is correct!

Reason:The needle tracks on the patient's arms indicate narcotic abuse, most likely heroin; however, her signs and symptoms are not consistent with those caused by a narcotic or any other central nervous system (CNS) depressant (eg, benzodiazepine [a sedative-hypnotic]). Signs of CNS depression include a decreased level of consciousness, hypoventilation, bradycardia, and hypotension. Her signs and symptoms are consistent with a sympathomimetic (upper) overdose. Sympathomimetic drugs mimic the effects of the sympathetic (fight or flight) nervous system; therefore, restlessness or hyperactivity, hypertension, tachycardia, and pupillary dilation are common findings in patients who overdose. Amphetamine and methamphetamine (eg, ice, speed, crack) are examples of sympathomimetics. Which of the following signs and symptoms are MOST characteristic of hyperglycemic ketoacidosis?

• A:Warm, dry skin and a slow onset
• B:Warm, dry skin and a rapid onset
• C:Cool, clammy skin and a rapid onset
• D:Cool, clammy skin and a slow onset Correct Answer You selected A; This is correct! Reason:Hyperglycemic ketoacidosis (diabetic coma) is characterized by a dangerously high blood glucose level (hyperglycemia); slow onset; warm, dry skin (from dehydration); and Kussmaul's respirations, which are deep and rapid and have a fruity or acetone

odor. Insulin shock results from a low blood glucose level (hypoglycemia) and is characterized by a rapid onset; altered mental status; and cool, clammy skin. Which of the following statements regarding lightning- related injuries is correct?

• A:Multiple fractures, including those of the cervical spine, are the most common cause of lightning-related deaths.
• B:The majority of patients who are struck by lightning die, even if CPR is provided immediately.
• C:Because of the high electrical energy associated with lightning, full-thickness burns are a common finding.
• D:The cardiovascular and nervous systems are most commonly injured during a lightning strike. Correct Answer The Correct Answer is D; Reason:The cardiovascular and nervous systems are most commonly injured during a lightning strike; therefore, respiratory or cardiac arrest is the most common cause of lightning-related deaths, especially if CPR is delayed. A lightning strike typically induces asystole (cardiac standstill); however, this spontaneously resolves in some people or can be reversed with early, high-quality CPR. The energy associated with lightning is composed of direct current (DC) of up to 200,000 amperes and a potential of 100 million volts or more; however, the duration of a lightning strike is short. Therefore, skin burns are usually superficial; full-thickness (third-degree) burns are rare. Lightning causes massive contraction of all the body's muscles, potentially resulting in long bone

and spinal fractures. Although this can clearly increase morbidity, it is not the most common cause of lightning-related deaths. You are transporting a 30-year-old man who is experiencing an emotional crisis. The patient does not speak when you ask him questions. How should you respond to his unwillingness to speak?

• A:Remain silent until the patient speaks to you.
• B:Do not speak to the patient, even if he begins to speak to you.
• C:Tell the patient that you cannot help if he won't talk.
• D:Continually encourage the patient to talk to you. Correct Answer You selected A; This is correct! Reason:When dealing with a psychiatric patient who is silent and unwilling to speak to you, do not fear the silence. The patient simply does not wish to speak. You should not press the issue, for doing so may upset the patient. You should remain calm until the patient speaks to you, and then respond accordingly. An elderly man is found unresponsive in his kitchen. The patient's wife tells you that her husband has diabetes and that he took his insulin, but did not eat anything. You should suspect:
• A:diabetic coma.
• B:hypoglycemia.
• C:ketoacidosis.
• D:hyperglycemia. Correct Answer The Correct Answer is B;

Reason:Several factors point to a field impression of hypoglycemia. First, the patient is known to have diabetes and second, he took his insulin but did not eat. Because insulin promotes the uptake of glucose into the cells, if the patient does not replace this glucose by eating, the glucose level in the blood will fall to dangerously low levels. Hypoglycemia can also occur when a patient takes too much of his or her insulin. Hyperglycemia occurs when a patient does not take his or her insulin. In such cases, glucose accumulates in the bloodstream and is not able to enter the cell. In the absence of glucose, the cells begin to metabolize fat, which results in the production of ketoacids and leads to hyperglycemic ketoacidosis (diabetic coma, hyperglycemic crisis). You and your partner arrive at the home of a 60-year-old man with shortness of breath. As you enter the residence, you find the patient sitting in his recliner; he is in obvious respiratory distress. As you approach him, he becomes verbally abusive, stating that it took you too long to get to his home. A small handgun is sitting on a table next to his recliner. You should:

• A:verbally distract the patient as your partner attempts to retrieve the gun.
• B:slowly back your way out of the residence and call law enforcement.
• C:turn around, rapidly exit the residence, and notify law enforcement.

• D:explain the reason for your delay as your partner administers oxygen. Correct Answer You selected B; This is correct! Reason:There is an immediate threat to you and your partner's safety! The patient is verbally abusive and has a firearm within arm's reach. In this situation, you and your partner should slowly back away from the patient, exit the residence, and notify law enforcement. Do NOT take your eyes off of the patient; if you turn your back, you may take a bullet in the back! Backing away gives you the opportunity to take cover if you see the patient reach for his gun. Remember, your safety comes before all else. A 55-year-old woman with a history of diabetes is found unresponsive with rapid, shallow respirations. The patient's husband tells you that he does not know when his wife last took her insulin. Management of this patient should include:
• A:subcutaneous injection of insulin and 100% oxygen.
• B:oral glucose and oxygen via nonrebreathing mask.
• C:assisted ventilations and oral glucose.
• D:assisted ventilations and rapid transport. Correct Answer You selected D; This is correct! Reason:Without knowing if and when the patient last took her insulin, it is difficult to determine if she is experiencing diabetic coma or insulin shock. Nonetheless, her rapid, shallow respirations—which are likely not producing adequate tidal volume—should be treated with ventilation

assistance. Because she is unresponsive and obviously unable to swallow, oral glucose is contraindicated. Assess the patient's blood glucose level and pass this information along to the hospital; if possible, arrange for a paramedic intercept so she can receive intravenous dextrose. If the patient is experiencing diabetic coma, insulin is what she truly needs; however, insulin is rarely, if ever, administered in the prehospital setting—even by paramedics. After ensuring adequate oxygenation and ventilation, transport the patient without delay. When treating an unresponsive man who was struck by lightning, you should:

• A:manually stabilize his head and open his airway.
• B:apply full spinal precautions before moving him.
• C:begin CPR at once if he is apneic and pulseless.
• D:ensure that you and the patient are in a safe place. Correct Answer You selected D; This is correct! Reason:Contrary to popular belief, lightning can (and does) strike in the same place twice. After lightning strikes, the ground remains electrically charged for a period of time; this increases the chance of a second strike within a short period of time. You must first ensure that you and the patient are safe by moving to a sheltered area, preferably indoors. After you have ensured the safety of yourself and the patient, begin treatment as dictated by the patient's condition. Do not let the life you save, or attempt to save, TAKE your own! You are assessing a 40-year-old male with an apparent psychiatric crisis. According to the mans's wife, he has a

history of depression and schizophrenia and takes Zoloft and Zyprexa. A police officer is present at the scene. The patient, who is obviously scared, tells you that he sees snakes everywhere. You should:

• A:let him know that going to the hospital will keep him safe from the snakes.
• B:let him know that it is important for him to be transported as soon as possible.
• C:tell him that you do not see any snakes, but they are obviously scaring him.
• D:advise him that you suspect he has not been compliant with his medications. Correct Answer You selected C; This is correct! Reason:When caring for any patient with a behavioral emergency, your primary responsibility is to yourself, to stay safe. The patient in this scenario, although scared, is not violent. In cases such as this, you should be prepared to spend extra time with the patient; it may take longer to assess, listen to, and prepare the patient for transport. Just because he is experiencing an acute crisis does not mean that he has not been taking his medications; to make that assumption is merely speculation on your part. You must be honest, reassuring, and nonjudgmental. Let the patient tell you how he or she is feeling in his or her own words, and acknowledge any auditory or visual hallucinations. Do not, however, play along with his or her hallucinations; this is cruel and only reinforces that what the patient is hearing or seeing is real.

Which of the following structures is NOT part of the endocrine system?

• A:Gallbladder
• B:Pancreas
• C:Thyroid
• D:Pituitary Correct Answer You selected A; This is correct! Reason:The gallbladder, which concentrates and stores bile, is not an endocrine organ; it is a digestive organ. Endocrine organs produce hormones, which regulate other body organs and systems. The thyroid regulates metabolism; the pancreas produces insulin and glucagon; and the pituitary gland, which is located within the brain, is the "master" endocrine gland and regulates the function of all endocrine glands in the body. Assessment and treatment of a patient with severe abdominal pain should include:
• A:giving the patient small sips of water.
• B:placing the patient in a supine position.
• C:administering supplemental oxygen.
• D:vigorously palpating the abdomen. Correct Answer You selected C; This is correct! Reason:Patients with severe abdominal pain should be given supplemental oxygen (in a concentration sufficient to maintain an SpO2 of greater than 94%) and immediate transport. Most patients with abdominal pain prefer to lie on their side with their knees drawn up into their chest (fetal position), which takes pressure off of the abdominal musculature and often affords them some relief. Vigorous

palpation of the abdomen should be avoided as this will only cause the patient more pain; instead, gently palpate each of the four abdominal quadrants, palpating the most painful area last. Because the patient may become nauseated and vomit and the possibility that he or she may require surgery, do not give him or her anything to eat or drink. You receive a call for a 54-year-old female who is having a seizure. When you arrive at the scene, the patient is actively seizing. Her husband tells you that she has a history of seizures, and that she has been seizing continuously for 20 minutes. It is MOST important for you to recognize that:

• A:her husband's description is consistent with status epilepticus.
• B:the patient may have stopped taking her seizure medication.
• C:her seizure could be the result of a low blood glucose level.
• D:the patient is hypoxic and needs oxygen as soon as possible. Correct Answer You selected D; This is correct! Reason: There are many causes of seizures, including noncompliance with prescribed anticonvulsant medications, hypoglycemia, stroke, head trauma, and poisoning, among others. Regardless of the underlying cause, it is most important to recognize that patients who are actively seizing, especially if the seizure is prolonged, are hypoxic and need high-flow oxygen as soon as

possible; in many cases, it may be necessary to assist the patient's ventilations. The husband's description of the seizure (eg, continuous for 20 minutes) is consistent with status epilepticus, which is all the more reason to recognize that she is severely hypoxic. Seizure-related deaths are the result of cerebral hypoxia. When insulin levels in the blood remain high:

• A:a fruity odor can be detected on the patient's breath.
• B:glucose is rapidly taken out of the blood to fuel the cells.
• C:the patient urinates excessively and becomes dehydrated.
• D:the cells starve for glucose and begin to metabolize fat. Correct Answer The Correct Answer is B; Reason:Insulin is a hormone that promotes the cellular uptake of glucose from the bloodstream. If insulin levels remain high, such as when a diabetic inadvertently takes too much insulin, glucose is rapidly taken out of the blood to fuel the cells. This leads to low circulating blood glucose levels (hypoglycemia) and a condition called insulin shock. By contrast, if insulin levels are too low, such as when a diabetic forgets to take his or her insulin, glucose cannot enter the cells and pools in the bloodstream (hyperglycemia). In the absence of glucose, the cells begin to metabolize fat, which produces ketoacids (diabetic ketoacidosis [DKA]). The respiratory system attempts to eliminate ketoacids from the blood with an increased rate and depth of breathing that is accompanied by a fruity or acetone breath odor (Kussmaul respirations).

Hyperglycemia causes the patient to eliminate excess water from the body through urination (diuresis), resulting in dehydration. The bite of a brown recluse spider is characterized by:

• A:two small puncture marks, swelling, and delayed onset of pain.
• B:immediate pain, swelling at the site, and painful muscle spasms.
• C:rapid swelling within 30 minutes and a decline in mental status.
• D:delayed onset of pain, swelling, and blister formation at the site. Correct Answer You selected D; This is correct! Reason:The venom of a brown recluse spider is cytotoxic; that is, it causes tissue and cellular damage. The bite itself is usually painless; however, the patient typically begins to complain of pain within a few hours. The area becomes swollen and tender, developing a pale, mottled, cyanotic center and possibly a small blister. Over the next several days, a scab of dead skin, fat, and debris will form and dig down into the skin, producing a large ulcer that may not heal unless promptly treated. The bite of a brown recluse spider is very small; therefore, puncture marks are not visible. Unlike the brown recluse spider, the black widow spider bite is characterized by immediate pain. Its venom is neurotoxic; that is, it supresses the central nervous system. The patient typically complains of intense muscle spasms, especially of the abdomen, and systemic signs of nervous system involvement (eg, dizziness, chest pain, difficulty breathing).

Which of the following is the MOST significant finding in a patient experiencing an allergic reaction?

• A:Widespread rash.
• B:Abdominal cramps.
• C:Headache
• D:Hoarseness Correct Answer You selected D; This is correct! Reason:A rash (urticaria), headache, abdominal cramps, and hoarseness are all signs of an allergic reaction. However, the presence of hoarseness is the most significant finding because it indicates upper airway swelling. Other significant findings include swelling of the face, neck, or tongue; wheezing and/or stridor; difficulty breathing; tachycardia; and hypotension. Death due to a severe allergic reaction (anaphylaxis) is caused by vascular collapse (caused by massive vasodilation) and respiratory failure (caused by upper and/or lower airway swelling). You receive a call to a restaurant where a 34-year-old man is experiencing shortness of breath. When you arrive, you immediately note that the man has urticaria on his face and arms. He is conscious, but restless, and is in obvious respiratory distress. You should:
• A:obtain a set of baseline vital signs and a SAMPLE history.
• B:place a nonrebreathing mask set at 15 L/min on the patient.
• C:ask the patient if he has an epinephrine auto-injector.

• D:remove the patient's shirt to inspect his chest for urticaria. Correct Answer You selected B; This is correct! Reason:Initial management of a patient with a suspected allergic reaction is to ensure a patent airway and provide high-flow oxygen. Positive-pressure ventilation may be required if the patient is breathing inadequately. After ensuring a patent airway and adequate ventilation and oxygenation, you should inquire whether the patient has a prescribed epinephrine auto-injector. If so, you should contact medical control and obtain permission (if required by local protocol) to assist the patient with the auto- injector. Your patient is a 75-year-old female who, according to her son, tripped on a throw rug and fell. The patient is conscious and alert, is sitting on the couch, and has a hematoma to her forehead. When you ask her what happened, her son interjects by saying, "I already told you, she tripped and fell." As you further question her, you find that she is hesitant to answer your questions and keeps looking at her son. You should:
• A:interview the patient and her son separately if possible.
• B:tell the son that you suspect his mother has been abused.
• C:notify law enforcement and have the son removed.
• D:ask the patient if someone hurt her intentionally. Correct Answer You selected A; This is correct! Reason:There are several indicators that suggest this patient's injury was intentionally inflicted: the son's

interjection, her hesitance to answer your questions, and the fact that she keeps looking at her son. If possible, interview the patient and her son separately; doing say may reveal inconsistencies regarding the event, which would further increase your index of suspicion for abuse. You must not, however, accuse her son of abuse or insinuate such. If you are wrong, you could be liable for slander. At present, the son is not verbally or physically abusive; however, if he becomes abusive, you should notify law enforcement at once. Remember, you are legally obligated to report any suspicions of abuse or neglect to the emergency department physician. You should make every effort to convince the patient to consent to treatment and transport. Which of the following signs or symptoms is MOST suggestive of a systemic reaction following ingestion of a poison?

• A:Painful or difficult swallowing
• B:Burns around the mouth
• C:Tachycardia and hypotension
• D:Nausea and vomiting Correct Answer You selected C; This is correct! Reason:Once an ingested poison gets into the system, it can affect multiple organ systems. Signs that this is occurring include tachycardia or bradycardia, hypotension or hypertension, weakness, restlessness, and an altered level of consciousness, among others. Local effects of an ingested poison include nausea and vomiting as the

poison irritates the gastric lining, burns in and around the mouth, and painful or difficult swallowing (dysphagia). A patient with a core body temperature of 94°F would MOST likely present with:

• A:joint and muscle stiffness.
• B:shivering and pale skin.
• C:decreased muscle activity.
• D:an altered mental status. Correct Answer The Correct Answer is B; Reason:Mild hypothermia is defined as a core body temperature (CBT) between 93.2°F and 96.8°F (34°C and 36°C). Mildly hypothermic patients are usually alert and shivering in an attempt to generate heat through muscular activity. Their skin is typically pale due to the body's constriction of blood vessels at the skin to retain heat. In moderate hypothermia (CBT between 86°F and 93.2°F [30°C and 34°C]), shivering stops and muscular activity decreases. As the CBT falls further, all muscle activity stops. In severe hypothermia (CBT < 86°F [30°C]), vital functions decrease (eg, level of consciousness, BP, pulse, respirations) and the patient is at risk for life-threatening cardiac dysrhythmias. The muscles become rigid and the patient appears stiff. The patient may appear dead; although a pulse is present, it may not be palpable. An 80-year-old woman has pain in the right upper quadrant of her abdomen and a yellow tinge to her skin. You should suspect dysfunction of the:
• A:gallbladder.

• B:liver.
• C:pancreas.
• D:spleen. Correct Answer You selected B; This is correct! Reason:Pain in the right upper quadrant and skin with a yellow tinge to it (jaundice) indicates a problem with the liver. Jaundice is the result of an excess level of bilirubin in the blood. Bilirubin, a yellow-colored substance, is the waste product that remains in the bloodstream after the iron is removed from the hemoglobin. One of the functions of the liver is to filter out waste, such as bilirubin, from the blood. If the liver is not functioning properly, bilirubin accumulates in the bloodstream. Dysfunction of the pancreas would result in possible fluctuations in the levels of blood glucose. Gallbladder inflammation (cholecystitis) typically produces right upper quadrant pain and/or referred pain to the right shoulder that occurs shortly after eating. Dysfunction of the spleen would cause left upper quadrant pain and/or referred pain to the left shoulder. A man is experiencing a severe allergic reaction after being stung by a scorpion. He does not have his own epinephrine; however, his wife is allergic to bees and has a prescribed epinephrine auto-injector. You should:
• A:request an ALS unit to respond to the scene to administer epinephrine.
• B:provide rapid transport and consider an ALS rendezvous.
• C:assist the patient with the wife's prescribed epinephrine.

• D:assist the patient with one half the usual dose of the wife's epinephrine. Correct Answer You selected B; This is correct! Reason:If a patient does not have a prescribed epinephrine auto-injector and is experiencing a severe allergic reaction, you should administer supplemental oxygen, assist the patient's ventilations if needed, and transport without delay. Closely monitor the patient's airway and breathing status en route and coordinate an ALS rendezvous if possible. If you carry an epinephrine auto-injector on your ambulance and your protocols allow you to administer it, do so without delay. Otherwise, the ALS unit will be able to administer epinephrine via the intramuscular or intravenous route. Never assist a patient with a medication that is not prescribed to him or her specifically. You are transporting a 35-year-old male who has a history of alcoholism. He stopped drinking 4 days ago and is now disoriented, diaphoretic, and tachycardic. You should be MOST concerned that he:
• A:may have a seizure.
• B:is severely dehydrated.
• C:will develop a high fever.
• D:will begin hallucinating Correct Answer You selected A; This is correct! Reason:A patient in alcohol withdrawal may experience frightening hallucinations, or delirium tremens (DTs), a syndrome characterized by restlessness, fever,

disorientation, sweating, agitation, and even seizures. About 1 to 7 days after a person stops drinking or when alcohol consumption levels are suddenly decreased, DTs may develop. Patients with DTs are often dehydrated due to sweating, fluid loss, insufficient fluid intake, or vomiting, and their hallucinations can be extremely frightening. However, the possibility of a seizure, clearly the most life- threatening complication associated with DTs, should concern you the most. While triaging patients at a mass-casualty incident, you encounter a responsive middle-aged female with a respiratory rate of 26 breaths/min. What should you do next?

• A:Triage her as immediate (red tag)
• B:Administer high-flow oxygen at once
• C:Assess for bilateral radial pulses
• D:Assess her ability to follow commands Correct Answer You selected C; This is correct! Reason: According to the Simple Triage And Rapid Treatment (START) method, if you encounter an adult patient with a respiratory rate that is less than 10 breaths/min or greater than 29 breaths/min, you should triage him or her as immediate (red tag) and move to the next patient. However, if the patient's respiratory rate is between 10 and 29 breaths/min, you should assess his or her hemodynamic status by checking for bilateral radial pulses. If the patient's radial pulses are absent, triage him or her as immediate and move to the next patient. If the patient's radial pulses are present, assess his or her ability

to follow simple commands. If the patient is able to follow simple commands, triage him or her as delayed (yellow tag) and move to the next patient. If the patient is unable to follow simple commands, triage him or her as immediate and move to the next patient. Treatment does not occur during the initial triage process. The ultimate goal of any EMS quality improvement program is to:

• A:recognize all EMTs who demonstrate consistency in providing competent patient care.
• B:provide protocols to all EMTs and hold them accountable if protocols are not followed.
• C:deliver a consistently high standard of care to all patients who are encountered.
• D:ensure that all personnel receive an adequate number of continuing education hours. Correct Answer You selected C; This is correct! Reason: Providing continuing education to all personnel, recognizing those who consistently provide competent patient care, and holding all personnel accountable for adhering to the EMS protocols are all components of any EMS quality improvement program. The ultimate goal, however, is to provide, as a system, a consistently high standard of care to all patients who are encountered. A set of regulations and ethical considerations that define the extent or limits of an EMT's job is called:
• A:the Medical Practices Act.
• B:confidentiality.