Emergency Medical Procedures: Airway Management, CPR, and Spinal Injuries, Exams of Nursing

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After an EMS call, some crew members begin discussing a recent case with some non-EMS personnel. This is unacceptable behavior because it is: a) A breach of the patient's right to know b) A breach of the patient's privacy and is unethical c) Against the New York State Good Samaritan Law d) Against the principles of patient consent - ✔✔b) A breach of the patient's privacy and is unethical Which form of consent allows you to treat an unconscious patient? a) Actual consent b) Implied consent c) Informed consent d) Legislated consent - ✔✔b) Implied consent

• Another name for the left lateral position is: a) Semi-Fowler's b) Trendelenburg c) Recovery position d) dorsal recumbent - ✔✔c) Recovery position
• In anatomic terms, an injury midway down the left forearm would be considered: a) Distal to the left elbow b) Proximal to the left elbow c) Superior to the left elbow d) Lateral to the left elbow - ✔✔a) Distal to the left elbow

If a life-threatening problem is discovered during the Initial Assessment, you should: a) Finish the Initial Assessment and then go back to correct the problem b) Complete both the Initial Assessment and the Detailed Physical Examination c) Transport the patient to the hospital immediately d) Correct the problem before continuing with the Initial Assessment - ✔✔d) Correct the problem before continuing with the Initial Assessment Which of the following is the BEST definition of the term "auscultation"? a) The reaction of a normal pupil to light b) Evaluating the blood pressure in the sitting and supine positions c) Listening d) Testing of reflexes - ✔✔c) Listening The "A" in the mnemonic AVPU as it relates to patient assessment, stands for: a) Allergy b) Airway c) Alert d) Auscultate - ✔✔c) Alert An unconscious trauma victim responds to painful stimuli in both extremities. The EMS Provider should presume that: a) There is no spinal injury b) Circulation to the extremities is defective c) There is proper circulation to the extremities d) There may still be a spinal injury - ✔✔d) There may still be a spinal injury The purpose of the first set of vital signs is to: a) Establish a baseline for additional evaluations b) Determine all that is necessary for the prehospital care report (PCR)

When performing abdominal thrusts on a conscious adult patient with a severe airway obstruction, the EMS Provider should place the thumb side of his/her hand against the patient's abdomen: a) Between the midportion of the sternum and the xiphoid process b) Directly on the umbilicus c) Directly on the xiphoid process d) Between the navel and the xiphoid process in the midline - ✔✔d) Between the navel and the xiphoid process in the midline You are attempting to ventilate a patient through a stoma and you notice that the patient's chest does not rise completely. You feel an escaping from the patient's mouth and nose. Your next step should be to: a) Perform abdominal thrusts b) Reposition the head and attempt to reventilate c) manually seal the patient's mouth and nose d) Blow more forcefully - ✔✔c) manually seal the patient's mouth and nose A correct statement concerning airway management of a patient who has a suspected spinal cord injury is that: a) The cord injury takes precedence over the airway; the patient can be ventilated only if this can be done without moving the cord b) The airway always takes precedence over the cord injury; the airway must be opened regardless of the damage it might do to the cord c) There is no difference in management; in the presence of cord injury, the airway is still opened in the usual way d) Special techniques must be employed to open the airway without moving the cord - ✔✔b) The airway always takes precedence over the cord injury; the airway must be opened regardless of the damage it might do to the cord When ventilating an infant with inadequate breathing, rescue breaths should be given at a rate of 1 breath every: a) 2 seconds b) 4 seconds

c) 6 seconds d) 8 seconds - ✔✔b) 4 seconds Which of the following organs is MOST SUSCEPTIBLE to damage if you place your hands on the xiphoid process during chest compression? a) Kidney b) Liver c) Spleen d) Appendix - ✔✔b) Liver You are called to the scene of a drowning. The patient is still in the water and is pulseless and apneic. When should you begin CPR? a) Immediately upon reaching the patient in the water b) After removing the patient from the water c) When a second rescuer reaches the patient in the water d) While in the water and supporting the patient's thorax - ✔✔b) After removing the patient from the water During two-rescuer CPR, at what point is it appropriate to change compressors? a) After each cycle b) After 2 minutes c) After 2 cycles d) After 5 minutes - ✔✔b) After 2 minutes All of the following are criteria for effective chest compressions in an adult EXCEPT: a) Compress the chest hard and fast b) minimize interruptions during compressions c) Allow for full chest recoil d) Pause chest compressions to check the pulse each minute - ✔✔d) Pause chest compressions to check the pulse each minute

a) Nasopharyngeal airways should be used only in the left nostril b) Nasopharyngeal airways should be coated with a water-soluble lubricant prior to insertion c) Nasopharyngeal airways are more likely to stimulate a gag reflex than would an oropharyngeal airway d) lf an obstruction is encountered as a nasopharyngeal airway is first introduced, you should immediately switch to an oropharyngeal airway - ✔✔b) Nasopharyngeal airways should be coated with a water-soluble lubricant prior to insertion In mouth-to-mask ventilation, the stomach is likely to be distended if too great a force is used to inflate the lungs. Lung ventilation may become more difficult because stomach inflation: a) Causes a spasm of the larynx b) Pushes up on the diaphragm and increases the likelihood of vomiting c) Produces a back pressure that pushes the epiglottis forward d) Causes a displacement of the lungs, resulting in deviation of the trachea - ✔✔b) Pushes up on the diaphragm and increases the likelihood of vomiting You have inserted an oropharyngeal airway into the mouth of an unconscious victim who reacts by having a gag reflex. You should: a) Remove the airway b) remove the airway, then reinsert it c) Pull the airway out slightly d) Use a smaller-sized airway - ✔✔a) Remove the airway The proper technique for suctioning a patient's mouth is to suction: a) As you are withdrawing the catheter b) As you are inserting the catheter c) While you insert and withdraw the catheter d) While ventilating with high-concentration oxygen - ✔✔a) As you are withdrawing the catheter An unconscious, breathing 18 - year-old patient has been rescued from a car that had the engine running. The patient's skin is red; vital signs are: BP = 110/70; P = 110; R = 18. Oxygen should, be administered with which of the following devices?

a) Nasal cannula b) Simple face mask c) Venturi mask d) Non-rebreathing mask - ✔✔d) Non-rebreathing mask You have attempted to insert a nasopharyngeal airway into the right nostril of a patient, but have encountered resistance, You should: a) Insert an oropharyngeal airway instead b) Insert the nasopharyngeal airway despite the resistance c) Remove the tube and try a larger size d) Relubricate the tube and try the other nostril. - ✔✔d) Relubricate the tube and try the other nostril. Approximately how many liters of blood does an adult male weighing 150 lb. have in his body? a) 3 liters b) 4 liters c) 6 liters d) 7 liters - ✔✔c) 6 liters How would you describe bleeding from a vein? a) Bright red; flowing steadily b) Bright red; spurting c) Dark red; flowing steadily d) Dark red; spurting - ✔✔c) Dark red; flowing steadily The PRINCIPAL cause of hypoperfusion (shock) in a victim with massive body burns is loss of: a) Fatty tissues b) Epidermis c) Plasma d) Dermis - ✔✔c) Plasma

c) Bathing the patient with towels wrung in cold water d) Keeping the patient warm and on his/her back with the legs elevated - ✔✔d) Keeping the patient warm and on his/her back with the legs elevated What is the recommended procedure for the transportation of a severed limb to the hospital? a) Wrap the limb in sterile gauze, seal in a plastic bag, and keep the limb cool b) Place the limb in sterile gauze, seal in a plastic bag, and keep the limb warm c) Place the limb on ice, wrap in sterile gauze, then seal both in a plastic bag d) Wrap the limb in sterile gauze, place on ice, then seal both in a plastic bag - ✔✔a) Wrap the limb in sterile gauze, seal in a plastic bag, and keep the limb cool An automobile collision patient has a piece of glass that penetrated through his cheek and is bleeding severely from the injury. The EMS Provider should: a) Remove the glass from the cheek and apply a dressing on both sides of the wound b) Leave the glass in the cheek and apply a dressing over the wound c) Leave the glass in the cheek and apply a dressing on both sides of the wound d) Remove the glass and dress the wound only if the glass interferes with breathing - ✔✔d) Remove the glass and dress the wound only if the glass interferes with breathing To assess the circulatory status of a patient's limbs distal to an injury site, you should check: a) Pulses, skin temperature, and AVPU b) Temperature, crepitus, and grating c) Pulses, skin color, and temperature d) Skin color, AVPU, and crepitus - ✔✔c) Pulses, skin color, and temperature A closed bone or joint injury is BEST defined as an injury: a) With associated muscle spasms or swelling around a joint b) In which there is no break in the continuity of the skin c) Of a long bone with skin discoloration over the affected area d) With associated ligament involvement - ✔✔b) In which there is no break in the continuity of the skin

After immobilizing a painful, swollen, deformed collarbone, your NEXT priority would be to: a) Check to see that the bone ends are approximated b) Ask the patient if the splint is comfortable c) Check the radial Pulse d) Check the airway - ✔✔c) Check the radial Pulse The MOST SERIOUS problem associated with an injury to a joint is that this type of injury: a) Is frequently accompanied by nerve and vascular damage b) Often produces grotesque deformity c) Is very difficult to assess d) Is extremely painful - ✔✔a) Is frequently accompanied by nerve and vascular damage The recommended treatment for a painful, swollen deformity of the forearm is to immobilize the: a) Elbow b) Elbow and wrist c) Wrist d) Wrist and hand - ✔✔b) Elbow and wrist A machine shop operator injured his hand while using a drill press. If the injured hand is to be splinted, the EMS Provider should splint it: a) In the position in which it is found b) In the position of function c) With the hand open d) With a pressure dressing - ✔✔b) In the position of function In the presence of good circulation, the EMS Provider should NOT straighten a dislocated joint before splinting because: a) It may break the bones of the joint

c) Administer oxygen at 6 liters/minute via nasal cannula d) check the proximal pulse - ✔✔c) Administer oxygen at 6 liters/minute via nasal cannula A patient was struck in the head with a pipe during a fight. The patient is unresponsive and bleeding from within the ear. You should: a) Transport immediately and do nothing with the ear b) Apply direct pressure to the ear c) Place your finger in the bleeding ear to prevent fluid loss d) Apply a loose sterile dressing to the ear - ✔✔d) Apply a loose sterile dressing to the ear To control a nosebleed in a patient WITHOUT suspected spinal trauma, the EMS Provider should: a) Have the patient sit upright with the head tilted backward b) Apply tepid compresses to the patient's face and nose c) Have the patient, positioned forward with the head between the legs d) Pinch the patient's nostrils together and sit the patient leaning forward to allow drainage - ✔✔d) Pinch the patient's nostrils together and sit the patient leaning forward to allow drainage The central nervous system consists of the: a) Brain and peripheral nerves b) Brain and spinal cord c) Spinal cord and autonomic functions d) Spinal cord and peripheral nerves - ✔✔b) Brain and spinal cord A patient with a severe head injury and increasing pressure within the skull will often present with: a) Decreased blood pressure and rapid pulse b) Normal blood pressure and rapid pulse c) Normal blood pressure and normal pulse d) Elevated blood pressure and slow pulse - ✔✔d) Elevated blood pressure and slow pulse

When treating a patient with a brain injury, it is important to record changes in the patient's: a) Mental status b) Pupil reaction c) Respiratory rate d) Blood pressure - ✔✔a) Mental status All of the following are signs and/or symptoms of a head injury EXCEPT: a) Sensation and motion in the arms but not in the legs b) Discoloration of soft tissue under the eyes (raccoon eyes) c) A momentary blackout after the injury d) Slight bleeding from the nose, mouth, and/or ear. - ✔✔a) Sensation and motion in the arms but not in the legs Which of the following is a sign of a skull fracture? a) Hypoperfusion (shock) b) Cerebrospinal fluid leaking from the ears c) Decreasing blood pressure d) Neurogenic shock - ✔✔b) Cerebrospinal fluid leaking from the ears Which areas of the spinal are comprised of five vertebrae each? a) Lumbar and sacrum b) Sacrum and cervical c) Cervical and coccyx d) Thoracic and lumber - ✔✔a) Lumbar and sacrum At which of the following levels does injury to the spinal cord result in loss of arm and leg function? a) Cervical b) Thoracic c) Lumbar

A 65 year-old male was involved in a two-car motor vehicle crash. Upon examination, he complains of chest pain upon breathing and tenderness of the sternum. Your INITIAL care would be to: a) Stabilize the sternum b) Position the patient on his side c) Administer high-concentration oxygen d) administer the patient's prescribed nitroglycerin - ✔✔c) Administer high-concentration oxygen A chest injury may interfere mechanically with the functioning of the: a) Xiphoid process b) Sternum c) Lungs d) Brain - ✔✔c) lungs You are treating a male patient who has a penetrating chest wound and frothy bright-red blood at the mouth. About 10 minutes after sealing the chest wall, you notice that the patient's breathing becomes much worse. At this point, you should: a) Immediately place the patient on his uninjured side b) Lift one corner of the dressing c) Administer positive-pressure ventilation immediately d) Administer pure oxygen to aid respiration - ✔✔b) Lift one corner of the dressing Signs and symptoms of multiple broken ribs include: a) Unequal chest expansion, inadequate breathing, deformity, and pain b) Rapid breathing, chest pain, rapid weak pulse, and cyanosis c) Equal chest expansion, slow weak pulse, cyanosis, and chest pain d) Slow breathing, cyanosis, chest pain, and rapid weak pulse - ✔✔a) Unequal chest expansion, inadequate breathing, deformity, and pain

You are called to treat a patient with a chest injury. There is no suspected spinal injury. How should this patient be transported? a) Prone with the head turned to the side b) Supine with feet elevated c) In a position of comfort d) On the uninjured side - ✔✔c) In a position of comfort A high school football player has received a hard direct blow to the abdomen. Which of the following may indicate internal bleeding? a) Profuse bleeding from the bowels, deep slow breathing, slow pulse b) Weak rapid pulse, tenderness, guarding, or pain in the abdomen c) Deep slow breathing, normal pulse, warm dry skin d) Warm dry skin, rapid pulse, nausea, deep regular breathing - ✔✔b) Weak rapid pulse, tenderness, guarding, or pain in the abdomen Upon arriving at the scene of an accident, you find a victim who has bowel loops protruding through an abdominal laceration. You should cover the loops: a) And apply direct pressure b) As you would an impaled object c) With a dry sterile absorbent dressing d) With a moist sterile dressing - ✔✔d) With a moist sterile dressing A patient m severe pain due to an abdominal injury should be placed in which of the following positions? a) One leg up, the other one straight b) In a position of comfort c) Both legs stretched out straight d) In a prone position - ✔✔b) In a position of comfort A patient with a history of diabetes has an altered mental status due to a diabetic emergency. The EMS Provider should:

c) Rapid pulse and cool clammy skin d) Slow pulse and cool clammy skin - ✔✔c) Rapid pulse and cool clammy skin A woman in her late 40s had been complaining of headaches and vision difficulties. On your arrival, you find that - she is responsive to pain, and has a droopy eyelid, unequal pupils and slow shallow respirations. Your FIRST action should be to: a) Immobilize the patient on a long backboard b) Administer glucose c) Administer high-concentration oxygen d) Assist the patient in administering her EpiPen - ✔✔c) Administer high-concentration oxygen On arriving at a home, you find an alert three-year-old child who has ingested an unknown quantity of drain cleaner. Which of the following would you do FIRST? a) Reassure the mother that the child will be all right b) Consult with Medical Control c) Induce vomiting with ipecac and retain the vomitus d) Administer ipecac and activated charcoal - ✔✔b) Consult with Medical Control Which of the following oxygen delivery devices should be used for treatment of a conscious patient who has inhaled a poisonous gas? a) Partial-rebreathing mask b) Simple face mask c) Non-rebreathing mask d) Venturi mask - ✔✔c) Non-rebreathing mask An EMS Provider can assist a conscious patient in taking his/her prescribed nitroglycerin pill by seeing to it that the patient: a) Chews it thoroughly b) Swallows it with a glass of water c) Places it under his/her tongue

d) Sucks on it until it dissolves - ✔✔c) Places it under his/her tongue Ln most cases, patients with Cardiac-related chest pain complain of: a) Sharp pain that varies with breathing b) Pressure or heaviness that does not vary with breathing c) Pressure or pain referred to the abdomen d) Sharp pain referred to the arms - ✔✔b) Pressure or heaviness that does not vary with breathing The MOST OBVIOUS indication of a paralyzed limb in a nontraumatic brain injury patient is that the limb will: a) Move if its extremity is lightly jabbed with a pin b) Be pulseless and feel cold to the touch c) Be cyanotic and pulseless d) Appear loose and will lack muscle tone when it is moved by the EMS Provider - ✔✔d) Appear loose and will lack muscle tone when it is moved by the EMS Provider Proper care for a victim of a respiratory emergency is: a) Placing the patient in a prone position b) assisting the patient with his/her inhaler c) Placing the patient in a supine position d) Suctioning of lung fluids to relieve edema - ✔✔b) assisting the patient with his/her inhaler Which of the following are respiratory effects of an allergic reaction? a) Itching, hives, headache b) Coughing, hoarseness, labored breathing c) Swelling of the face, neck, hands, and feet d) Increased heart rate, decreased blood pressure - ✔✔b) Coughing, hoarseness, labored breathing In which position should, the mother be placed for delivery?