Paramedic Emergency Response and Patient Care, Exams of Nursing

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COPR Practice Exam – III Questions With Complete Solutions A nurse meets the paramedic at the door. On the way to the patient's room, the nurse gives the paramedic the details noted above. She also notes that she has spoken to the patient's family and they would like the patient to be seen by her doctor. The paramedic kneels down by the patient, introduces himself and asks the patient for her name. She does not answer. The paramedic then explains that they are there to help her. The patient says that her name is Mary. Through this exchange, what has.... Correct Answer ....The paramedic tried to achieve with the patient? A. Trust and rapport B. Empathy and libel C. Authority and confidence D. Ethnocentrism and respect A A paramedic is at the scene of an MCI, and has been assigned the role of Transport Officer. Which of the following considerations are the MOST IMPORTANT to take into account when assigning transport designations? A. Number of patients, extent of patient injuries, and off-load times B. Extent of patient injuries, level/scope of paramedics, and facility capabilities

C. Number of crews/ambulances available, distance to hospital, and time of day D. Treatments already performed on scene, age of... Correct Answer ...patients, and number of facility staff B A paramedic is attending to a patient who is experiencing non- traumatic back pain. As the paramedic is going through SAMPLE with the patient, what question should be asked when the "M" is reached? A. Do you have any mild pain? B. Are you on any medications? C. Do you have a medical alert bracelet? D. Are you having a medical emergency? Correct Answer B A paramedic is participating in a public awareness campaign at an elementary school. In the parking lot, a mock MVC is depicted between a car and a bicycle. Which of the following approaches should the paramedic use to discuss the situation with the students? A. Order the students to always wear a seat belt and bicycle helmet B. Tell the students that situations like this most often cannot be avoided C. In a non-threatening manner, inform the students of how to prevent similar emergencies D. .. Correct Answer .. Sensitively tell the students that accidents happen and that prevention can be very difficult

C

A paramedic is transporting a pediatric patient in respiratory arrest, lights and sirens to the nearest hospital. Approaching a busy intersection the light turns red in the direction of the hospital. Which of the following actions is MOST APPROPRIATE for the paramedic to take? A. Stop; look both ways and proceed when traffic allows B. Slow down; look both ways and continue en route to the hospital C. Stop; wait for the light to turn green and proceed when traffic allows D. Slow down; ... Correct Answer ... choose the most appropriate lane and continue en route to the hospital A A patient fell from a second story balcony. The paramedic finds the patient is unable to extend his elbow. This finding indicates a possible spinal injury at which level of vertebrae? A. L B. L C. C D. C7 Correct Answer D A patient requires supplemental oxygen by NRB at 10 L/min. 800 psi remains in the D tank. Assume a safe residual pressure

of 500 psi is required, how long can supplemental oxygen be provided with this tank? A. 8 minutes B. 6 minutes C. 5 minutes D. 3 minutes Correct Answer C A rotary-wing aircraft (helicopter) has just landed at a scene to transport a patient. Which of the following procedures BEST describes when it is safe for the paramedics to approach the aircraft? A. When the paramedics feels that it is safe to approach the aircraft B. When the pilot gives the paramedics approval to approach the aircraft C. When the police give the paramedics approval to approach the aircraft D. When the pilot exits the cabin and escorts the paramedics to the aircraft Correct Answer B During a mass casualty incident (MCI), who is INITIALLY responsible for triage? A. Any physician on scene B. The first responding Fire Chief on scene C. The highest ranking police officer on scene D. The first responding ambulance crew on scene Correct Answer D

During the initial assessment of the elderly gentleman, stertorous respirations are confirmed. Which of the following conditions is the MOST LIKELY cause? A. A narrowing of the trachea due to irritation secondary to excessive smoking B. Partial occlusion of the upper airway caused by a loss of control of the tongue C. Damaged trachea, as often observed in unconscious collapsed elderly patients D. Localized laryngeal trauma resulting in a collapsed tracheal- laryngeal opening Correct Answer B En route to the hospital, what treatment and type of transport should the paramedic provide for this patient? A. Oxygen via nasal cannula and rapid transport B. High-flow oxygen, spinal immobilization and slow, quiet transportation C. Emotional support, be on alert for changes to LOC and lights and sirens D. Emotional support, oxygen via nasal cannula and calm, smooth transport Correct Answer D En route, the patient becomes unconscious and apneic. Which of the following treatments is MOST APPROPRIATE under these new circumstances? A. Insert an OPA and ventilate B. Insert an OPA and apply an NRB C. Perform jaw thrust and apply an NRB

D. Place patient on her side and ventilate Correct Answer A Following the paramedic's hand-off of patient care to the emergency room nurse, the paramedic completes the written Patient Care Report (PCR). The paramedic notices that an error occurred during documentation. What is the proper procedure for correcting the error on the PCR? A. Discard the report and start a new one B. Place an X through the error and initial C. Make note of the error at the bottom of the PCR D. Cross out the error with a single line and initial Correct Answer D Given the patient's condition, frequent auscultation of her lung sounds is required. What is the BEST technique for Auscultating the patient's lung sounds? A. Beginning at the bases, auscultate all lobes on one side, and, then all lobes on the other side B. Beginning at the apices, auscultate all lobes on one side, and, then all lobes on the other side C. Beginning at the bases, auscultate comparing one side to the other while moving up the chest D. Beginning at the apices, auscultate..... Correct Answer ....comparing one side to the other while moving down the chest D

Nitroglycerin 0.3 mg is administered through which of the following routes? A. Oral B. Buccal C. Inhalation D. Sublingual Correct Answer D Often these calls will be emotionally charged and require a great deal of empathy and compassion for the patient and their loved ones. If the wife of the elderly gentleman loses control on scene, which of the following courses of action would be BEST? A. Provide the toll-free number for the "crisis line" B. Discuss advanced directives with medical direction C. Allow the patient's wife to display her emotion as it will help her adjust D. Provide immediate empathy and compassion to the wife while Correct Answer .. maintaining control of the situation D Paramedics are treating an unconscious male who is unable to maintain his airway. The paramedics deem that an airway adjunct is a necessary intervention and decide to insert an oropharyngeal airway (OPA). Which of the following actions should the paramedics take first? A. Prepare a laryngoscope with the appropriate sized blade B. Clear the upper airway of all secretions, blood or vomitus C. Insert the OPA following the natural curvature of the mouth

D. Position the patient on his left side .... Correct Answer ...prior to insertion of the OPA B Paramedics arrive on scene just as a woman delivers a full term baby that is apneic. Which of the following initial treatments is MOST APPROPRIATE for the baby? A. Tactile stimulation B. Chest compressions C. Suction for 15 seconds D. Insertion of an LMA and ventilation Correct Answer A Post routine laboratory blood test of a 55 year old male patient reveal a pH value of 6.7. Which of the following metabolic states is this patient in? A. Acidosis B. Carbonic C. Alkalosis D. Bicarbonic Correct Answer A The on-site Fire/Rescue squad member, who is trained in basic lifesaving, assists the EMS team with ventilating the patient. This leaves one paramedic to proceed with next steps. Which of the following actions should the paramedic take? A. Perform a head-to-toe search for entry and exit wounds B. Initial 1,000 mL normal saline via 18 gauge IV Cathleen anticubital

C. Ascertain and record the voltage, source, amperage and contact duration D. Recognize that the burning process in the tissues may Correct Answer ..still be occurring and take immediate steps to apply sterile dressings A The paramedic arrives at the scene of an MVC to find a patient trapped in a car. The patient has obvious deformity to both legs and is complaining that his "belly hurts." The paramedic is unsure if the patient will survive extrication. The patient is obviously scared and asks, "Am I going to be alright?" Which of the following responses is MOST APPROPRIATE? A. "Don't worry, I'll stay with you. You're going to be fine." B. "You have nothing to worry about, you are in good hands." C. "I'm.... Correct Answer ...unsure of the extent of your injuries. We're doing everything we can." D. "You are critically hurt and probably will not survive your injuries. I'll stay with you." C The paramedic has controlled an arterial bleed to the upper right leg with direct pressure. The patient has lost approximately 500 ml of blood. Which of the following positions would be the MOST appropriate for this patient? A. Prone position with feet raised with a pillow B. Semi-Fowler's with the injured leg laying on the stretcher

C. Left lateral recumbent position with the injured leg on top D. Supine with the injured leg elevated 12 inches off the ground Correct Answer D The paramedic is on scene with a 58 year old female who is a known diabetic who states, "I'm dizzy and not feeling well." She tells the paramedic she has not eaten today. Which of the following values of BGL would this patient be MOST LIKELY to have? A. 3.0 mmol/L B. 5.0 mmol/L C. 7.0 mmol/L D. 9.0 mmol/L Correct Answer A The paramedic learns that the child seems to have been shaking when the mother came into the bedroom. The baby is now laying supine and unresponsive in the crib. Based on the scene assessment and history, which phase of seizure activity is the patient currently exhibiting? A. Aura phase B. Tonic phase C. Clonic phase D. Postictal phase Correct Answer D The paramedic performs a second set of vitals on this patient and gets a BP reading of 118/50. The paramedic notices that the patient weighs about 41 kg (90 lbs) and that the nursing home's vitals monitor has a large BP cuff on it. The nurse says that she

got a different value for the patient's BP. What is the most likely reason for the difference in blood pressure readings? A. The paramedic used a BP cuff that was too small for the patient. B. The nursing home staff used a BP cuff that was.... Correct Answer ....too large for the patient. C. The paramedic used a manual BP monitor, which is more accurate than an automatic monitor. D. The nursing home staff used an automatic BP monitor, which is more accurate than a manual monitor. B The paramedic suspects that the patient has a pulmonary embolism. Which of the following treatments should be included for this patient? A. Acetylsalicylic acid (ASA) to help dissolve the clot, thereby allowing for increased oxygenation B. Nitroglycerin to dilate the pulmonary arteries, thereby allowing for increased pulmonary blood flow C. Supplemental oxygen, thereby allowing the patient to compensate without increasing the work of breathing D. Position supine with legs elevated to increase.. Correct Answer ...blood flow returning to the heart, thereby increasing pulmonary oxygenation C

The paramedics are providing care for a patient who is suicidal and refusing to be transported to the hospital. Which of the following additional resources would be the MOST appropriate to contact at this time? A. Local police B. Another crew C. EMS supervisor D. Patient's physician Correct Answer A The patient is currently stable and all vital signs are within normal limits. Under the circumstances, what is the MOST APPROPRIATE treatment? A. Administer salbutamol via MDI B. Establish an IV and bolus the patient C. Transport patient in position of comfort D. Transport patient in Trendelenburg position Correct Answer C The patient responds to loud verbal stimuli by opening her eyes and moaning. According to the Glasgow Coma Scale, this response represents what level of "eye opening"? A. 1 B. 2 C. 3 D. 4 Correct Answer C

The patient's blood glucose level is determined to be 2. mmol/L. Considering this, what is the MOST APPROPRIATE action? A. Administer fluids B. Administer oxygen C. Administer glucose D. Administer glucagon Correct Answer C The patient's heart has been restarted but the patient remains unconscious and breathing. What is the MOST appropriate treatment the paramedics should perform? A. Cover the burn with cool and sterile dressing and initiate an IV B. Bandage entrance and exit wound, stabilize any fractures and initiate an IV C. Flush burn sites for 20 minutes, stabilize any fractures and prepare for cardioversion D. Place moist sterile dressing over any wounds, place ECG on patient and prepare for cardioversion Correct Answer B Upon assessment, the patient is found to be unresponsive, with no respirations or pulse. CPR is initiated while an AED is attached to the patient. What two heart rhythms are considered to be "shockable rhythms"? A. Sinus tachycardia and asystole B. Ventricular fibrillation and sinus tachycardia C. Asystole and pulseless ventricular tachycardia

D. Ventricular fibrillation and pulseless ventricular tachycardia Correct Answer D Use the following scenario the answer the next 3 questions: Age: 78 years old Gender: Female Chief Complaint: Weakness Past Medical Hx: Dementia, prior stroke less than 3 years ago Medications: Unknown 1st Vital signs: HR 120, irregular; RR 18; BP 98/ Physical Findings: Headache with nausea and vomiting, speech disturbance and numbness of the face Other information: The patient has not eaten properly for 2 weeks and currently resides in a long term care facility. Observations of old... Correct Answer ...bruising on her arms and legs in varying stages of healing Use the following scenario to answer the next 3 questions: Age: 59 years old Gender: Male Chief Complaint: Altered LOC Past Medical Hx: Unknown Medications: Metformin 1st Vital Signs: HR 126, RR 16, BP 142/74; SPO2 92% on room air, GCS 12 Physical Findings: Confused, slurred speech, smell of alcohol on breath Other information: RCMP found patient staggering around in the downtown core Correct Answer

Use the following scenario to answer the next 4 questions: A BLS crew has been dispatched to a local industrial worksite. ON arrival, the on-site Fire/Rescue squad member informs the paramedics that a 57 year old male was repairing an electrical box on a machine when he was electrocuted. They are also told that all the power has been shut off and it is safe to enter the site. Correct Answer Use the following scenario to answer the next 4 questions: The paramedic is dispatched to a residence for an elderly gentleman collapsed. Upon the arrival the wife directs you to the bathroom where an elderly gentleman is lying supine on the floor. He has stertorous respirations and a 2 inch laceration on his forehead with minimal bleeding. His wife tells you that her husband has terminal cancer and is home to die. Correct Answer Use the following scenario to answer the next 5 questions: Age: 2 years old Gender: Female Chief Complaint: Seizure Past Medical Hx: None Medications: Tylenol Physical Findings: Hot, red and diaphoretic skin Other Information: Mother stated child has been fighting flu like symptoms recently. Mother placed child in bed for a nap about 30 minutes ago. Mother heard a noise from the crib, checked on

child and found her lying face up not moving or crying. Correct Answer Use the following scenario to answer the next 6 questions: The paramedic is dispatched to a residence for a 35 year old female complaining of sharp chest pain. The woman is sitting on her couch and she indicates that she has been bedridden as a result of a leg fracture that occurred seven weeks ago. She is exhibiting mild dyspnea and is slightly pale and clammy to the touch. She says that she hoped the pain would go away, but finally called for an ambulance an hour later, thinking she may be.... Correct Answer ...having a reaction to a new IUD, which which she began using yesterday. What are the proper landmarks for measuring an oropharyngeal airway? A. From the centre of the ear to the tip of the nose B. From the tip of the earlobe to the centre of the chin C. From the centre of the mouth to the middle of the ear D. From the tip of the earlobe to the corner of the mouth Correct Answer D What is the term for a fracture that is diagonal or slanting break and occurs between the horizontal and perpendicular planes of the bone? A. Spiral B. Oblique C. Transverse

D. Comminuted Correct Answer B What type of suction catheter should be used to suction beyond the oropharynx? A. Endotracheal catheter B. Tonsil tip (Yankauer) C. Esophageal catheter D. Whistle tip (French) Correct Answer D When a patient's respirations are assisted with a bag valve mask (BVM) but without supplemental oxygen, what concentration of oxygen is being delivered to the patient? A. 16% B. 21% C. 37% D. 66% Correct Answer B When communicating via radio with hospital staff regarding a patient, what type of information is appropriate for the paramedic to relay? A. Patient name, chief complaint, treatment and estimated time of arrival B. Patient information, chief complaint, pertinent assessment and treatment C. Patient age, response to treatment, patient diagnosis and history of scene D. Patient presentation, description of scene, hospital treatment and time of departure Correct Answer B

When someone has become a fully qualified and licensed paramedic in his or her province, what type of goals, if any, should the paramedic set in order to continue in this profession? A. No goal sneed to be set as he or she is licensed and ready to work B. The paramedic should set goals only after he or she has some field experience C. The paramedic should set goals related to staying up-to-date on new protocols and research D. The employer has a responsibility to set goals for its employees... Correct Answer ... and the paramedic should follow them C Which of the following acronyms refer to the system used to assess a patient's neurological status? A. PMH B. AVPU C. SAMPLE D. OPQRST Correct Answer B Which of the following answers are examples of problem solving situations? Select all that apply. A. Analyze a problem and find options to deal with the issue B. Allow both individuals involved to discuss in detail the issue at a later time to allow for rationalization

C. Involve critical thinking by the more experienced team member to derive an appropriate solution D. Allow a person to identify the problem clearly and come up with a course of action Correct Answer A,B,C,D Which of the following assessments help the paramedic differentiate between cardiac related chest pain and a respiratory related problem? Select all that apply. A. Putting the patient on a cardiac monitor B. Determining if the patient's pain is radiating anywhere C. Asking the patient if there is anything that makes the chest pain better or worse D. Placing the patient on an oxygen saturation monitor to determine their oxygen saturation Correct Answer A,B,C,D Which of the following causes most likely explains why this elderly gentleman is experiencing ongoing dizziness? A. Increased cerebral perfusion B. A hypertensive state caused by his cancer C. Depression with diminished motor function D. Use of pain medication and possible poor food intake Correct Answer D Which of the following conditions are potential differential diagnoses for this patient? Select all that apply. A. Hypoglycemia B. Ketoacidosis C. Overdose

D. Head injury Correct Answer A,B,C,D Which of the following conditions is likely to cause a patient to be the MOST thirsty? A. Insulin shock B. Hypoglycemia C. Hyperglycaemia D. Abdominal pain Correct Answer C Which of the following conditions is oxycodone used to treat? A. Hypertension B. Atrial fibrillation C. High cholesterol D. Acute musculoskeletal pain Correct Answer D Which of the following descriptions BEST defines status epilepticus? A. A seizure lasting up to 15 minutes in duration B. A seizure lasting up to 3 minutes in duration C. A series of 2 or more seizures with periods of consciousness D. A series of 1 or more seizures without any period of consciousness Correct Answer D Which of the following histories would MOST LIKELY indicate a febrile seizure? A. High-grade fever for past 3 to 4 hours B. Low-grade fever for the past 3 to 4 days

C. Low-grade fever that began this morning D. High-grade fever that is controlled by Tylenol. Correct Answer A Which of the following interventions is MOST APPROPRIATE during the primary survey of this patient? A. Give oral glucose or glucose tabs, position patient lateral, cover with extra blankets and restrain patient to cot B. Insert and OPA, position the patient in position of comfort and cover with extra blankets followed by immediate transport. C. Clear and maintain airway, administer oxygen (high concentration), assist ventilations if required and position patient supine for ease of treatment. Correct Answer D. Ensure properly measured OPA is ready for use, position patient lateral due to decreased LOC, apply high concentration oxygen by NRB and have suction close by. D Which of the following lifestyle factors is NOT affected by shift work? A. Diet B. Sleep C. Health D. Knowledge Correct Answer D Which of the following patient would require intervention with a bag valve mask and supplemental oxygen? Select all that apply.

A. A conscious patient with a respiratory rate of 38 and exhibiting central cyanosis B. A conscious patient with a respiratory rate of 28 and bilateral wheezes C. An unconscious patient with a respiratory rate of 28 and fine crackles from bases to apices D. An unconscious patient with a respiratory rate of 28 and skin that is pink, cool, and dry Correct Answer A,B,C,D Which of the following pieces of equipment should be cleaned and/or disinfected after each use? Select all that apply. A. OPA B. Laryngoscope blade C. Blood pressure cuff D. Stretcher E. Suction Catheter Correct Answer C,D Which of the following routes is the most appropriate to deliver a bronchodilator to a geriatric patient? A. Rectal B. Intraosseous C. Nebulization D. Subcutaneous Correct Answer C Which of the following signs and symptoms are MOST common of a sympathomimetic overdose/exposure? A. Confusion, CNS depression, SLUDGE, coma, convulsions and seizures

B. Delirium, tachycardia, dry and flushed skin, dilated pupils and seizures C. Delusions, paranoia, tachycardia, bradycardia, hypertension and seizures D. Euphoria, hypotension, respiratory depression, nausea, pinpoint pupils and seizures Correct Answer C Which of the following signs and symptoms would be MORE INDICATIVE of CHF than of a pulmonary embolism? A. Pulmonary edema B. Pain on inspiration C. Pinpoint chest pain D. Shortness of breath Correct Answer A Which of the following statements BEST describes the primary purpose of an ongoing assessment? A. To establish the baseline vitals B. To re-establish patient priorities C. To determine the need for IV intervention D. To assess the patient as a load-and-go or stay-and-stabilize Correct Answer B While assessing the elderly gentleman his wife becomes increasingly upset, begins to cry and becomes withdrawn from the bathroom area. Which of the following decisions is the MOST APPROPRIATE for this situation? A. Contact medical direction immediately for a decision about patient care.

B. Remain calm and provide emotional support for all involved and transport patient to hospital. C. Respect the patient's initial request "to die at home" and explain to the wife that her husband is best left at Correct Answer ... home to die D. Explain to the wife that her husband is diagnosed with terminal cancer and is dying so she really needs to deal with the truth B While cutting some vegetables, a person accidentally cuts off the tip of his finger creating a flap type wound. Which of the following terms is the correct classification of this injury? A. Avulsion B. Abrasion C. Laceration D. Degloving Correct Answer A While on a call, a paramedic observes an unconscious 16 year old female. THere are empty pill bottles on the floor, the residence is dishevelled and the ashtrays are overflowing. THe girl appears to have poor hygiene and has the smell of alcohol on her breath. Which of the following observations from the scene are MOST PERTINENT to the care of this patient? A. Empty pill bottles and poor hygiene B. Empty pill bottles and alcohol odour on breath C. Alcohol odour on breath, poor hygiene and .... Correct Answer ...overflowing ashtrays

D. Alcohol odour on breath, overflowing ashtrays and dishevelled residence B Why should a nasal cannula NOT be used to provide more than the recommended maximum oxygen flow rate? A. It can desiccate the nasal mucosa B. It will force air into the Eustachian tube C. It consumes oxygen reserves at a greater rate D. It may place the patient at increased risk of pneumothorax Correct Answer A Without treatment, which of the following conditions is this patient MOST LIKELY to develop? A. Insulin shock B. Diabetic coma C. Hyperosmolar ketotic acidosis D. Hyperglycaemia hyperosmolar nonketotic coma Correct Answer A