all quizzes up to midterm Flashcards

1
Q

A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the ____________ forearm.

superior
distal
proximal
dorsal

A

distal

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2
Q

A diabetic patient has polydipsia. This means that she:

urinates frequently.
is excessively thirsty.
has low blood sugar.
is unable to swallow.

A

is excessively thirsty.

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3
Q

A fracture of the humerus just above the elbow would be described as a:

distal humerus fracture.
proximal humerus fracture.
distal forearm fracture.
proximal elbow fracture.

A

distal humerus fracture.

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4
Q

After applying a tourniquet, the injury from a patient’s leg stops bleeding. This is called:

hemostasis.
hemolysis.
hematemesis.
hemiplegia.

A

hemostasis.

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5
Q

An intoxicated 40-year-old male is found lying face down. How would you document his body’s position?

Recumbent
Dorsal
Supine
Prone

A

Prone

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6
Q

A patient has fractured both femurs. Anatomically, these injuries would be described as being:

proximal.
medial.
bilateral.
unilateral.

A

bilateral.

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7
Q

A patient in a semi-reclined position with the head elevated to facilitate breathing is in the ___________ position.

supine
recovery
Fowler
prone

A

Fowler

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8
Q

A patient with a pneumothorax has unilateral chest expansion. This means that:

only one side of his chest rises when he inhales.
both sides of his chest are moving minimally.
both of his lungs are expanding when he inhales.
his chest and his abdomen are moving in opposite directions.

A

only one side of his chest rises when he inhales.

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9
Q

A pregnant patient is diagnosed with hyperemesis gravidarum. This means that:

her unborn baby is very large.
she has excessive vomiting.
her respiratory rate is rapid.
she has frequent urination.

A

she has excessive vomiting.

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10
Q

A young male jumped from a tree and landed feet first. Which aspect of his body has sustained the initial injury?

Ventral
Plantar
Dorsal
Palmar

A

Plantar

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11
Q

In relation to the chest, the back is:
anterior.
inferior.
posterior.
ventral.

A

posterior.

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12
Q

Enlargement of the liver is called:
nephritis.
pneumonitis.
hydrocephalus.
hepatomegaly.

A

hepatomegaly.

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13
Q

1 / 1 pts
Movement or motion away from the body’s midline is called:
extension.
abduction.
flexion.
adduction.

A

abduction.

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14
Q

In relation to the wrist, the elbow is:
medial.
lateral.
distal.
proximal.

A

proximal.

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15
Q

The ___________ of the heart is the inferior portion of the ventricles.
apex
dorsum
base
septum

A

apex

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16
Q

The term “pericardiocentesis” means:
surgical repair of the sac around the heart.
the removal of fluid from around the heart.
a surgical opening made in the heart.
narrowing of the arteries supplying the heart.

A

the removal of fluid from around the heart.

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17
Q

The term “supraventricular tachycardia” means:
a slow heart rate that originates from within the ventricles.
a rapid heart rate that originates from above the ventricles.
a rapid heart rate that originates from within the ventricles.
a slow heart rate that originates from above the ventricles.

A

a rapid heart rate that originates from above the ventricles.

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18
Q

The topographic term used to describe the location of body parts that are closer toward the midline of the body is:
medial.
midclavicular.
midaxillary.
lateral.

A

medial.

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19
Q

The topographic term used to describe the parts of the body that are nearer to the feet is:
internal.
dorsal.
superior.
inferior.

A

inferior.

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20
Q

Which of the following anatomic terms is synonymous with the word “dorsal”?
Posterior
Medial
Palmar
Anterior

A

Posterior

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21
Q

Activities such as walking, talking, and writing are regulated by the:
Correct!
somatic nervous system.
central nervous system.
involuntary nervous system.
autonomic nervous system.

A

somatic nervous system.

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22
Q

Anterior to the knee is a specialized bone called the:
calcaneus.
patella.
tibia.
femur.

A

patella.

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23
Q

Contraction of the right ventricle causes:
blood to flow into the pulmonary circulation.
ejection of blood into the systemic circulation.
a return of blood from the pulmonary veins.
closure of the mitral and aortic valves.

A

blood to flow into the pulmonary circulation.

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24
Q

Deoxygenated blood from the abdomen, pelvis, and lower extremities is returned to the right atrium via the:
common iliac vein.
superior vena cava.
inferior vena cava.
coronary sinus vein.

A

inferior vena cava.

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25
Q

Negative-pressure breathing involves:
a drop in pressure within the chest cavity.
pushing or forcing air into the lungs.
increasing airway resistance during breathing.
relaxing the respiratory muscles.

A

a drop in pressure within the chest cavity.

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26
Q

Stimulation of the parasympathetic nervous system would result in:
a strong pulse.
a slower heart rate.
vasoconstriction.
tachycardia.

A

a slower heart rate.

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27
Q

The air you breathe is _______ oxygen, and the air you exhale is _______ oxygen.
25%; 32%
16%; 25%
21%; 16%
21%; 35%

A

21%; 16%

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28
Q

The average adult has approximately ___________ of blood in his or her vascular system.
3 L
4 L
6 L
5 L

A

6 L

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29
Q

The bones of the forearm are called the:
humerus and ulna.
tibia and radius.
radius and ulna.
radius and humerus.

A

radius and ulna.

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30
Q

The bones that constitute the fingers and toes are called:
carpals.
phalanges.
metatarsals
metacarpals.

A

phalanges.

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31
Q

The carpal bones form the:
wrist.
hand.
foot.
ankle.

A

wrist.

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32
Q

The diaphragm and intercostal muscles contract during:
exhalation.
ventilation.
inhalation.
respiration.

A

inhalation.

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33
Q

The firm cartilaginous ring that forms the inferior portion of the larynx is called the:
costal cartilage.
cricoid cartilage.
tracheal cartilage.
thyroid cartilage.

A

tracheal cartilage.

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34
Q

The kidneys and pancreas are called retroperitoneal organs because they:
are located behind the abdominal cavity.
sit in front of the liver, spleen, and stomach.
lie just anterior to the costovertebral angle.
are protected by the anterior rib cage.

A

are located behind the abdominal cavity.

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35
Q

The leaf-shaped flap of cartilage that prevents food and liquid from entering the trachea during swallowing is called the:
vallecula.
uvula.
pharynx.
epiglottis.

A

epiglottis.

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36
Q

The part of the brain that controls the left side of the body is the:
right-side cerebrum.
right temporal lobe.
left parietal lobe.
left-side cerebrum.

A

right-side cerebrum.

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37
Q

The primary organ responsible for absorption of products of digestion is the:
pancreas.
gallbladder.
large intestine.
small intestine.

A

small intestine.

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38
Q

The three bones that make up the shoulder girdle are the:
acromion, clavicle, and scapula.
acromion, humerus, and clavicle.
acromion, scapula, and humerus.
clavicle, scapula, and humerus.

A

clavicle, scapula, and humerus.

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39
Q

The waste products of aerobic metabolism include:
uric acid and nitrogen.
carbon dioxide and water.
ATP and glucose.
glucose and lactic acid.

A

carbon dioxide and water.

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40
Q

What happens when blood volume is lost from the body?
The arteries contract to increase the blood pressure.
Widespread vasodilation causes blood pressure to decrease.
Arterial blood is diverted to the skin and muscles.
The veins dilate to increase systemic perfusion.

A

The arteries contract to increase the blood pressure.

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41
Q

A 56-year-old female is found supine in a narrow hallway of her mobile home. She complains of severe weakness and dizziness, and states that she is unable to walk. There is no evidence of trauma, and the patient states that she did not fall. How should you and your partner move this patient to a more spacious area?
Direct carry
Scoop stretcher
Emergency move
Extremity lift

A

Extremity lift

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42
Q

After applying medical restraints to a combative patient, you should:
remove them only if the patient verbally commits to calming down.
inform the patient that the restraints are punishment for their behavior.
position the patient prone in order to further prevent injury to yourself.
remove them only after hospital personnel have requested you to do so.

A

remove them only after hospital personnel have requested you to do so.

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43
Q

An 81-year-old female fell and struck her head. You find the patient lying on her left side. She is conscious and complains of neck and upper back pain. As you are assessing her, you note that she has a severely kyphotic spine. What is the most appropriate method of immobilizing this patient?
Immobilize her in a supine position on a long backboard and secure her with straps.
Leave her on her side and use blanket rolls to immobilize her to the long backboard.
Move her to a supine position and immobilize her with a scoop stretcher and padding.
Apply a cervical collar and place her in a sitting position on the wheeled stretcher.

A

Leave her on her side and use blanket rolls to immobilize her to the long backboard.

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44
Q

An EMT might injure his or her back, even if it is straight, if the:
force is exerted straight down the spine.
hands are held close to the legs.
shoulder is aligned over the pelvis.
back is bent forward at the hips.

A

back is bent forward at the hips.

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45
Q

An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should:
apply a cervical collar and immobilize him with a vest-style device.
slide a scoop stretcher under his buttocks and rotate him laterally.
perform a detailed head-to-toe assessment and apply a cervical collar.
maintain manual stabilization of his head and grasp him by the clothes.

A

apply a cervical collar and immobilize him with a vest-style device.

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46
Q

As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden, sharp pain in your lower back. You should:
guide your partner while moving the chair backwards.
stop the move and have the patient walk down the stairs.
stop the move and request additional lifting assistance.
reposition your hands and continue to move the patient.

A

stop the move and request additional lifting assistance.

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47
Q

General guidelines for carrying a patient on a stretcher include:
leaning back from your waist when lifting.
constant communication with your partners.
maintaining slight flexion of your back.
slightly twisting your body when carrying.

A

constant communication with your partners.

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48
Q

In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include:
increased stability from a wider wheelbase.
a collapsible undercarriage.
weight capacity of up to 650 pounds.
two safety rails on both sides of the stretcher.

A

increased stability from a wider wheelbase.

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49
Q

In which of the following situations is an emergency patient move indicated?
A patient has an altered mental status or is in shock.
A significant mechanism of injury is involved.
The EMT has to gain access to lesser-injured patients in a vehicle.
The EMT is unable to protect the patient from scene hazards.

A

The EMT is unable to protect the patient from scene hazards.

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50
Q

In which of the following situations would a direct ground lift be the most appropriate method of moving a patient?
A pedestrian with back pain after being struck by a car
An unconscious patient with a possible ischemic stroke
A patient who complains of hip pain following a fall
A conscious patient complaining of abdominal pain

A

A conscious patient complaining of abdominal pain

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51
Q

Situations in which you should use the rapid extrication technique include all of the following, except:
a patient who can be properly assessed while still in the vehicle.
a patient who needs immediate care that requires a supine position.
a patient who blocks access to another seriously injured patient.
a patient whose condition requires immediate transport to the hospital.

A

a patient who can be properly assessed while still in the vehicle.

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52
Q

The most appropriate carrying device to use when moving a patient across rough or uneven terrain is the:
wheeled stretcher.
scoop stretcher.
stair chair.
basket stretcher.

A

basket stretcher.

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53
Q

The proper technique for using the power grip is to:
lift with your palms up.
rotate your palms down.
position your hands about 6″ apart.
hold the handle with your fingers.

A

lift with your palms up.

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54
Q

To facilitate a safe and coordinated move, the team leader should:
never become involved in the move, only direct the move.
use preparatory commands to initiate any moves.
speak softly but clearly to avoid startling the patient.
be positioned at the feet so the team can hear.

A

use preparatory commands to initiate any moves.

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55
Q

Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should:
apply a vest-style extrication device before attempting to move the patient.
direct your partner to apply manual in-line support of the patient’s head.
slide a long backboard under his buttocks and lay him sideways on the board.
apply a cervical collar and quickly remove the patient with a clothes drag.

A

direct your partner to apply manual in-line support of the patient’s head.

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56
Q

When carrying a patient on a backboard up or down stairs:
keep the foot end elevated.
keep your palms facing down.
keep the head end elevated.
carry the patient headfirst.

A

keep the head end elevated.

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57
Q

When performing the rapid extrication technique to remove a patient from his or her vehicle, you should:
apply a cervical collar and immobilize the patient on a short backboard.
grasp the patient by the clothing and drag him or her from the car.
apply a vest-style extrication device prior to moving the patient.
apply a cervical collar and remove the patient on a long backboard.

A

apply a cervical collar and remove the patient on a long backboard.

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58
Q

When pulling a patient, you should extend your arms no more than ________ in front of your torso.
15″ to 20″
10″ to 15″
5″ to 10″
20″ to 30″

A

15″ to 20″

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59
Q

Which is the most appropriate method to use when moving a patient from his or her bed to a wheeled stretcher?
Extremity carry
Log roll
Draw sheet method
Direct carry

A

Draw sheet method

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60
Q

You and your partner respond to the scene of a 49-year-old male with acute abdominal pain. As you enter his residence, you find him lying on the floor in severe pain. He is conscious and alert. The patient appears to weigh in excess of 350 pounds. Your first action should be to:
assess him and then move him to the stretcher with a direct carry.
encourage the patient to walk himself to the awaiting ambulance.
request the fire department if one attempt to move him fails.
request additional personnel before making any attempts to lift him.

A

request additional personnel before making any attempts to lift him.

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61
Q

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The most appropriate treatment for this patient includes:
performing a focused physical exam.
applying oxygen via nasal cannula.
preparing for immediate transport.
a detailed assessment of his abdomen.

A

preparing for immediate transport.

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62
Q

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing but is bleeding significantly from the wound. You should:
control the bleeding with direct pressure.
apply a tourniquet proximal to the wound.
apply oxygen with a nonrebreathing mask.
ensure the patient has a patent airway.

A

control the bleeding with direct pressure.

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63
Q

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:
having the patient pinch his own nostrils and then lie supine.
packing both nostrils with gauze pads until the bleeding stops.
pinching the patient’s nostrils and having him lean forward.
placing a rolled 4 × 4-inch dressing between his lower lip and gum.

A

pinching the patient’s nostrils and having him lean forward.

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64
Q

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost:
100 mL
50 mL
200 mL
150 mL

A

100 mL

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65
Q

An organ or tissue might better resist damage from hypoperfusion if the:
body’s demand for oxygen is markedly increased.
systolic arterial blood pressure is at least 60 mm Hg.
heart rate is maintained at more than 100 beats/min.
body’s temperature is considerably less than 98.6°F (37.0°C).

A

body’s temperature is considerably less than 98.6°F (37.0°C).

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66
Q

A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would most likely control the bleeding:
Apply chemical ice packs to the wound and transport.
Apply a topical hemostatic agent with direct pressure.
Apply a pelvic binder device to stabilize the pelvis.
Position the patient with his injured side down.

A

Apply a topical hemostatic agent with direct pressure.

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67
Q

A young male was shot in the abdomen by an unknown type of gun. Law enforcement personnel have ensured that the scene is safe. The patient is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
perform a secondary assessment.
obtain baseline vital signs.
assist the patient’s ventilations.
apply a nonrebreathing mask.

A

assist the patient’s ventilations.

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68
Q

Bleeding from the nose following head trauma:
is usually due to hypertension caused by the head injury.
should be controlled by packing the nostril with gauze.
should be assumed to be caused by a fractured septum.
is a sign of a skull fracture and should not be stopped.

A

is a sign of a skull fracture and should not be stopped.

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69
Q

Capillaries link the arterioles and the:
cells.
veins.
venules.
aorta.

A

venules.

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70
Q

Early signs and symptoms of intra-abdominal bleeding include:
pain and distention.
widespread ecchymosis.
bruising only.
significant hypotension.

A

pain and distention.

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71
Q

External bleeding from a vein is relatively easy to control because:
blood typically oozes from a vein.
veins are under a lower pressure.
veins carry deoxygenated blood.
veins hold smaller blood volume.

A

veins are under a lower pressure.

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72
Q

Hypoperfusion is another name for:
shock.
cellular death.
cyanosis.
hypoxemia.

A

shock.

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73
Q

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:
digital pressure to a proximal artery.
a splint and elevate the extremity.
additional sterile dressings.
a tourniquet proximal to the injury.

A

a tourniquet proximal to the injury.

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74
Q

Internal bleeding into a fractured extremity is most often controlled by:
applying chemical ice pack.
splinting the extremity.
keeping the patient warm.
applying a tourniquet.

A

splinting the extremity.

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75
Q

In which of the following situations would external bleeding be the most difficult to control:
Carotid artery laceration and a systolic blood pressure of 60 mm Hg
Antecubital vein laceration and a blood pressure of 138/92 mm Hg
Jugular vein laceration and a systolic blood pressure of 90 mm Hg
Femoral artery laceration and a blood pressure of 140/90 mm Hg

A

Femoral artery laceration and a blood pressure of 140/90 mm Hg

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76
Q

Perfusion is most accurately defined as the:
circulation of blood within an organ in adequate amounts to meet the body’s metabolic needs.
effective transfer of oxygen from the venules across the systemic capillary membrane walls.
effective removal of carbon dioxide and other metabolic waste products from the body’s cells.
ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure.

A

circulation of blood within an organ in adequate amounts to meet the body’s metabolic needs.

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77
Q

Regardless of the type of tourniquet used, it is important to remember that:
you should try to control the bleeding by applying pressure to a proximal arterial pressure point first.
bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding.
the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released.
the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

A

the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released.

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78
Q

The ability of a person’s cardiovascular system to compensate for blood loss is most related to:
the part of the body injured.
how fast his or her heart beats.
how rapidly he or she bleeds.
his or her baseline blood pressure.

A

how rapidly he or she bleeds.

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79
Q

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:
capillary arteries.
vena cavae.
venules.
arterioles.

A

arterioles.

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80
Q

Which of the following is not considered a basic technique when controlling bleeding:
Apply direct pressure over the wound with a dry, sterile dressing.
Apply a tourniquet to an extremity above the level of the bleeding.
Pack the wound with a hemostatic impregnated gauze.
Apply a cervical collar and place the patient on a long backboard.

A

Apply a cervical collar and place the patient on a long backboard.

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81
Q

Question 1: A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:
- request a paramedic unit that is stationed approximately 15 miles away.
- transport him immediately and provide supportive care while en route.
- repeat the epinephrine injection after consulting with medical control.
- consider that he may actually be experiencing an acute asthma attack.

A

repeat the epinephrine injection after consulting with medical control

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82
Q

Question 2: A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:
- wrap the towel with pressure bandages.
- apply pressure to the brachial artery.
- apply a tourniquet proximal to the wrist.
- administer high-flow supplemental oxygen.

A

apply pressure to the brachial artery

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83
Q

Question 3: A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
- Full immobilization of her spine
- Rapid transport to a trauma center
- Intravenous fluid administration
- High-flow oxygen administration.

A

Full immobilization of her spine

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84
Q

Question 4: A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:
- follow standard precautions.
- ask bystanders what happened.
- form a general impression.
- call for an ALS ambulance.

A

follow standard precautions

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85
Q

Question 5: A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient’s wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient’s present condition is:
- dehydration from GI virus.
- a ruptured aortic aneurysm.
- severe septic hypoperfusion.
- acute myocardial infarction.

A

acute myocardial infarction

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86
Q

Question 6: A 59-year-old male presents with severe vomiting and diarrhea of 3 days’ duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying supplemental oxygen, you should:
- perform a head-to-toe exam.
- allow him to drink plain water.
- prepare for immediate transport.
- obtain a repeat blood pressure in 5 minutes.

A

prepare for immediate transport

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87
Q

Question 7: A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 90/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing:
- septic shock.
- pump failure.
- decompensated shock.
- a local infection.

A

septic shock

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88
Q

Question 8: A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:
- assisted ventilation, thermal management, and elevation of the lower extremities.
- assisted ventilation, preventing hyperthermia, and elevating his lower extremities.
- oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head.
- oxygen via nonrebreathing mask, thermal management, and elevation of his legs.

A

assisted ventilation

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89
Q

Question 9: All of the following conditions should make you suspect shock, EXCEPT:
- anaphylaxis.
- severe infection.
- spinal injury.
- ischemic stroke.

A

ischemic stroke

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90
Q

Question 10: Cardiogenic shock may result from all of the following, EXCEPT:
- increased afterload.
- increased preload.
- heart attack.
- poor contractility.

A

increased preload

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91
Q

Question 11: Clinical signs of compensated shock include all of the following, EXCEPT:
- restlessness or anxiety.
- cool and clammy skin.
- absent peripheral pulses.
- rapid, shallow breathing.

A

absent peripheral pulses

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92
Q

Question 12: Distributive shock occurs when:
- widespread dilation of the blood vessels causes blood to pool in the vascular beds.
- temporary but severe vasodilation causes a decrease in blood supply to the brain.
- severe bleeding causes tachycardia in order to distribute blood to the organs faster.
- an injury causes restriction of the heart muscle and impairs its pumping function.

A

widespread dilation of the blood vessels causes blood to pool in the vascular beds

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93
Q

Question 13: Hypotension in a child with blunt or penetrating trauma is particularly significant because:
- it typically develops earlier in children than it does in adults.
- it often indicates the loss of half of his or her blood volume.
- most children with hypotension die in the prehospital setting.
- the most likely cause of the hypotension is respiratory failure.

A

it often indicates the loss of half of his or her blood volume

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94
Q

Question 14: Hypovolemic shock caused by severe burns is the result of a loss of:
- whole blood.
- plasma.
- red blood cells.
- platelets.

A

plasma

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95
Q

Question 15: Patients develop septic shock secondary to:
- poor vessel function and severe volume loss.
- an infection that weakens cardiac contractions.
- weak vessel tone caused by nervous system damage.
- failure of the blood vessels to adequately dilate.

A

poor vessel function and severe volume loss

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96
Q

Question 16: Shock is the result of:
- temporary dysfunction of a major organ.
- hypoperfusion to the cells of the body.
- widespread constriction of the blood vessels.
- the body’s maintenance of homeostasis.

A

hypoperfusion to the cells of the body

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97
Q

Question 17: Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:
- neurogenic shock.
- neurologic shock.
- vasovagal shock.
- psychogenic shock.

A

psychogenic shock

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98
Q

Question 18: To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:
- the lungs.
- the brain.
- the heart.
- the skin.

A

the skin

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99
Q

Question 19: When assessing a patient with signs and symptoms of shock, it is important to remember that:
- multiple fractures are the most common cause of hypovolemic shock.
- the patient’s respirations are deep during the early stages of shock.
- blood pressure may be the last measurable factor to change in shock.
- irreversible shock often responds well to a prompt blood transfusion.

A

blood pressure may be the last measurable factor to change in shock

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100
Q

Question 20: Which of the following clinical signs is unique to anaphylactic shock:
- Hypotension
- Pallor
- Dizziness
- Wheezing.

A

Wheezing

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101
Q

Question 1: The energy of a moving object is called:
- converted energy
- kinetic energy
- potential energy
- latent energy

A

kinetic energy

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102
Q

Question 2: Which of the following statements regarding gunshot wounds is correct:
- The size of a bullet has the greatest impact on the injury produced
- High-velocity bullets will cause less severe internal injuries
- The speed of a bullet has the greatest impact on the injury produced
- Low-velocity bullets will cause the greatest amount of trauma

A

The speed of a bullet has the greatest impact on the injury produced

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103
Q

Question 3: Which of the following is NOT one of the three types of collisions in a typical impact in a motor vehicular crash:
- Collision of the internal organs against the body’s solid structures
- Collision of two passenger bodies within the same vehicle
- Collision of a car against another car, a tree, or another object
- Collision of the passenger against the interior of the car

A

Collision of two passenger bodies within the same vehicle

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104
Q

Question 4: When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the airbag deploys upon impact:
- dashboard
- windshield
- steering wheel
- door

A

door

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105
Q

Question 5: While en route to a major motor vehicle crash, an on-scene police officer advises you that a 6-year-old male who was riding in the front seat is involved. He further states that the child was only wearing a lap belt and that the airbag deployed. On the basis of this information, you should be MOST suspicious that the child has experienced:
- open abdominal trauma
- lower extremity fractures
- blunt trauma to the head
- neck and facial injuries

A

neck and facial injuries

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106
Q

Question 6: A driver involved in a rollover motor vehicle crash will MOST likely experience serious injuries or death if he or she:
- remains within the vehicle
- is ejected or partially ejected
- is wearing only a lap belt
- experiences multiple impacts

A

is ejected or partially ejected

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107
Q

Question 7: A small compact car was involved in a rollover crash. As you are approaching the vehicle, you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient’s condition?
- Whiplash injury to the neck during the rollover
- Lateral bending of the neck during the crash
- Compression of the head against the roof
- Impact of the head against the steering wheel

A

Compression of the head against the roof

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108
Q

Question 8: A 15-year-old female was struck by a small car while riding her bicycle. She was wearing a helmet and was thrown to the ground, striking her head. In addition to managing problems associated with airway, breathing, and circulation, it is MOST important for you to:
- obtain baseline vital signs
- stabilize her entire spine
- leave her bicycle helmet on
- inspect the helmet for cracks

A

stabilize her entire spine

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109
Q

Question 9: A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is MOST likely responsible for his back pain?
- Lateral impact to the spine
- Direct trauma to the spinal column
- Energy transmission to the spine
- Secondary fall after the initial impact

A

Energy transmission to the spine

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110
Q

Question 10: Factors that should be considered when assessing a patient who has fallen include all of the following, EXCEPT:
- the height of the fall
- the surface struck
- the primary impact point
- the speed of the fall

A

the speed of the fall

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111
Q

Question 11: When assessing an elderly patient who fell, it is important to remember that:
- elderly patients who fall usually have a secondary head injury
- osteoporosis can cause a fracture as a result of a fall from a standing position
- bilateral hip fractures usually occur when an elderly person falls
- any fall in the elderly is considered to be high-energy trauma

A

osteoporosis can cause a fracture as a result of a fall from a standing position

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112
Q

Question 12: Which of the following statements regarding low-energy penetrating injuries is correct:
- The area of injury is usually close to the path the object took through the body
- Exit wounds are typically easy to locate with low-energy penetrating injuries
- It is usually easy to differentiate between an entrance wound and an exit wound
- Internal injuries caused by low-velocity bullets are usually easy to predict

A

The area of injury is usually close to the path the object took through the body

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113
Q

Question 13: Internal injuries caused by gunshot wounds are difficult to predict because:
- exit wounds caused by the bullet are usually small
- the bullet may tumble or ricochet within the body
- the caliber of the bullet is frequently unknown
- the area of damage is usually smaller than the bullet

A

the bullet may tumble or ricochet within the body

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114
Q

Question 14: The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as:
- conversion
- cavitation
- capitation
- congruent

A

cavitation

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115
Q

Question 15: A young male sustained a gunshot wound to the abdomen during an altercation. As your partner is assessing and managing his airway, you should control the obvious bleeding and then:
- obtain baseline vital signs
- assess for an exit wound
- apply a cervical collar
- auscultate bowel sounds

A

assess for an exit wound

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116
Q

Question 16: If a person is standing near a building that explodes, which of the following injuries would he or she MOST likely experience as a result of the pressure wave:
- Severe burns
- Eardrum rupture
- Fractured bones
- Impaled objects

A

Eardrum rupture

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117
Q

Question 17: Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma:
- Elevation of the lower extremities
- Intravenous fluid administration
- Early administration of oxygen
- Rapid transport to a trauma center

A

Rapid transport to a trauma center

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118
Q

Question 18: Following a blunt injury to the head, a 22-year-old female is confused and complains of a severe headache and nausea. On the basis of these signs and symptoms, you should be MOST concerned with the possibility of:
- spinal cord injury
- a fracture of the skull
- airway compromise
- intracranial bleeding

A

intracranial bleeding

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119
Q

Question 19: While assessing a young male who was struck in the chest with a steel pipe, you note that his pulse is rapid and irregular. You should be MOST suspicious for:
- bruising of the heart muscle
- underlying cardiac disease
- traumatic rupture of the aorta
- a lacerated coronary artery

A

bruising of the heart muscle

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120
Q

Question 20: During your assessment of a patient with a head injury, you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:
- 9
- 10
- 7
- 8

A

7

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121
Q

Question 1: A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother’s lap. His father is sitting in a nearby chair. The child’s mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:
- give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability
- attempt to calm the child’s mother, but avoid separating her from her child because this will increase her anxiety
- ask the father to hold the child so you can assess him while your partner tries to calm the mother
- reassure the child’s mother that seizures in children are very common and that there is nothing to worry about

A

ask the father to hold the child so you can assess him while your partner tries to calm the mother

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122
Q

Question 2: A 60-year-old man complains of chest pain. He is conscious, alert, and denies shortness of breath. Which of the following questions would be the most appropriate to ask him:
- Does the pain in your chest feel like a stabbing sensation?
- Does the pain in your chest move to either of your arms?
- Do you have any heart problems or take any medications?
- Were you exerting yourself when the chest pain began?

A

Do you have any heart problems or take any medications?

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123
Q

Question 3: After delivering your patient to the hospital, you sit down to complete the handwritten PCR. When documenting the patient’s last blood pressure reading, you inadvertently write 120/60 instead of 130/70. To correct this mistake, you should:
- draw a single horizontal line through the error, initial it, and write the correct data next to it
- cover the error with correction fluid and then write the patient’s actual blood pressure over it
- erase the error, initial it, and then write the correct data on a separate addendum
- leave the error on the PCR, but inform the staff of the patient’s actual blood pressure

A

draw a single horizontal line through the error

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124
Q

Question 4: After receiving online orders from medical control to perform a patient care intervention, you should:
- repeat the order to medical control word for word
- ask the physician to repeat the order
- perform the intervention as ordered
- confirm the order in your own words

A

repeat the order to medical control word for word

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125
Q

Question 5: Any radio hardware containing a transmitter and a receiver that is located in a fixed location is called a:
- base station
- repeater
- multiplex
- mobile radio

A

base station

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126
Q

Question 6: As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should:
- place the patient in a high-visibility area and then respond to the call
- respond only after giving a verbal patient report to a nurse or physician
- inform the admissions clerk of the situation and then respond at once
- leave a copy of the run form with a nurse and then respond to the call

A

respond only after giving a verbal patient report to a nurse or physician

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127
Q

Question 7: Despite your numerous, sincere efforts to convince a 40-year-old man to consent to EMS treatment and transport, he refuses. After explaining the potential consequences of his refusal and determining that the patient has decision-making capacity, you ask him to sign an EMS refusal form, but he refuses to do that as well. You should:
- sign the refusal form, include the date and time, and have your partner witness it with his or her signature
- document the patient’s refusal, but leave the refusal form blank because only the patient can legally sign it
- advise the patient that unless he signs the refusal form, he cannot legally refuse EMS treatment or transport
- ask a family member, law enforcement officer, or bystander to sign the form verifying that the patient refused to sign

A

ask a family member

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128
Q

Question 8: During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should:
- repeat your question because he probably did not hear you
- allow him time to think about the question and respond to it
- ask him if he frequently experiences severe headaches and nausea
- tell him that you cannot help him unless he answers your questions

A

allow him time to think about the question and respond to it

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129
Q

Question 9: Ethnocentrism is defined as:
- suspecting that a person has an ulterior motive based on the tone of his or her voice when answering a question
- subconsciously forcing your cultural values onto a patient because you believe that your own values are more acceptable
- considering your own cultural values as more important when interacting with people of a different culture
- understanding that people from different cultural backgrounds respond to pain and stress differently

A

considering your own cultural values as more important when interacting with people of a different culture

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130
Q

Question 10: Medical control gives you an order that seems inappropriate for the patient’s condition. After confirming that you heard the physician correctly, you should:
- advise the physician that the order is unclear and ask for clarification
- state that you will not carry out the order because it is inappropriate
- obtain consent from the patient and then carry out the order as usual
- carry out the order and then carefully document it on the run form

A

advise the physician that the order is unclear and ask for clarification

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131
Q

Question 11: The official transfer of patient care does not occur until the EMT:
- notifies the admitting clerk of the patient’s arrival at the hospital
- informs dispatch of the patient’s arrival at the emergency department
- gives an oral report to the emergency room physician or nurse
- gives a radio report to the receiving medical facility

A

gives an oral report to the emergency room physician or nurse

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132
Q

Question 12: When communicating with a visually impaired patient, you should:
- possess an in-depth knowledge of sign language
- recall that most visually impaired patients are blind
- determine the degree of the patient’s impairment
- expect the patient to have difficulty understanding

A

determine the degree of the patient’s impairment

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133
Q

Question 13: Which of the following incidents does not require a report to be filed with local authorities:
- Spousal abuse
- Animal bites
- Cardiac arrest
- Gunshot wounds

A

Cardiac arrest

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134
Q

Question 14: Which of the following statements is not appropriate to document in the narrative section of a PCR:
- The patient admits to smoking marijuana earlier in the day
- General impression revealed that the patient was intoxicated
- After oxygen was administered, the patient’s breathing improved
- Significant damage was noted to the front end of the vehicle

A

General impression revealed that the patient was intoxicated

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135
Q

Question 15: Which of the following statements regarding a patient refusal is correct:
- Documentation of proposed care is unnecessary if the patient refuses treatment
- A patient who consumed a few beers will likely be able to refuse EMS treatment
- A mentally competent adult has the legal right to refuse EMS care and transport
- Advice given to a patient who refuses EMS treatment should not be documented

A

A mentally competent adult has the legal right to refuse EMS care and transport

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136
Q

Question 16: Which of the following statements regarding communication with a child is correct:
- Standing over a child often increases his or her level of anxiety
- Unlike adults, children cannot see through lies or deceptions
- The EMT should give the child minimal information to avoid scaring him or her
- Most children are intrigued by strangers wearing uniforms

A

Standing over a child often increases his or her level of anxiety

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137
Q

Question 17: Which of the following statements regarding standing orders is correct:
- Standing orders require you to contact medical control first before providing an intervention
- Standing orders should be followed when physician contact is not possible
- Standing orders have less legal authority than orders given via radio
- Standing orders only highlight the care that you may provide

A

Standing orders should be followed when physician contact is not possible

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138
Q

Question 18: You and your partner are dispatched to a residence for an “ill person.” When you arrive, you find that the patient, a 44-year-old man, does not speak English. There are no relatives or bystanders present who can act as an interpreter. You should:
- use short, simple questions and point to specific parts of your body to try to determine the source of the patient’s complaint
- refrain from performing any assessment or treatment until you can contact someone who can function as an interpreter
- give the patient oxygen, assess his vital signs, and transport him to the hospital in a position of comfort
- speak to the patient with a moderately louder voice to facilitate his ability to understand what you are saying

A

use short, simple questions and point to specific parts of your body to try to determine the source of the patient’s complaint

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139
Q

Question 19: You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions about her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that:
- a patient’s personal space should not be violated, regardless of any barriers that might hamper communication
- as you physically get closer to the patient, a greater and greater sense of trust must be established
- it is necessary to enter an older person’s intimate space because the elderly are typically hearing impaired
- placing yourself in the patient’s personal space is relaying to her that you can be trusted

A

as you physically get closer to the patient, a greater and greater sense of trust must be established

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140
Q

Question 20: You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child’s parents explain that these marks represent coining. You should:
- document this finding on your patient care report and advise the emergency department staff of what the child’s parents told you
- acknowledge and respect this practice as a cultural belief, but advise the child’s parents that it has no healing power
- advise the child’s parents that this is a harmful practice and is considered a form of child abuse in the United States
- advise the emergency department physician that you believe the child was intentionally abused by his parents

A

document this finding on your patient care report and advise the emergency department staff of what the child’s parents told you

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141
Q

Question 1: Which of the following general statements regarding consent is correct?
1. A patient can consent to transport but can legally refuse treatment.
2. All patients older than 18 years can legally refuse treatment or transport.
3. Patients who are intoxicated are generally allowed to refuse treatment.
4. Expressed consent is valid only if given in writing by a family member.

A

A patient can consent to transport but can legally refuse treatment.

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142
Q

Question 2: Which type of consent is involved when a 39-year-old, mentally competent female with a severe headache asks you to take her to the hospital?
1. Expressed
2. Implied
3. Informed
4. Formal

A

Expressed

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143
Q

Question 3: Which of the following scenarios is an example of informed consent?
1. An EMT advises a patient of the risks of receiving treatment.
2. A patient is advised by an EMT of the risks of refusing care.
3. A patient advises an EMT of why he or she is refusing care.
4. An EMT initiates immediate care for an unconscious adult.

A

An EMT advises a patient of the risks of receiving treatment.

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144
Q

Question 4: Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?
1. Implied
2. Expressed
3. Informed
4. Actual

A

Implied

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145
Q

Question 5: You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which of the following types of consent describes her agreement?
1. Informed
2. Minor’s
3. Expressed
4. Implied

A

Expressed

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146
Q

Question 6: Shortly after you load your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
1. A mentally competent adult can withdraw his or her consent to treat at any time.
2. Any patient who refuses EMS treatment must legally sign a patient refusal form.
3. Once the patient is in the ambulance, he cannot legally refuse EMS treatment.
4. Because of your suspicions, the best approach is to transport him to the hospital.

A

A mentally competent adult can withdraw his or her consent to treat at any time.

147
Q

Question 7: All of the following are considered to be protected health information (PHI), except:
1. Assessment findings.
2. Treatment rendered.
3. Location of the call.
4. Patient history.

A

Location of the call.

148
Q

Question 8: During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient’s name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:
1. Are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.
2. Adequately safeguarded the patient’s PHI because the cases were discussed internally.
3. Violated the patient’s privacy because you should have discussed the information only with the EMTs involved.
4. Acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others.

A

Are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.

149
Q

Question 9: For a do not resuscitate (DNR) order to be valid, it must:
1. Clearly state the patient’s medical problem.
2. Be signed by the local justice of the peace.
3. Be dated within the previous 24 months.
4. Be updated a minimum of every 6 months.

A

Clearly state the patient’s medical problem.

150
Q

Question 10: You respond to the home of a 59-year-old man who is unconscious with slow, shallow breathing and a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient, but they are unable to locate it. You should:
1. Transport the patient without providing any treatment.
2. Decide on further action once the DNR order is produced.
3. Begin treatment and contact medical control as needed.
4. Honor the patient’s wishes and withhold all treatment.

A

Begin treatment and contact medical control as needed.

151
Q

Question 11: When is forcible restraint permitted?
1. Only if consent to restrain is given by a family member.
2. When the patient poses a significant threat to self or others.
3. Anytime that the EMT feels threatened.
4. Only if law enforcement personnel have witnessed threatening behavior.

A

When the patient poses a significant threat to self or others.

152
Q

Question 12: The EMT’s scope of practice within his or her local response area is defined by the:
1. EMS supervisor.
2. Local health district.
3. State EMS office.
4. Medical director.

A

Medical director.

153
Q

Question 13: As an EMT, the performance of your duties will be compared to that of:
1. A paramedic supervisor.
2. The medical director.
3. The general public.
4. Another EMT.

A

Another EMT.

154
Q

Question 14: In which of the following situations does a legal duty to act clearly exist?
1. The EMT witnesses a vehicle crash while off duty.
2. A call is received 15 minutes prior to shift change.
3. The EMT hears of a cardiac arrest after his or her shift ends.
4. A bystander encounters a victim who is not breathing.

A

A call is received 15 minutes prior to shift change.

155
Q

Question 15: When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient’s condition continues to deteriorate: He develops cardiac arrest and dies at the hospital. This scenario is an example of:
1. Abandonment.
2. Assault.
3. Battery.
4. Negligence.

A

Negligence.

156
Q

Question 16: Which of the following scenarios most accurately depicts abandonment?
1. An AEMT transfers patient care to a paramedic.
2. An EMT gives a verbal report to an emergency room nurse.
3. A paramedic transfers patient care to an EMT.
4. A physician assumes patient care from an EMT.

A

A paramedic transfers patient care to an EMT.

157
Q

Question 17: Which of the following statements regarding Good Samaritan laws is correct?
1. Such laws do not protect EMTs who are off duty.
2. Such laws will not protect the EMT in cases of gross negligence.
3. Such laws guarantee that the EMT will not be held liable if he or she is sued.
4. Such laws provide the EMT with absolute immunity from a lawsuit.

A

Such laws will not protect the EMT in cases of gross negligence.

158
Q

Question 18: Which of the following situations requires you to notify the appropriate authorities?
1. Drug overdose.
2. Accidental knife wound.
3. Cardiac arrest.
4. Attempted suicide.

A

Attempted suicide.

159
Q

Question 19: You are dispatched to an apartment complex to respond to a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:
1. Obtain permission from law enforcement before moving anything.
2. Quickly move the coffee table so you can access and treat the patient.
3. Drag the patient into a larger area so that you can begin treatment.
4. Treat the patient where he is so that you do not destroy any evidence.

A

Quickly move the coffee table so you can access and treat the patient.

160
Q

Question 20: While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:
1. Exclude this intervention from the PCR because it did not harm the patient.
2. Notify law enforcement so they can file an incident report.
3. Document the error and report it to your supervisor.
4. Contact medical control and notify them of the error.

A

Contact medical control and notify them of the error.

161
Q

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:
carefully probe the wound to determine its depth.
transport only if signs of shock begin to develop.
assume that the arrow injured an internal organ.
clean the wound and apply a dry, sterile dressing.

A

assume that the arrow injured an internal organ.

162
Q

A 22-year-old male was kicked in the abdomen several times. You find him lying on his left side with his knees drawn up. He is conscious and alert and complains of increased pain and nausea when he tries to straighten his legs. His blood pressure is 142/82 mm Hg, his pulse rate is 110 beats/min and strong, and his respirations are 22 breaths/min and regular. In addition to administering high-flow oxygen, you should:
place him supine but allow him to keep his knees bent.
apply full spinal motion restriction precautions.
transport him in the position in which you found him.
keep him on his side but gently straighten his legs.

A

transport him in the position in which you found him.

163
Q

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The most appropriate treatment for this patient includes:
applying direct pressure with a dry, sterile dressing.
covering the avulsion with moist, sterile dressings.
administering 100% oxygen via a nonrebreathing mask.
requesting a paramedic to administer pain medication.

A

applying direct pressure with a dry, sterile dressing.

164
Q

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be most pertinent to ask him:
What does your blood pressure normally run?
Has blood soaked through your undergarments?
Do you take any over-the-counter medications?
Have you experienced recent abdominal trauma?

A

Have you experienced recent abdominal trauma?

165
Q

Accumulation of blood in the abdominal cavity will most likely cause:
distention.
nausea or vomiting.
referred pain.
diffuse bruising.

A

distention.

166
Q

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be most suspicious for:
blunt injury to the kidney.
a lacerated liver or spleen.
external genitalia injury.
a ruptured urinary bladder.

A

blunt injury to the kidney.

167
Q

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:
make one attempt to replace the bowel back into the abdomen and then cover the wound with a sterile dressing.
cover the bowel with a dry sterile dressing, elevate his lower extremities, and cover him with a blanket.
cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.
gently irrigate the exposed bowel with sterile saline and then cover the wound with a dry sterile dressing.

A

cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

168
Q

A sign of kidney damage after blunt trauma is:
hematuria.
hemoptysis.
hematochezia.
hematemesis.

A

hematuria.

169
Q

Assuming that no obvious signs of intra-abdominal injury are present, which of the following injuries would most likely cause an injury to the liver or spleen to be overlooked:
Pelvic fracture
Shoulder fracture
Lumbar spine fracture
Femur fracture

A

Shoulder fracture.

170
Q

Because the depth of an open abdominal wound is often difficult to determine:
the abdomen must be vigorously palpated.
the EMT must perform a thorough exam.
vital signs should be monitored frequently.
prompt transport to the hospital is essential.

A

prompt transport to the hospital is essential.

171
Q

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:
a poorly placed lap belt.
airbag deployment.
failure to wear seat belts.
rapid vehicle deceleration.

A

a poorly placed lap belt.

172
Q

During your assessment of a patient who experienced blunt trauma to the abdomen, you notice bruising around the umbilicus. This is a sign of:
rupture of a hollow organ.
a ruptured spleen.
intra-abdominal bleeding.
a severe liver laceration.

A

intra-abdominal bleeding.

173
Q

Early bruising following abdominal trauma often manifests as:
red areas of skin.
gross distention.
localized pain.
dark purple marks.

A

red areas of skin.

174
Q

Placing a pregnant patient in a supine position during the third trimester of pregnancy:
often causes hypotension secondary to cardiac compression.
is recommended if the patient has severe abdominal discomfort.
might decrease the amount of blood that returns to the heart.
results in spontaneous urinary incontinence if the bladder is full.

A

might decrease the amount of blood that returns to the heart.

175
Q

The presence of tachycardia following a significant abdominal injury:
should be assumed to be a sign of shock.
indicates a state of decompensated shock.
is always accompanied by hypotension.
is most commonly caused by severe pain.

A

should be assumed to be a sign of shock.

176
Q

When documenting a call involving a female patient who was sexually assaulted, the EMT should:
avoid speculation and document only factual data.
include the results of the internal vaginal exam.
include a description of the suspected perpetrator.
theorize as to why the sexual assault occurred.

A

avoid speculation and document only factual data.

177
Q

Which of the following organs would most likely bleed profusely when injured:
Liver
Bladder
Intestine
Stomach

A

Liver.

178
Q

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:
the patient is conscious.
law enforcement is at the scene.
the severity of the injury is known.
there are other patients involved.

A

law enforcement is at the scene.

179
Q

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:
closely monitor him and reassess him frequently.
forgo the hospital radio report because of his condition.
perform a comprehensive secondary assessment.
begin documenting the call on the patient care form.

A

closely monitor him and reassess him frequently.

180
Q

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:
arrange for a rape crisis center representative to speak with the patient.
visualize the vaginal area and pack the vagina with sterile dressings.
allow her to change her clothes and take a shower before you transport.
control any external bleeding, administer oxygen, and transport at once.

A

control any external bleeding, administer oxygen, and transport at once.

181
Q

A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should:
1) provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.
2) ventilate with a bag-valve mask, apply a rigid cervical collar, remove his wet clothing, and transport rapidly.
3) suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once.
4) apply high-flow oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.

A

1) provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully.

182
Q

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:
1) apply an automated external defibrillator and assess his cardiac rhythm.
2) open his airway and give two rescue breaths.
3) assess for a carotid pulse for up to 60 seconds.
4) apply chemical heat packs to his groin and axillae.

A

3) assess for a carotid pulse for up to 60 seconds.

183
Q

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:
1) elevating the lower extremities and giving antivenin.
2) transporting only with close, continuous monitoring.
3) applying ice to the wound and transporting quickly.
4) supine positioning, splinting the leg, and transporting.

A

4) supine positioning, splinting the leg, and transporting.

184
Q

After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should:
1) remove the stingers from his leg by scraping them with a stiff object.
2) apply warmth to the sting area and cover it with a dry sterile dressing.
3) administer oxygen and epinephrine and prepare for rapid transport.
4) begin transport and immerse his leg in hot water to help reduce pain.

A

3) administer oxygen and epinephrine and prepare for rapid transport.

185
Q

All of the following snakes are pit vipers, except for the:
1) cottonmouth.
2) rattlesnake.
3) coral snake.
4) copperhead.

A

3) coral snake.

186
Q

An air embolism associated with diving occurs when:
1) the alveoli completely collapse due to high pressure.
2) the diver holds his or her breath during a rapid ascent.
3) high water pressure forces air into the mediastinum.
4) the diver hyperventilates prior to entering the water.

A

2) the diver holds his or her breath during a rapid ascent.

187
Q

A person’s ability to shiver is lost when his or her body temperature falls below:
1) 92°F (33°C).
2) 94°F (34°C).
3) 90°F (32°C).
4) 95°F (35°C).

A

3) 90°F (32°C).

188
Q

Burns associated with lightning strikes are typically:
1) superficial.
2) partial-thickness.
3) third-degree.
4) full-thickness.

A

1) superficial.

189
Q

Common signs and symptoms of heat exhaustion include all of the following, except:
1) dry tongue and thirst.
2) hot, dry skin.
3) nausea.
4) tachycardia.

A

2) hot, dry skin.

190
Q

For sweating to be an effective cooling mechanism:
1) the relative humidity must be above 90%.
2) the body must produce at least 1 L per hour.
3) it must evaporate from the body.
4) several layers of clothing must be worn.

A

3) it must evaporate from the body.

191
Q

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:
1) exhibit poor thermoregulation.
2) have smaller body surface areas.
3) have relatively smaller heads.
4) have less body fat.

A

1) exhibit poor thermoregulation.

192
Q

Heat loss from the body through respiration occurs when:
1) cool air is inhaled and displaces warm air.
2) air temperature is greater than body temperature.
3) warm air is exhaled into the atmosphere.
4) the core body temperature is greater than 98°F (37°C).

A

3) warm air is exhaled into the atmosphere.

193
Q

Heatstroke occurs when:
1) a person’s core body temperature rises above 103°F (39°C).
2) a person becomes dehydrated secondary to excess water loss.
3) the ambient temperature exceeds 90°F (32°C) and the humidity is high.
4) the body’s heat-eliminating mechanisms are overwhelmed.

A

4) the body’s heat-eliminating mechanisms are overwhelmed.

194
Q

In contrast to Lyme disease, Rocky Mountain spotted fever:
1) causes painful joint swelling after a few days or weeks.
2) presents with flu-like symptoms and a bull’s-eye rash.
3) might be confused with rheumatoid arthritis.
4) can cause paralysis and cardiorespiratory collapse.

A

4) can cause paralysis and cardiorespiratory collapse.

195
Q

In contrast to the brown recluse spider, the black widow spider:
1) has a bite that usually produces local pain but no systemic signs or symptoms.
2) is very small and has a violin-shaped marking on its back.
3) has a bite that is typically painless until a blister develops.
4) is large and has a red-orange hourglass mark on its abdomen.

A

4) is large and has a red-orange hourglass mark on its abdomen.

196
Q

Most of the serious injuries associated with scuba diving are caused by:
1) too rapid of a descent.
2) too rapid of an ascent.
3) alcohol consumption.
4) cold water temperature.

A

2) too rapid of an ascent.

197
Q

Signs and symptoms of an air embolism include all of the following, except:
1) dysphasia.
2) dizziness.
3) pale skin.
4) joint pain.

A

3) pale skin.

198
Q

The EMT must assume that any unwitnessed water-related incident is accompanied by:
1) possible spinal injury.
2) cold-water immersion.
3) an air embolism.
4) alcohol intoxication.

A

1) possible spinal injury.

199
Q

The most prominent symptom of decompression sickness is:
1) difficulty with vision.
2) dizziness and nausea.
3) tightness in the chest.
4) abdominal or joint pain.

A

4) abdominal or joint pain.

200
Q

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:
1) conduction.
2) convection.
3) evaporation.
4) radiation.

A

1) conduction.

201
Q

A 19-year-old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what most likely occurred:
1) Asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta
2) Fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia
3) Collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest
4) Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

A

4) Ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle.

202
Q

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress, and his oxygen saturation is 78%. His breath sounds are equal bilaterally, and his jugular veins are normal. You should suspect:
1) tension pneumothorax.
2) massive hemothorax.
3) pulmonary contusion.
4) traumatic asphyxia.

A

3) pulmonary contusion.

203
Q

An open pneumothorax is:
1) a fractured rib that perforates the tissue of the lung surface.
2) the entry of air into the pleural space from a perforated lung.
3) extreme pleural pressure that causes the lung to rupture.
4) an open chest wound through which air moves during breathing.

A

4) an open chest wound through which air moves during breathing.

204
Q

A rapid, irregular pulse following blunt trauma to the chest is most suggestive of a:
1) ruptured aorta.
2) tension pneumothorax.
3) myocardial contusion.
4) pericardial tamponade.

A

3) myocardial contusion.

205
Q

A spinal cord injury at the level of C7 would most likely result in:
1) immediate cardiac arrest.
2) paralysis of all the respiratory muscles.
3) paralysis of the diaphragm.
4) paralysis of the intercostal muscles.

A

4) paralysis of the intercostal muscles.

206
Q

Common signs and symptoms of a chest injury include all of the following, except:
1) chest wall ecchymosis.
2) hematemesis.
3) localized pain.
4) tachypnea.

A

2) hematemesis.

207
Q

Elevation of the rib cage during inhalation occurs when:
1) the intercostal muscles contract.
2) abdominal contents descend.
3) the diaphragm descends.
4) intrathoracic pressure decreases.

A

1) the intercostal muscles contract.

208
Q

Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade:
1) Widening pulse pressure
2) Engorged jugular veins
3) A rapid, irregular pulse
4) Diminished breath sounds

A

2) Engorged jugular veins.

209
Q

Following blunt trauma to the chest, an 18-year-old female presents with respiratory distress, shallow breathing, and cyanosis. Her blood pressure is 80/50 mm Hg and her pulse is 130 beats/min and thready. You should:
1) perform a rapid head-to-toe physical assessment.
2) apply 100% oxygen via a nonrebreathing mask.
3) provide ventilation assistance with a bag valve mask.
4) place her supine and elevate her lower extremities.

A

3) provide ventilation assistance with a bag valve mask.

210
Q

Hemoptysis is defined as:
1) vomiting blood.
2) blood in the pleural space.
3) abnormal blood clotting.
4) coughing up blood.

A

4) coughing up blood.

211
Q

Pleural fluid is contained between the:
1) visceral and parietal pleurae.
2) visceral pleura and the lung.
3) parietal pleura and the heart.
4) parietal pleura and the chest wall.

A

1) visceral and parietal pleurae.

212
Q

Signs and symptoms of a tension pneumothorax include all of the following, except:
1) unilaterally absent breath sounds.
2) altered mental status.
3) profound cyanosis.
4) collapsed jugular veins.

A

4) collapsed jugular veins.

213
Q

Subcutaneous emphysema is an indication that:
1) at least half of one lung has completely collapsed.
2) your patient is experiencing a pericardial tamponade.
3) blood is slowly accumulating within the tissue of the lung.
4) air is escaping into the chest wall from a damaged lung.

A

4) air is escaping into the chest wall from a damaged lung.

214
Q

The most critical treatment for a tension pneumothorax involves:
1) placing a bulky dressing over the affected side of the chest.
2) inserting a needle through the rib cage into the pleural space.
3) assisting the patient’s breathing with increased tidal volume.
4) surgically removing the portion of the lung that is damaged.

A

2) inserting a needle through the rib cage into the pleural space.

215
Q

To avoid exacerbating a patient’s injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:
1) flail chest.
2) cardiac tamponade.
3) pneumothorax.
4) myocardial contusion.

A

3) pneumothorax.

216
Q

When a person is lying supine at the end of exhalation, the diaphragm:
1) is less prone to penetrating trauma.
2) contracts and flattens inferiorly.
3) descends below the level of the navel.
4) might rise as high as the nipple line.

A

4) might rise as high as the nipple line.

217
Q

When assessing a patient with a hemothorax, you will most likely find:
1) ipsilateral tracheal deviation.
2) signs and symptoms of shock.
3) jugular venous engorgement.
4) distant or muffled heart tones.

A

2) signs and symptoms of shock.

218
Q

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, tachycardic, and diaphoretic. Your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. You should be most suspicious that this patient has experienced a:
1) tension pneumothorax.
2) laceration of the aorta.
3) pericardial tamponade.
4) massive hemothorax.

A

2) laceration of the aorta.

219
Q

You have sealed the open chest wound of a 40-year-old male who was stabbed in the anterior chest. Your reassessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. You should:
1) begin ventilatory assistance.
2) partially remove the dressing.
3) call for a paramedic ambulance.
4) begin rapid transport at once.

A

2) partially remove the dressing.

220
Q

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:
1) perform a focused secondary exam.
2) insert an oropharyngeal airway.
3) obtain a set of baseline vital signs.
4) immediately request ALS support.

A

4) immediately request ALS support.

221
Q

A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:
a) perform a rapid secondary assessment.
b) place a pillow under his arm and apply a sling.
c) straighten his arm and apply a board splint.
d) immobilize the injury with a sling and swathe.

A

immobilize the injury with a sling and swathe.

222
Q

A 21-year-old male was thrown over the handlebars of his motorcycle when he rear-ended a car that was stopped at a red light. He was wearing a helmet, which he removed prior to your arrival. He is conscious but restless and has closed deformities to both of his femurs. His skin is pale, his heart rate is rapid and weak, and his respirations are rapid and shallow. You should:
a) apply traction splints to both of his legs, keep him warm, and transport without delay.
b) splint each of his deformed femurs with long board splints and transport without delay.
c) bind his legs together on the backboard, keep him warm, and transport without delay.
d) splint each of his deformed femurs with air splints, elevate his lower extremities, and transport.

A

bind his legs together on the backboard

223
Q

A 22-year-old female was ejected from her car after striking a tree head-on. As you approach her, you note obvious closed deformities to both of her femurs. She is not moving and does not appear to be conscious. You should:
a) administer oxygen and perform a rapid assessment.
b) apply manual stabilization to both of her femurs.
c) assess for a carotid pulse and assist her ventilations.
d) stabilize her head and perform a primary assessment.

A

stabilize her head and perform a primary assessment.

224
Q

A 30-year-old man complains of severe pain to his right tibia after an injury that occurred the day before. The patient’s leg is pale, and he is unable to move his foot. The EMT should suspect that:
a) pressure in the fascial compartment is elevated.
b) a severe infection has developed in the muscle.
c) the nerves behind the knee are compromised.
d) the nerves supplying the foot have been severed.

A

pressure in the fascial compartment is elevated.

225
Q

A 45-year-old female was the unrestrained passenger of a small car that rear-ended another vehicle at a moderate rate of speed. She is conscious and alert but complains of pain to both of her knees. There is visible damage to the dashboard on the passenger’s side of the vehicle. In addition to fractures or dislocations of the knees, you should be most suspicious for:
a) anterior hip dislocation.
b) fracture of the tibia or fibula.
c) a thoracic spine fracture.
d) posterior hip dislocation.

A

posterior hip dislocation.

226
Q

A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:
a) assess distal pulses as well as sensory and motor functions.
b) gently manipulate the injured leg until the numbness dissipates.
c) manually stabilize the leg above and below the site of injury.
d) control the bleeding and cover the wound with a sterile dressing.

A

control the bleeding and cover the wound with a sterile dressing.

227
Q

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:
a) apply padded board splints to both sides of the leg.
b) flex the knee slightly and apply a formable splint.
c) bind the legs together and elevate them six feet to eight feet.
d) apply a traction splint to realign the deformity.

A

apply padded board splints to both sides of the leg.

228
Q

A 77-year-old woman slipped and fell on a throw rug and landed on her left hip. She denies striking her head or losing consciousness. Assessment of her left leg reveals that it is shortened and externally rotated. Distal pulses, sensory, and motor functions are intact. You should:
a) place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.
b) carefully slide a long backboard underneath her, keep her in a supine position, and apply a splint to her leg.
c) bind both of her legs together with triangular bandages and carefully secure her onto the ambulance stretcher.
d) manually stabilize her left leg, apply a traction splint, and then secure her to a long backboard or scoop.

A

place her onto a scoop stretcher

229
Q

A Colles fracture involves a fracture of the:
a) radius and ulna.
b) distal ulna.
c) distal radius.
d) proximal radius.

A

distal radius.

230
Q

A construction worker’s arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient’s skin is cool, clammy, and pale. The EMT should:
a) wrap the severed arm in a sterile dressing.
b) administer high-flow oxygen to the patient.
c) remove the towel and inspect the wound.
d) apply a tourniquet just below the shoulder.

A

apply a tourniquet just below the shoulder.

231
Q

A ____________ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments.
a) Strain
b) Dislocation
c) Fracture
d) Sprain

A

Sprain.

232
Q

A(n) __________ fracture occurs in the growth section of a child’s bone and might lead to bone growth abnormalities.
a) metaphyseal
b) epiphyseal
c) diaphyseal
d) greenstick

A

epiphyseal.

233
Q

A person who experiences a calcaneus fracture after jumping and landing on his or her feet would most likely experience an accompanying fracture of the:
a) coccygeal spine.
b) lumbar spine.
c) symphysis pubis.
d) thoracic spine.

A

lumbar spine.

234
Q

Bones are connected to other bones by bands of tough fibrous tissues called:
a) ligaments.
b) cartilage.
c) bursa.
d) tendons.

A

ligaments.

235
Q

Common signs and symptoms of a sprain include all of the following, except:
a) swelling.
b) deformity.
c) guarding.
d) ecchymosis.

A

deformity.

236
Q

During your assessment of a 29-year-old female with significant deformity to her left elbow, you are unable to palpate a radial pulse. Your transport time to the hospital is approximately 40 minutes. You should:
a) splint the elbow in the position of deformity and transport immediately.
b) make two or three attempts to restore distal circulation by manipulating the elbow.
c) apply gentle manual traction in line with the limb and reassess for a pulse.
d) carefully straighten the injured arm and secure it with padded board splints.

A

apply gentle manual traction in line with the limb and reassess for a pulse.

237
Q

During your secondary assessment of a 19-year-old female with multiple traumas, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic, and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining manual stabilization of her head. The most appropriate treatment for this patient includes:
a) immobilizing her to a backboard and rapidly transporting.
b) splinting her femur fracture with padded board splints.
c) carefully splinting each of her deformed extremities.
d) applying a traction splint to immobilize her femur.

A

immobilizing her to a backboard and rapidly transporting.

238
Q

During your secondary assessment of a 30-year-old male who fell 25 feet, you note crepitus when palpating his pelvis. Your partner advises you that the patient’s blood pressure is 80/50 mm Hg, and his heart rate is 120 beats/min and weak. After completing your assessment, you should:
a) perform a focused physical exam with emphasis on the pelvis.
b) stabilize the pelvis with a pelvic binder and protect the spine.
c) log roll the patient onto a long backboard and transport at once.
d) defer spinal immobilization and transport to a trauma center.

A

stabilize the pelvis with a pelvic binder and protect the spine.

239
Q

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting:
a) distal circulation.
b) bruising to the shoulder.
c) the presence of deformity.
d) the patient history.

A

the patient history.

240
Q

Skeletal muscle is also referred to as __________ muscle.
a) striated
b) connective
c) smooth
d) involuntary

A

striated.

241
Q

After assessing your patient, you determine that his condition is stable. You provide the appropriate treatment and then load him into the ambulance. While en route to the hospital, you should:
a) turn your emergency lights off and obey all traffic laws.
b) drive slowly and remain in the far left-hand lane, if possible.
c) use your lights and siren but drive slowly and defensively.
d) keep your emergency lights on but avoid using the siren.

A

turn your emergency lights off and obey all traffic laws.

242
Q

Aggressive ambulance driving might have a negative effect on other motorists because:
a) they move to the right or drive as close to the curb as possible.
b) they might become enraged and attempt to run you off the road.
c) they often freeze when they see the lights in the rearview mirror.
d) it might not allow for their reaction time to respond to your vehicle.

A

it might not allow for their reaction time to respond to your vehicle.

243
Q

A medical transport helicopter is incoming, and you are responsible for setting up the landing zone (LZ). You should:
a) use weighted cones to mark all four corners of the LZ.
b) ask bystanders to stand at all four corners of the LZ.
c) place four flares 100 feet apart in an “X” pattern.
d) use yellow caution tape to mark off the LZ perimeter.

A

use weighted cones to mark all four corners of the LZ.

244
Q

As soon as you leave the hospital and are en route back to your station, you should inform the dispatcher:
a) that you are prepared for another call.
b) of the name of the accepting physician.
c) about the patient’s clinical condition.
d) whether you are back in service.

A

whether you are back in service.

245
Q

Characteristics of a safe ambulance operator include:
a) the ability to operate an ambulance at a high rate of speed.
b) an offensive attitude about driving during an emergency call.
c) a positive attitude about the ability to tolerate other drivers.
d) realizing that lights and siren will be effective traffic tools.

A

a positive attitude about the ability to tolerate other drivers.

246
Q

Common safety equipment carried on the ambulance includes all of the following, except:
a) safety goggles.
b) hazardous materials gear.
c) face shields.
d) turnout gear.

A

safety goggles.

247
Q

Delivering a patient to the hospital involves all of the following activities, except:
a) informing the dispatcher of your arrival.
b) restocking any disposable items you used.
c) completing a detailed written report.
d) giving a verbal report to the triage clerk.

A

giving a verbal report to the triage clerk.

248
Q

For every emergency request, the dispatcher should routinely gather and record all of the following information, except the:
a) caller’s phone number.
b) patient’s medical history.
c) location of the patient(s).
d) nature of the call.

A

patient’s medical history.

249
Q

General guidelines for safe ambulance driving include all of the following, except:
a) avoiding routes with heavy traffic congestion.
b) assuming that other drivers will not see you.
c) avoiding one-way streets whenever possible.
d) regularly using the siren as much as possible.

A

regularly using the siren as much as possible.

250
Q

If hydroplaning of the ambulance occurs, the driver should:
a) slowly move the steering wheel back and forth.
b) slowly pump the brakes until he or she regains vehicle control.
c) gradually slow down without jamming on the brakes.
d) quickly jerk the steering wheel.

A

gradually slow down without jamming on the brakes.

251
Q

If you could only take two pieces of equipment with you to a patient’s side, you should choose the:
a) BVM and portable oxygen.
b) AED and portable suction unit.
c) oral airways and sterile dressings.
d) cervical collar and long backboard.

A

AED and portable suction unit.

252
Q

Immediately upon arriving at the scene of an emergency call involving a traumatic injury, you should notify the dispatcher of your arrival and then:
a) carefully assess the mechanism of injury.
b) determine if additional units are needed.
c) observe the scene for safety hazards.
d) quickly gain access to the patient.

A

observe the scene for safety hazards.

253
Q

In general, medevac helicopters should be utilized when:
a) a patient has been in cardiac arrest for more than 15 minutes and has not responded to CPR and defibrillation.
b) a patient has a time-dependent injury or illness, and traffic conditions would cause a significant delay in definitive care.
c) ground transport would leave your service area without an ambulance for greater than 30 minutes.
d) ground transport to the hospital exceeds 30 to 45 minutes, even if the patient’s present condition is stable.

A

a patient has a time-dependent injury or illness

254
Q

Minimum airway and ventilation equipment that should be carried on every ambulance include all of the following, except:
a) various sizes of oral and nasal airways.
b) adult and pediatric bag-valve masks.
c) mounted and portable suctioning units.
d) Combitubes, or laryngeal mask airways.

A

Combitubes

255
Q

Minimum staffing in the patient compartment of a basic life support (BLS) ambulance includes:
a) at least two EMTs.
b) at least one EMT.
c) an EMT and an AEMT.
d) an EMT and a paramedic.

A

at least one EMT.

256
Q

The main objective of traffic control at the scene of a motor vehicle crash is to:
a) prevent curious onlookers from observing the scene.
b) facilitate a route for the media to access the scene.
c) get oncoming traffic past the scene as soon as possible.
d) warn oncoming traffic and prevent another crash.

A

warn oncoming traffic and prevent another crash.

257
Q

The most common and usually the most serious ambulance crashes occur at:
a) stop signs.
b) intersections.
c) stop lights.
d) railroad crossings.

A

intersections.

258
Q

The use of lights and siren on an ambulance:
a) legally gives the emergency vehicle operator the right of way.
b) signifies a request for other drivers to yield the right of way.
c) allows other drivers to hear and see you from a great distance.
d) is required any time a patient is being transported to the hospital.

A

signifies a request for other drivers to yield the right of way.

259
Q

Upon arriving at the scene of a major motor vehicle crash at night, you find that the safest place to park your ambulance is in a direction that is facing oncoming traffic. You should:
a) place a flare near the crash.
b) turn your headlights off.
c) turn all warning lights off.
d) quickly access the patient.

A

turn your headlights off.

260
Q

When arriving at the scene of an overturned tractor-trailer rig, you note that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but bleeding profusely from the head. After notifying the hazardous materials team, you should:
a) quickly gain access to the patient.
b) position the ambulance upwind.
c) ask the driver to exit the vehicle.
d) park downhill from the scene.

A

position the ambulance upwind.

261
Q

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations, and has bilateral closed femur deformities. You should:
a) apply oxygen via a nonrebreathing mask.
b) obtain baseline vital signs and transport at once.
c) direct your partner to begin ventilatory assistance.
d) stabilize her legs with long board splints.

A

direct your partner to begin ventilatory assistance.

262
Q

A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain and left leg pain. The vehicle is stable, and no hazards are present. When removing this patient from his vehicle, you should:
a) immobilize him with a vest-style device.
b) maintain slight traction to his neck area.
c) use the rapid extrication technique.
d) apply a full leg splint prior to extrication.

A

immobilize him with a vest-style device.

263
Q

A 50-year-old female is entrapped in her passenger car after it struck a tree. As the rescue team is preparing to extricate her, you quickly assess her and determine that she is breathing shallowly and her radial pulse is absent. You should:
a) maintain spinal stabilization as she is extricated.
b) secure her with a short backboard or vest device.
c) begin CPR as the rescue team begins extrication.
d) stabilize her condition before extrication begins.

A

maintain spinal stabilization as she is extricated.

264
Q

As you and your team are removing an unresponsive patient from her wrecked car, you note that she has deformities to both of her legs and a deformity to her left humerus. You should:
a) support the injured extremities and continue removal.
b) assess distal neurovascular functions in her extremities.
c) realign the deformed extremities before continuing.
d) splint the deformities before moving her any further.

A

support the injured extremities and continue removal.

265
Q

A unique consideration when dealing with a hybrid vehicle is that:
a) you must locate the ignition switch and cut it to prevent a fire.
b) cutting the battery cables often results in an explosion or fire.
c) the battery has higher voltage than a traditional vehicle battery.
d) rescue teams should disconnect the positive battery cable first.

A

the battery has higher voltage than a traditional vehicle battery.

266
Q

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, except:
a) ongoing assessment of critical patients.
b) preparing all patients for transportation.
c) keeping bystanders at a safe distance.
d) assigning all patients a triage category.

A

keeping bystanders at a safe distance.

267
Q

In contrast to simple access, complex access:
a) does not involve the breaking of glass.
b) often involves simply unlocking a door.
c) is a skill commonly taught to EMTs.
d) involves forcible entry into a vehicle.

A

involves forcible entry into a vehicle.

268
Q

Once entrance and access to the patient have been provided, you should:
a) begin treating his or her injuries.
b) allow extrication to commence.
c) administer high-flow oxygen.
d) perform a primary assessment.

A

perform a primary assessment.

269
Q

Situational awareness is most accurately defined as:
a) the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.
b) performing an initial scan of the scene to identify hazards that will pose an immediate threat to you and your crew.
c) an ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics.
d) predicting the presence of certain hazards at the scene after receiving initial information from the dispatcher.

A

the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.

270
Q

The rescue team is in the process of extricating a 40-year-old male from his truck. The patient’s wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should:
a) allow her to observe the extrication and keep her calm.
b) allow her to talk to her husband during the extrication.
c) ensure that she is in a safe area, away from the scene.
d) ask her follow-up questions about the details of the crash.

A

ensure that she is in a safe area

271
Q

The scene size-up at a motor vehicle crash or other incident:
a) is a quick visual assessment of the scene prior to entry.
b) determines who is allowed to safely enter the hot zone.
c) is an ongoing process until the incident is terminated.
d) should be performed by the most experienced EMT.

A

is an ongoing process until the incident is terminated.

272
Q

To evaluate hazards present at the scene and determine the number of patients, you should:
a) request the fire department at all scenes.
b) interview bystanders present at the scene.
c) use the information provided by dispatch.
d) perform a 360° walkaround of the scene.

A

perform a 360° walkaround of the scene.

273
Q

Trench collapses usually involve large areas of falling dirt that weigh approximately _______ per cubic foot.
a) 100 lbs
b) 50 lbs
c) 150 lbs
d) 200 lbs.

A

100 lbs.

274
Q

Upon arriving at the scene of a law enforcement tactical situation, you should ensure your own safety and then:
a) report to the incident commander for instructions.
b) apprise medical control of the tactical situation.
c) begin immediate triage of any injured personnel.
d) locate all injured personnel and begin treatment.

A

report to the incident commander for instructions.

275
Q

When determining the exact location and position of the patient(s) in a wrecked vehicle, you and your team should routinely consider all of the following, except:
a) the make and model of the vehicle.
b) the position of the crashed vehicle.
c) hazards that pose a risk to rescuers.
d) the possibility of vehicle instability.

A

the make and model of the vehicle.

276
Q

Which of the following situations would require the use of a specialized rescue team?
a) A patient trapped in a cave or a confined space
b) A patient in a badly damaged car, not entrapped
c) A patient found floating face down in a swimming pool
d) An obese patient who must be moved to the ambulance.

A

A patient trapped in a cave or a confined space.

277
Q

Which of the following statements regarding the rapid extrication technique is correct?
a) The only indication for performing a rapid extrication is if the patient is not entrapped and is in cardiac arrest.
b) It involves rapidly removing a patient from his or her vehicle after immobilizing him or her with a short backboard.
c) Rapid extrication is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.
d) Rapid extrication involves the use of heavy equipment to disentangle a patient from his or her crashed vehicle.

A

Rapid extrication is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

278
Q

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state, We have located a victim” over the radio. You should:

A
279
Q

a) immediately locate the incident commander and ask where the victim is located.

A
280
Q

b) notify the hospital that you will be transporting a burn patient to their facility.

A
281
Q

c) remain with the ambulance and wait for fire personnel to bring the victim to you.

A
282
Q

d) locate the victim and provide initial care while your partner stays with the ambulance.”

A

remain with the ambulance and wait for fire personnel to bring the victim to you.

283
Q

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should:
a) grab him by the clothes and immediately move him to safety.
b) treat only critical injuries before moving him to a place of safety.
c) perform a rapid assessment and move him to a place of safety.
d) limit your primary assessment to airway and breathing only.

A

grab him by the clothes and immediately move him to safety.

284
Q

Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should:
a) park your ambulance behind the incident commander’s vehicle.
b) set up a staging area where firefighters can be treated if necessary.
c) ask the incident commander where the ambulance should be staged.
d) contact medical control and apprise him or her of the situation.

A

ask the incident commander where the ambulance should be staged.

285
Q

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured, and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should:
1) decontaminate the patient as they would any other patient and then move him to the area where EMTs are waiting.
2) request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment of the patient.
3) cut away all of the patient’s clothing and do a rapid rinse to remove as much of the contaminating matter as they can.
4) defer the decontamination procedure and bring the patient directly to awaiting EMS personnel for immediate treatment.

A

request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment of the patient.

286
Q

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min, you should:
1) assess for a distal pulse.
2) assess neurologic status.
3) assign an immediate category.
4) look for posturing.

A

assess for a distal pulse.

287
Q

According to the START triage system, what should you do if you encounter an unresponsive patient who is not breathing?
1) Ventilate the patient for 2 minutes and reassess.
2) Assign the patient in the ‘immediate’ category.
3) Open the airway and reassess breathing status.
4) Triage the patient as ‘expectant’ and move on.

A

Open the airway and reassess breathing status.

288
Q

A critical function of the safety officer is to:
1) determine the most efficient approach to extricate a victim.
2) brief responders during the demobilization phase of an incident.
3) stop an emergency operation whenever a rescuer is in danger.
4) monitor emergency responders for signs of stress and anxiety.

A

stop an emergency operation whenever a rescuer is in danger.

289
Q

After recognizing that an incident involves a hazardous material, you should contact the hazardous materials team and then:
1) don standard equipment before gaining access to any patients.
2) not allow anyone within 25’ to 50’ of the incident scene.
3) take measures to ensure the safety of yourself and others.
4) identify the chemical using the Emergency Response Guidebook.

A

take measures to ensure the safety of yourself and others.

290
Q

A Level 4 hazardous material:
1) is mildly toxic but still requires the use of a self-contained breathing apparatus.
2) requires specialized gear designed for protection against that particular hazard.
3) causes temporary damage or injury unless prompt medical care is provided.
4) requires protective gear to ensure that no part of the skin’s surface is exposed.

A

requires specialized gear designed for protection against that particular hazard.

291
Q

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then:
1) quickly identify the walking wounded.
2) call for additional resources.
3) establish command.
4) begin the triage process.

A

establish command.

292
Q

A supervisor who has more than seven people reporting to him or her:
1) has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.
2) should regularly report to the incident commander (IC) to inform him or her of the functions that his or her team is performing.
3) should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the tasks were carried out.
4) is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can accomplish more tasks.

A

has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.

293
Q

At a very large incident, the __________ section is responsible for managing the tactical operations usually handled by the incident commander on routine EMS calls.
1) logistics
2) finance
3) operations
4) planning

A

operations

294
Q

A tour bus has overturned, resulting in numerous patients. When you arrive, you are immediately assigned to assist in the triage process. Patient 1 is a middle-aged male with respiratory distress, chest pain, and a closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert but has bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you assign to these patients?
1) Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)
2) Patient 1, immediate (red); Patient 2, minimal (green); Patient 3, delayed (yellow); Patient 4, expectant (black)
3) Patient 1, delayed (yellow); Patient 2, immediate (red); Patient 3, delayed (yellow); Patient 4, immediate (red)
4) Patient 1, delayed (yellow); Patient 2, delayed (yellow); Patient 3, minimal (green); Patient 4, immediate (red)

A

Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)

295
Q

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:
1) perform a rapid assessment to locate critical injuries.
2) ask a firefighter what the patient was exposed to.
3) begin some form of positive-pressure ventilation.
4) administer high-flow oxygen via a nonrebreathing mask.

A

begin some form of positive-pressure ventilation.

296
Q

General principles for approaching a potential HazMat incident include:
1) taking standard precautions before entering any HazMat scene.
2) maintaining a safe distance and viewing the scene with binoculars.
3) parking the ambulance in a location that is upwind and downhill.
4) asking for wind direction from dispatch and entering downwind.

A

maintaining a safe distance and viewing the scene with binoculars.

297
Q

If an incident increases in scope and complexity, the incident commander should consider:
1) maintaining responsibility for all of the command functions.
2) relinquishing command to someone with more experience.
3) requesting a second incident commander to assist him or her.
4) ceasing all operations until a revised plan is established.

A

relinquishing command to someone with more experience.

298
Q

Interoperability, an important feature of the NIMS, refers to the ability of:
1) EMS systems and fire departments in the same jurisdiction to effectively work as a team.
2) the federal government to intervene during any large- or small-scale incident involving terrorism.
3) county and state law enforcement agencies to acquire information and pass it along to EMS personnel.
4) agencies of different types or from different jurisdictions to communicate with each other.

A

agencies of different types or from different jurisdictions to communicate with each other.

299
Q

Placards and labels on a storage container are intended to:
1) give a general idea of the hazard inside that particular container.
2) provide specific information about the chemical being carried.
3) advise responders of the appropriate neutralizing measures.
4) broadly classify chemicals as being explosive or nonexplosive.

A

give a general idea of the hazard inside that particular container.

300
Q

The __________ area is where incoming ambulances meet and await further instructions at the scene of a multiple-casualty incident.
1) triage
2) staging
3) support
4) transportation

A

staging

301
Q

The function of the National Incident Management System (NIMS) is to:
1) prepare for, prevent, respond to, and recover from domestic incidents.
2) facilitate a standard method of incident command for natural disasters.
3) educate city and county governments regarding foreign terrorist attacks.
4) prepare for the potential of a nuclear attack against the United States.

A

prepare for, prevent, respond to, and recover from domestic incidents.

302
Q

The process of removing or neutralizing and properly disposing of a hazardous material is called:
1) decontamination.
2) antidotal treatment.
3) neutralization.
4) chemical containment.

A

decontamination.

303
Q

The ____________ supervisor is responsible for notifying area hospitals and determining their availability and capabilities.
1) triage
2) medical
3) transportation
4) treatment

A

transportation

304
Q

Which of the following activities occurs in the warm zone?
1) Medical monitoring
2) Personnel staging
3) Command
4) Decontamination

A

Decontamination

305
Q

A 52-year-old male presents with a fever of 102.5°F and a severe headache. As you assess him, you note the presence of multiple blisters on his face and chest, which are all identical in shape and size. This patient’s clinical presentation is most consistent with:
1) cutaneous anthrax.
2) yellow fever virus.
3) sarin toxicity.
4) smallpox.

A

smallpox.

306
Q

A disease vector is defined as:
1) the period of time between exposure and illness.
2) any agent that acts as a carrier or transporter.
3) the spectrum of signs that define a disease.
4) the ability of a virus or bacterium to be spread.

A

any agent that acts as a carrier or transporter.

307
Q

After eating at a local restaurant, a 20-year-old male complains of blurred vision, difficulty speaking, and difficulty breathing. He is conscious; however, his respirations are profoundly labored and producing minimal tidal volume. You should:
1) apply oxygen via a nonrebreathing mask.
2) request a paramedic to administer atropine.
3) assist his ventilations with high-flow oxygen.
4) position him supine and elevate his legs.

A

assist his ventilations with high-flow oxygen.

308
Q

All of the following are vesicant agents, except:
1) lewisite.
2) sarin.
3) phosgene oxime.
4) sulfur mustard.

A

sarin.

309
Q

All of the following biologic agents or diseases can be transmitted from person to person, except:
1) smallpox.
2) ricin.
3) viral hemorrhagic fevers.
4) pneumonic plague.

A

ricin.

310
Q

An attack on an abortion clinic would most likely be carried out by a(n):
1) extremist political group.
2) single-issue group.
3) violent religious group.
4) doomsday cult.

A

single-issue group.

311
Q

As you and your partner report for duty, you check your ambulance and begin talking about the possibility of a terrorist attack. The most effective and appropriate way to determine the likelihood of this happening is to:
1) know the current threat level issued by the Department of Homeland Security.
2) ascertain the current situation overseas regarding the number of casualties.
3) ask your immediate supervisor if he or she has been watching the local news.
4) check with local businesses to see if they have received any terrorist threats.

A

know the current threat level issued by the Department of Homeland Security.

312
Q

A weapon of mass destruction is most accurately defined as:
1) any device used for the express purpose of creating carnage to make a particular point.
2) any agent used to bring about mass death, casualties, or massive infrastructural damage.
3) a nuclear or chemical weapon that can be launched from one country to another country.
4) a device or agent used to destroy a specific area or region within a given geographic location.

A

any agent used to bring about mass death, casualties, or massive infrastructural damage.

313
Q

Botulinum is:
1) an acute viral infection.
2) a potent bacterial neurotoxin.
3) a disease of the leukocytes.
4) rarely associated with death.

A

a potent bacterial neurotoxin.

314
Q

Continual reassessment of the scene at a suspected terrorist or weapon of mass destruction incident is most important because:
1) terrorists are often at the scene after an attack.
2) bystanders might destroy the evidence.
3) weather conditions might change quickly.
4) a secondary explosive device might detonate.

A

a secondary explosive device might detonate.

315
Q

Cross-contamination occurs when:
1) two EMTs are exposed to the same agent after being decontaminated.
2) an EMT has direct contact with a chemical agent at a terrorist incident.
3) an EMT is exposed to a victim who has not yet been decontaminated.
4) an EMT provides care to a victim after the victim has been decontaminated.

A

an EMT is exposed to a victim who has not yet been decontaminated.

316
Q

Early signs and symptoms of smallpox include all of the following, except:
1) high fever.
2) headaches.
3) skin blisters.
4) body aches.

A

skin blisters.

317
Q

Exposure to _________ would most likely result in immediate respiratory distress:
1) tabun
2) soman
3) lewisite
4) chlorine

A

chlorine

318
Q

If the incident command system is already established at the scene of a terrorist attack, the EMT should:
1) begin triaging patients and start treating the most critical ones.
2) contact the EMS medical director and obtain further instructions.
3) remain in the rehabilitation area until he or she is assigned a task.
4) locate the medical staging officer to obtain his or her assignment.

A

locate the medical staging officer to obtain his or her assignment.

319
Q

In determining the potential for a terrorist attack, you should routinely observe all of the following on every call, except:
1) the type of call.
2) the location type.
3) weather conditions.
4) victim’s statements.

A

weather conditions.

320
Q

Initial signs and symptoms associated with viral hemorrhagic fevers include:
1) severe abdominal muscle spasms.
2) acute onset of double vision.
3) joint pain and unequal pupils.
4) headache and sore throat.

A

headache and sore throat.

321
Q

Most cases of anthrax begin with:
1) flulike symptoms.
2) pulmonary edema.
3) signs of shock.
4) respiratory distress.

A

flulike symptoms.

322
Q

Multiple people in a small town began experiencing abdominal cramps, excessive salivation and urination, and muscle twitching shortly after a small crop duster plane made several passes over the community. As you are assessing the patients, you further determine that most of them are bradycardic and have miosis. In addition to high-flow oxygen, the most appropriate treatment for these patients includes:
1) atropine and pralidoxime chloride.
2) epinephrine and hyperbaric oxygen.
3) amyl nitrate and naloxone.
4) activated charcoal and glucose.

A

atropine and pralidoxime chloride.

323
Q

Phosgene (CG) has an odor that resembles:
1) garlic.
2) bleach.
3) almonds.
4) cut grass.

A

cut grass.

324
Q

__________ rays easily penetrate through the human body and require lead or several inches of concrete to prevent penetration:
1) Beta
2) Neutron
3) Gamma
4) Alpha

A

Gamma

325
Q

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:
acute retinitis.
conjunctivitis.
a detached retina.
a corneal abrasion.

A

acute retinitis.

326
Q

A 30-year-old female was robbed and assaulted as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
begin immediate ventilatory assistance.
visualize her mouth for obvious wounds.
apply oxygen via a nonrebreathing mask.
suction her oropharynx.

A

suction her oropharynx.

327
Q

A 39-year-old female experienced a severe closed head injury. She is unresponsive with her eyes slightly open; her pupils are bilaterally dilated and slow to react. In addition to managing problems with airway, breathing, and circulation, you should:
close her eyes and cover them with a moist dressing.
secure her eyes open so you can reassess her pupils.
inspect her eyes and gently remove impaled objects.
irrigate her eyes with water to prevent mucosal drying.

A

close her eyes and cover them with a moist dressing.

328
Q

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:
scrape the splinter away with moist, sterile gauze.
cover his right eye and flush the left eye with saline.
cover both of his eyes and transport to the hospital.
remove the object with a cotton-tipped applicator.

A

cover his right eye and flush the left eye with saline.

329
Q

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes:
applying a tight pressure dressing.
padding between the ear and the scalp.
packing the ear with sterile gauze pads.
covering the wound with a moist dressing.

A

padding between the ear and the scalp.

330
Q

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should:
leave the contact lenses in place and flush his eyes with sterile water.
remove the contact lenses and cover his eyes with a dry, sterile dressing.
leave the contact lenses in place and cover both eyes with a dry dressing.
carefully remove the contact lenses and then irrigate his eyes with saline.

A

carefully remove the contact lenses and then irrigate his eyes with saline.

331
Q

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:
fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.
assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport.
fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport.
apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

A

fully immobilize her spine

332
Q

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will most likely improve her chance of survival is:
requesting a paramedic ambulance.
carefully monitoring her vital signs.
rapidly transporting her to the hospital.
quickly immobilizing her spinal column.

A

rapidly transporting her to the hospital.

333
Q

Abnormal variations in pupil size and reaction would most likely be observed in a patient with:
retinitis.
contact lenses.
conjunctivitis.
a brain injury.

A

a brain injury.

334
Q

A patient who is complaining of seeing flashing lights, specks, or “floaters” in his or her field of vision has most likely experienced:
conjunctivitis.
acute hyphema.
a blow-out fracture.
a detached retina.

A

a detached retina.

335
Q

A young female experienced a laceration to her left eyeball from flying glass when her boyfriend broke a soda bottle against a wall. There is moderate bleeding, and the patient states that she cannot see out of the injured eye. You should:
carefully examine her eye and remove any foreign objects if needed.
avoid applying pressure to the globe when you are covering the eye.
ask her to move the injured eye to assess the integrity of the optic nerve.
apply firm direct pressure to the injured eye and cover the opposite eye.

A

avoid applying pressure to the globe when you are covering the eye.

336
Q

Bleeding from soft-tissue injuries to the face is most effectively controlled with:
pressure dressings and chemical ice packs.
digital pressure to an adjacent pulse point.
direct pressure using dry, sterile dressings.
ice packs and elevation of the patient’s head.

A

direct pressure using dry

337
Q

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient’s clinical presentation is most consistent with:
a lacerated globe.
a blow-out fracture.
a ruptured eyeball.
optic vessel compression.

A

a blow-out fracture.

338
Q

Significant trauma to the face should increase the EMT’s index of suspicion for a(n):
airway obstruction.
displaced mandible.
basilar skull fracture.
spinal column injury.

A

spinal column injury.

339
Q

The term “hyphema” is defined as:
blood in the anterior chamber of the eye.
an acute rupture of the globe of the eye.
inflammation of the iris, cornea, and lens.
compression of one or both optic nerves.

A

blood in the anterior chamber of the eye.

340
Q

When a light is shone into the pupil:
the opposite pupil should dilate.
it should become smaller in size.
it should become larger in size.
both pupils should dilate together.

A

it should become smaller in size.

341
Q

When transporting a patient with a facial injury, it is most important to be as descriptive as possible with the hospital regarding the patient’s injuries because:
they must make arrangements for an ICU bed.
they might need to call a specialist to see the patient.
it saves time on repeat assessments at the hospital.
most patients with facial trauma will need surgery.

A

they might need to call a specialist to see the patient.

342
Q

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is most pertinent to ask him if he:
is allergic to any medications.
has a history of eye surgeries.
regularly sees a family physician.
noticed the change during a meal.

A

has a history of eye surgeries.

343
Q

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:
apply direct pressure below the lacerated vessel.
circumferentially wrap a dressing around his neck.
apply pressure to the closest arterial pressure point.
apply direct pressure above and below the wound.

A

apply direct pressure above and below the wound.

344
Q

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should:
quickly suction his oropharynx.
turn the backboard onto its side.
reassess his breathing adequacy.
alert the hospital of the situation.

A

turn the backboard onto its side.

345
Q

A 45-year-old male was working on his roof when he fell approximately 12 feet, landing on his feet. He is conscious and alert and complains of an ache in his lower back. He is breathing adequately and has stable vital signs. You should:
immobilize his spine and perform a focused secondary exam.
perform a rapid head-to-toe exam and immobilize his spine.
obtain a Glasgow Coma Score value and give him oxygen.
allow him to refuse transport if his vital signs remain stable.

A

immobilize his spine and perform a focused secondary exam.

346
Q

A female patient with a suspected head injury has slow, shallow breathing. The most appropriate treatment for her includes:
hyperventilating her at 30 breaths/min.
administering oxygen via a nonrebreathing mask.
ventilation assistance to maintain an ETCO 2 of 30 to 35 mm Hg.
ventilation assistance to maintain an oxygen saturation of 90%.

A

ventilation assistance to maintain an ETCO 2 of 30 to 35 mm Hg.

347
Q

After your partner assumes manual in-line stabilization of the patient’s head, you should:
use four people to log roll the patient onto a backboard.
thoroughly palpate the patient’s head for deformities.
apply an appropriately sized rigid cervical collar.
assess distal neurovascular status in the extremities.

A

assess distal neurovascular status in the extremities.

348
Q

A high school football player was injured during a tackle and complains of neck and upper back pain. He is conscious and alert and is breathing without difficulty. The EMT should:
leave his helmet and shoulder pads in place.
remove his helmet and shoulder pads.
remove his helmet, but leave his shoulder pads in place.
leave his helmet in place, but remove his shoulder pads.

A

leave his helmet and shoulder pads in place.

349
Q

A man jumped from the roof of his house and landed on his feet. He complains of pain to his heels, knees, and lower back. This mechanism of injury is an example of:
hyperflexion.
hyperextension.
axial loading.
distraction.

A

axial loading.

350
Q

A patient who cannot remember the events that preceded his or her head injury is experiencing:
retrograde amnesia.
prograde amnesia.
posttraumatic amnesia.
anterograde amnesia.

A

retrograde amnesia.

351
Q

A patient with a head injury presents with abnormal flexion of his extremities. What numeric value should you assign to him for motor response:
2
5
4
3.

A

3

352
Q

Bleeding within the brain tissue itself is called a(n):
subdural hematoma.
subarachnoid hemorrhage.
epidural hematoma.
intracerebral hematoma.

A

intracerebral hematoma.

353
Q

Common signs and symptoms of a serious head injury include all of the following, except:
a rapid, thready pulse.
decerebrate posturing.
widening pulse pressure.
cerebrospinal fluid leakage from the ears.

A

a rapid

354
Q

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you note that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should:
pack his nostrils to stop the drainage of blood.
assist his ventilations with a bag valve mask.
immobilize his spine and transport immediately.
suction his oropharynx for up to 15 seconds.

A

suction his oropharynx for up to 15 seconds.

355
Q

During your primary assessment of a semiconscious 30-year-old female with closed head trauma, you note that she has slow, irregular breathing and a slow, bounding pulse. As your partner maintains manual in-line stabilization of her head, you should:
immediately place her on a long backboard and prepare for rapid transport.
apply 100% oxygen via a nonrebreathing mask and obtain baseline vital signs.
instruct your partner to assist her with ventilations instead while you perform a rapid assessment.
perform a focused secondary assessment of the patient’s head and neck.

A

instruct your partner to assist her with ventilations instead while you perform a rapid assessment.

356
Q

Following a head injury, a 20-year-old female opens her eyes spontaneously, is confused, and obeys your commands to move her extremities. You should assign her a GCS score of:
13.
15.
12.
14.

A

14

357
Q

In which of the following situations would the EMT be the least likely to immobilize a patient’s spine:
Pain to the c-spine, but no numbness or tingling.
No spinal pain, but tingling in the extremities.
No distracting injuries or evidence of intoxication.
Unresponsive, but moving all extremities equally.

A

No distracting injuries or evidence of intoxication.

358
Q

Once a cervical collar has been applied to a patient with a possible spinal injury, it should not be removed unless:
lateral immobilization has been applied.
it causes a problem managing the airway.
the patient adamantly denies neck pain.
sensory and motor functions remain intact.

A

it causes a problem managing the airway.

359
Q

Rapid deceleration of the head, such as when it impacts the windshield, causes:
stretching or tearing of the anterior aspect of the brain and compression injuries or bruising to the posterior aspect of the brain.
compression injuries and contusions to the anterior, posterior, and lateral aspects of the brain.
primary impact to the posterior aspect of the brain, resulting in compression injuries, bruising, or torn blood vessels.
compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

A

compression injuries or bruising to the anterior portion of the brain and stretching or tearing to the posterior portion of the brain.

360
Q

The cervical spine is composed of _____ vertebrae:
5
8
7
6.

A

7

361
Q

The five sections of the spinal column, in descending order, are the:
coccygeal, sacral, lumbar, thoracic, and cervical.
cervical, coccygeal, thoracic, sacral, and lumbar.
thoracic, cervical, lumbar, coccygeal, and sacral.
cervical, thoracic, lumbar, sacral, and coccygeal.

A

cervical

362
Q

The most important immediate treatment for patients with a head injury, regardless of severity, is to:
establish an adequate airway.
immobilize the entire spine.
transport to a trauma center.
administer high-flow oxygen.

A

establish an adequate airway.

363
Q

The most reliable sign of a head injury is:
a pulse that is rapid and thready.
a decreased level of consciousness.
decreased sensation in the extremities.
an abnormally low blood pressure.

A

a decreased level of consciousness.

364
Q

When activated, the sympathetic nervous system produces all of the following effects, except:
shunting of blood to vital organs.
pupillary constriction.
increase in heart rate.
dilation of the bronchiole smooth muscle.

A

pupillary constriction.