Chapter 28, 8, 35, 36, 37 Flashcards
1
Q
1) The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive is:
A) acute renal failure. B) end-stage renal disease. C) hepatic failure. D) terminal kidney disease.
A
B) end-stage renal disease.
2
Q
2) The sensation felt when palpating an arterial-venous fistula or shunt is known as a:
A) bruit. B) frill. C) thrill. D) fluttering.
A
C) thrill
3
Q
3) Which of the following is the most accurate definition of anemia?
A) An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells
B) The loss of the kidneys’ ability to filter the blood and remove toxins and excess fluid from the body
C) The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys
D) A lack of a normal number of red blood cells in the circulation
A
D) A lack of a normal number of red blood cells in the circulation
4
Q
4) What is continuous ambulatory peritoneal dialysis?
A) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
B) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered below the level of an abdominal catheter to fill the abdominal cavity and raised above the level of the abdominal catheter to drain the fluid out
C) A mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution
D) A type of dialysis that is performed while walking
A
A) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
5
Q
5) Which of the following abbreviations is not correct?
A) SCA for sickle cell anemia B) RBC for red blood cells
C) WBC for white blood cells D) CAPD for continuous acute peripheral disease
A
D) CAPD for continuous acute peripheral disease
6
Q
6) The blood has many functions critical to a patient’s health. Which of the following is not a function of the blood?
A) Control of bleeding by clotting
B) Delivery of oxygen to the cells
C) Removal and delivery of waste products to organs that provide filtration and removal, such as the kidneys and liver
D) Removal of carbon monoxide from the cells
A
D) Removal of carbon monoxide from the cells
7
Q
7) What is the purpose of the red blood cells?
A) They are responsible for the delivery of oxygen to the cells.
B) They are responsible for the removal of oxygen from the cells.
C) They are critical in response to infection and are mediators of the body’s immune response.
D) They are crucial in the formation of clots.
A
A) They are responsible for the delivery of oxygen to the cells.
8
Q
8) Which of the following medications does not interfere with the blood-clotting process?
A) Acetaminophen B) Warfarin C) Aspirin D) Clopidogrel
A
A) Acetaminophen
9
Q
9) You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history of:
A) sickle cell anemia. B) taking blood thinners. C) high blood pressure. D) poorly controlled diabetes.
A
B) taking blood thinners.
10
Q
10) Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping (called aggregation) of platelets is the body’s most rapid response to stop bleeding from an injured site. However, in some situations the clumping of platelets is not desirable, such as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets is: A) aspirin. B) plasma. C) hemoglobin. D) acetaminophen.
A
A) aspirin.
11
Q
11) Certain drugs are commonly referred as “blood thinners” or drugs that inhibit clotting. Which of the following would not be considered such a drug? A) Coumadin (warfarin) B) Lovenox (enoxaparin) C) Aspirin D) Prilosec
A
D) Prilosec
12
Q
12) Which of the following organs may be seriously damaged in sickle cell anemia, subsequently leading to severe infections? A) Lungs B) Kidneys C) Liver D) Spleen
A
D) Spleen
13
Q
13) ________ patients are at high risk for acquiring the inherited disorder called sickle cell anemia.
A) Native American B) African American C) Eastern European D) Hispanic
A
B) African American
14
Q
14) Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may occasionally experience ________, causing a blockage of small blood vessels.
A) sludging B) aggregation C) clotting D) clumping
A
A) sludging
15
Q
15) You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing:
A) anxiety disorder. B) chronic anemia. C) sickle cell anemia. D) acute anemia.
A
B) chronic anemia
16
Q
16) A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in short, shallow respirations. However, the patient’s oxygen saturation via pulse oximetry is 100% on room air. The best approach regarding supplemental oxygen is to:
A) do nothing; no supplemental oxygen is necessary. B) place the patient on a nonrebreather mask.
C) place the patient on a nasal cannula. D) place the patient on a simple face mask.
A
B) place the patient on a nonrebreather mask.
17
Q
17) Patients with a history of chronic sickle cell anemia (SCA) may present with which of the following signs and symptoms?
A) Bluish discoloration of the skin and shortness of breath B) Yellowing of the skin and dyspnea on exertion
C) Flushed appearance and shortness of breath D) Pale appearance and dyspnea on exertion
A
B) Yellowing of the skin and dyspnea on exertion
18
Q
18) You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should:
A) administer high-concentration oxygen. B) monitor for signs of inadequate respiration.
C) be prepared to treat for shock if he also has a high fever.
D) treat the patient as any other 52-year-old with chest pain.
A
D) treat the patient as any other 52-year-old with chest pain.
19
Q
19) What is one of the most common diseases to affect the renal and urinary system?
A) Urinary tract infections B) Acute renal failure C) End-stage renal disease D) Kidney stones
A
A) Urinary tract infections
20
Q
20) The kidney’s major function(s) include(s):
A) maintaining blood volume. B) balancing electrolytes. C) excreting urea. D) All of the above
A
D) All of the above
21
Q
21) Which of the following pathologies put patients at high risk for acute renal failure?
A) Polycystic kidney disease B) Shock C) Uncontrolled diabetes D) Hypertension
A
B) Shock
22
Q
22) You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 days. The 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of disorientation, nausea, and vomiting. What do you think is the underlying cause for the illness?
A) Chronic renal failure B) End-stage renal disease
C) Acute renal failure D) Gastrointestinal infection
A
C) Acute renal failure
23
Q
23) Approximately how many Americans are currently on some type of dialysis?
A) 200,000 B) 900,000 C) 100,000 D) 450,000
A
D) 450,000
24
Q
24) Approximately what percentage of United States dialysis patients treat themselves at home?
A) 50 percent B) 8 percent C) 25 percent D) 16 percent
A
B) 8 percent
25
25) Hemodialysis is used to help the kidneys filter ________ and remove excess ________.
A) electrolytes; hormones B) urine; poisons C) blood; cholesterol D) toxins; fluids
D) toxins; fluids
26
26) Peritoneal dialysis allows patients to dialyze at home through:
A) a dialysis machine. B) the abdomen. C) an AV fistula. D) the urethra.
B) the abdomen
27
27) What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis called?
A) Exchange B) Set C) Rotation D) Trade
A) Exchange
28
28) How long does a typical hemodialysis treatment last?
A) 7 to 8 hours B) 3 to 4 hours C) 1 to 2 hours D) 10 to 12 hours
B) 3 to 4 hours
29
29) How many times per week do the majority of American hemodialysis patients receive treatment?
A) Five B) Three C) Seven D) One
B) Three
30
30) There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is:
A) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.
B) hemodialysis is usually done at home and peritoneal dialysis is usually done at a special facility.
C) hemodialysis filters the blood and peritoneal dialysis filters the urine.
D) hemodialysis filters the urine and peritoneal dialysis filters the blood.
A) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.
31
31) How frequently is peritoneal dialysis treatment required?
A) Three to five times per week B) Once a day C) Multiple treatments per day D) Once a week
C) Multiple treatments per day
32
32) Patients who dialyze at home are at high risk for what type of infection?
A) Peritonitis B) Decubitus ulcers C) Cellulitis D) Fistula infection
A) Peritonitis
33
33) You are dispatched to a private residence for a sick person. You arrive and find a 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the tell-tale sign that this is what is happening in this case?
A) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.
B) The patient's dialysis fluid appears clear when it is drained from the peritoneal cavity rather than having its normal cloudy appearance.
C) The patient has trouble urinating. D) The patient has swollen ankles.
A) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance.
34
34) Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________. A) blood clots; COPD B) high cholesterol; cerebral aneurysms
C) heart failure; stroke D) hypertension; diabetes
D) hypertension; diabetes
35
35) Dialysis patients who have missed an appointment may present with signs of ________, which is a similar presentation to ________.
A) fluid accumulation; congestive heart failure B) shortness of breath; pneumonia
C) chest pain; acute myocardial infarction D) neurological disturbances; stroke
A) fluid accumulation; congestive heart failure
36
36) One of the more serious diseases of the body is renal failure. Renal failure occurs when the:
A) adrenal glands stop working. B) kidneys fail to function as required.
C) liver fails to function properly. D) pancreas stops working.
B) kidneys fail to function as required.
37
37) A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the electrolyte:
A) phosphorous. B) potassium. C) sodium. D) calcium.
B) potassium
38
38) You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis. Which of the following statements is most accurate?
A) Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED.
B) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.
C) Calling for ALS would not be very helpful because they cannot really do anything that an EMT cannot do in these situations.
D) You should delay transport if necessary to wait for ALS.
B) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED.
39
39) You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic, the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and initiate chest compressions. However, the patient's cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is to:
A) call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts.
B) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure.
C) run a "no-electricity" code in which compressions and ventilation are continued. No additional defibrillations are necessary.
D) continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations.
B) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure.
40
40) Once you encounter uncontrolled bleeding from an AV fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and elevation?
A) Internal wound management B) Tourniquet C) Hemostatic dressings D) Pressure points
C) Hemostatic dressings
41
41) You are dispatched to a private residence for a sick person. When you arrive, you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would not be part of your care?
A) Assess the ABCs.
B) When you obtain vital signs, obtain a blood pressure on an arm that does not have a fistula.
C) Place the patient in a supine position.
D) Administer oxygen at 15 lpm by nonrebreather mask.
C) Place the patient in a supine position.
42
42) The most frequently transplanted organ is the: A) liver. B) heart. C) kidney. D) pancreas.
C) kidney.
43
43) The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility of: A) infection. B) renal failure. C) ulcers. D) congestive heart failure.
A) infection.
44
44) Under which of the following circumstances do the kidneys help the body retain fluid?
A) Electrolyte imbalance B) Kidney stones C) Dehydration D) Urinary tract infection
C) Dehydration
45
1) When you place your finger in an infant's palm, she grasps it with her fingers. This is an example of which reflex?
A) Sucking B) Palmar C) Rooting D) Moro
B) Palmar
46
2) Which of the following is the feeling infants get when they know all their needs will be met?
A) Scaffolding B) Bonding C) Trust D) Moro reflex
B) Bonding
47
3) Infancy is defined as the stage of life from birth to:
A) 9 months. B) 18 months. C) 15 months. D) 12 months.
D) 12 months.
48
4) When you startle a 4-month-old, he throws his arms out, spreads his fingers, then grabs with his fingers and arms. The reaction is known as the: A) rooting reflex. B) startle reflex. C) Moro reflex. D) scaffolding reflex.
C) Moro reflex.
49
5) A 26-month-old toddler is reported to have fallen and lacerated his chin. His mother did not witness the fall. As you proceed through your assessment, your partner reports that she's concerned about his heart rate, which she measures as 64. She's checked it twice. Your knowledge of normal vital signs for a patient this age suggests that his heart rate is: A) too slow. B) too fast. C) within normal range. D) not reliable.
A) too slow
50
6) At which of the following stages is toilet-training most likely to begin?
A) Preschool age B) Infant C) Toddler D) School age
C) Toddler
51
7) Which of the following would be a normal set of vitals for a 4-year-old male patient?
A) Heart rate 140/minute, respiratory rate 30/minute, and systolic blood pressure of 60 mmHg
B) Heart rate 100/minute, respiratory rate 44/minute, and systolic blood pressure of 100 mmHg
C) Heart rate 60/minute, respiratory rate 24/minute, and systolic blood pressure of 96 mmHg
D) Heart rate 110/minute, respiratory rate 24/minute, and systolic blood pressure of 98 mmHg
D) Heart rate 110/minute, respiratory rate 24/minute, and systolic blood pressure of 98 mmHg
52
8) What is a normal heart rate for a school age child?
A) 90-160/minute B) 80-140/minute C) 70-120/minute D) 65-120/minute
D) 65-120/minute
53
9) The transition from childhood to adulthood is known as which of the following?
A) Transitional B) Young adult C) Adolescence D) Early adulthood
C) Adolescence
54
10) During which age group is the body in peak physical condition?
A) Preschool B) Adolescence C) Early adult D) Middle adult
C) Early adult
55
11) Middle adulthood is the stage of life from ________ to ________ years.
A) 35; 55 B) 35; 65 C) 41; 60 D) 31; 60
C) 41; 60
56
12) Which of the following stages is commonly referred to as "the twilight years"?
A) Middle adulthood B) Late adulthood C) Adolescence D) Early adulthood
) Late adulthood
57
13) Which of the following is not a common psychosocial challenge of late adulthood?
A) Self-destructive behaviors B) Concern about death and dying
C) Financial burdens D) Issues of self-worth
A) Self-destructive behaviors
58
14) Which of the following is the term used to describe an infant's reaction to his environment?
A) Attitude B) Bonding C) Personality D) Temperament
D) Temperament
59
15) Patients in late adulthood are likely to face which of the following challenges?
A) Self-worth B) Hygiene C) Tax burden D) All of the above
A) Self-worth
60
16) Patients in which age group tend to be very concerned with body image?
A) School age B) Adolescence C) Middle adulthood D) Early adulthood
B) Adolescence
61
17) What is the stage of development where there are several physiological and psychosocial changes, second only to those seen in infancy or adolescence?
A) Late adulthood B) Middle adulthood C) Toddler D) Preschool age
A) Late adulthood
62
18) You are assessing a 6-month-old female patient who, according to the parents, is not acting normally. At this stage of development, the patient should be able to do which of the following?
A) Sit alone on the floor B) Sit upright in a high chair C) Sleep D) Respond to the word "no"
B) Sit upright in a high chair
63
19) You are assessing a female patient with depression. She tells you that her psychologist said that she is dealing with "empty-nest syndrome." What age group is this associated with?
A) Middle adulthood B) Middle-aged adulthood C) Late adulthood D) Early adulthood
A) Middle adulthood
64
20) In which age group do you anticipate seeing patients who have less efficient cardiovascular systems and a reduction of previous blood volume? A) Infancy B) Late adulthood C) Early adulthood D) Middle adulthood
B) Late adulthood
65
21) You are assessing a 12-year-old male patient who has been involved in a bicycle accident. This patient would be classified as being in which stage of life? A) Middle school age B) School age C) Adolescence D) Junior school age
B) School age
66
22) You have been dispatched to a shopping mall to assess a 1-month-old female patient that tumbled out of her stroller while her mother was shopping. Upon your arrival, the baby is awake, alert, and happily smiling and cooing at her mom. The mother reports that the child did not appear to suffer any injuries as a result of the fall. As you assess the patient and place your finger in her hand, she grasps it tightly. This is known as the:
A) sucking reflex. B) Moro reflex. C) palmar reflex. D) rooting reflex.
C) palmar reflex.
67
23) Your 4-month-old patient is reported to be irritable and lethargic after feeding poorly for two days. One method for assessing the patient's level of hydration is to look at one of the soft spots on the surface of the skull. This soft spot is known as the: A) anterior fontanelle. B) acromion process. C) mandibles. D) carpals.
A) anterior fontanelle.
68
24) You have been called to a private residence where a 16-year-old female patient is reported by her parents to be "acting strangely" and possibly "on something." Upon your arrival, the patient is locked in her bedroom refusing to open the door. The patient refuses to speak to you and will only come out if her best friend is present. Your knowledge of life-span development indicates that the following characteristics are common with a patient of this age.
A) Depression and suicide B) Preoccupation with body image
C) Self-destructive behaviors such as tobacco, alcohol, and drug use D) All of the above
D) All of the above
69
25) Your 89-year-old male patient has called for help because he almost passed out after bringing in his garbage cans from the curb. The patient lives alone and says that he became panicked when he started feeling so lightheaded and dizzy. Patients in this age group often undergo all of the following changes to their health except:
A) a decrease in blood volume. B) an increase in metabolism.
C) sleep-wake cycle disruption. D) deterioration of the respiratory system.
B) an increase in metabolism.
70
26) You are caring for a 4-month-old male patient who is reported to have vomited five times today. His parents describe no other associated symptoms or complaints. The patient is lying on the couch with a pacifier in his mouth, smiling at you. Developmentally, you would expect a patient of this age to be able to:
A) sit up without assistance. B) drool without swallowing.
C) say the word "no." D) have attachment anxiety or fear strangers.
B) drool without swallowing.
71
1) In which of the following situations would a person lose heat by conduction?
A) Sitting on cold metal bleachers at a football game B) Wearing wet clothing in windy weather
C) Breathing D) Going outside without a coat during a cold but calm day
A) Sitting on cold metal bleachers at a football game
72
2) Which of the following is the process in which heat is lost from the body as wind passes over it?
A) Convection B) Hydrodynamic cooling C) Exposure D) Condensation
A) Convection
73
3) Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming.
A) central B) active C) passive D) peripheral
B) active
74
4) A patient who is lying on cold ground is losing the most amount of heat by what mechanism?
A) Radiation B) Convection C) Conduction D) Shivering
C) Conduction
75
5) In which of the following ways does the body produce heat in response to being cold?
A) Excreting more urine B) Burning fewer calories C) Shivering D) Increasing the respiratory rate
C) Shivering
76
6) What is a common sign or symptom of high-altitude cerebral edema?
A) Paresthesia B) Altered mental status C) Peripheral edema D) Nosebleed
B) Altered mental status
77
7) Most radiant heat is lost through which part(s) of the body?
A) Hands and feet B) Head and neck C) Buttocks D) Torso
B) Head and neck
78
8) When the body is in water, how many times faster does it lose heat than when it is in still air?
A) 2 B) 100 C) 10 D) 25
D) 25
79
9) Which of the following terms describes the temperature of the surrounding air?
A) Wind chill B) Shell temperature C) Core temperature D) Ambient temperature
D) Ambient temperature
80
10) Which of the following does not make infants and children more prone to hypothermia?
A) Inefficient metabolism B) Large body surface area C) Small muscle mass D) Little body fat
A) Inefficient metabolism
81
11) For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups? A) Faster metabolism B) Increased body mass
C) Inadequate salt intake D) Poor ability to regulate body temperature
D) Poor ability to regulate body temperature
82
12) Why are infants and young children more prone to hypothermia than adults?
A) Their immune system is not fully developed. B) They are unable to recognize how cold they are.
C) They shiver more than adults. D) They have less fat than adults.
D) They have less fat than adults.
83
13) In mild cases, what may overcome acute mountain sickness?
A) Rest and rehydration at altitude B) Moving the patient to a higher altitude
C) Positive-pressure ventilations D) Vigorous exercise
A) Rest and rehydration at altitude
84
14) Which of the following signs would you least expect to see in a patient suffering from severe hypothermia?
A) Numbness B) Heavy shivering C) Drowsiness D) Skin cool to the touch
B) Heavy shivering
85
15) Which of the following would you expect to see in a patient with severe hypothermia?
A) Irrational behavior B) Loss of muscle tone C) Rapid respirations D) Tachycardia
A) Irrational behavior
86
16) Why is it important to remove constricting items such as rings before thawing a frozen extremity?
A) Because thawed areas often swell B) To prevent damage to the property such as rings and watches
C) Because thawing leaves clots behind in the veins D) All of the above
A) Because thawed areas often swell
87
17) Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following? A) Core rewarming B) Passive rewarming C) Active rewarming D) Natural rewarming
B) Passive rewarming
88
18) Which of the following is acceptable when actively rewarming a hypothermic patient?
A) Encouraging the patient to exercise B) Giving the patient hot coffee
C) Warming the patient as quickly as possible D) Avoid rewarming the limbs
D) Avoid rewarming the limbs
89
19) When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ °F. A) 115 B) 100 C) 85 D) 80
B) 100
90
20) The technique for central rewarming requires the application of heat to which of the following areas of the patient's body? A) Chest, back, neck, and armpits B) Lateral chest, neck, armpits, and groin
C) Head, neck, chest, and back D) Head, neck, chest, and groin
B) Lateral chest, neck, armpits, and groin
91
21) To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body? A) Forehead B) Cheek C) Abdomen D) Inner wrist
C) Abdomen
92
22) Why is it important to keep patients at rest when they are hypothermic?
A) Because the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raise the core body temperature.
B) Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure.
C) Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.
D) None of the above.
C) Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.
93
23) You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient?
A) Allow the patient to warm up inside the ambulance by passive rewarming measures.
B) Place the patient inside the ambulance and begin active rewarming measures.
C) Warm the affected areas with gentle rubbing.
D) Tell the patient that his condition is superficial and allow him to return to the game.
A) Allow the patient to warm up inside the ambulance by passive rewarming measures.
94
24) You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search-and-rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is to:
A) gently bandage the digits. B) actively rewarm the digits.
C) gently warm the digits by slowly massaging them.
D) keep the digits frozen on ice until they can be properly rewarmed at the hospital.
A) gently bandage the digits.
95
25) You respond to the scene of a 14-year-old patient found outside in a cold environment. He is unresponsive and hypothermic. Emergency Medical Responders have moved the patient inside and secured the airway prior to your arrival. What is your next action?
A) Vigorously rub the patient to increase the body temperature. B) Actively rewarm the patient.
C) Passively rewarm the patient. D) Assess for signs of frostbite and treat immediately.
C) Passively rewarm the patient.
96
26) In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?
A) Contact medical control for input into the best treatment for this patient.
B) Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death.
C) Check distal CSM, apply warming packs to the extremities, and transport the patient.
D) Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.
D) Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.
97
27) In a hypothermic patient the coldest blood is found in what part of the patient's body?
A) Intestines B) Heart and lungs C) Head D) Extremities
D) Extremities
98
28) You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt but does not have pants on. His skin feels cold to the touch. The week's temperatures have not been above 50°F. Which of the following should you do immediately after ensuring the patient has an adequate airway? A) Apply the AED. B) Provide manual stabilization of the cervical spine.
C) Begin passive rewarming. D) Check the carotid pulse.
D) Check the carotid pulse.
99
29) Rough handling of a patient with severe hypothermia may result in which of the following?
A) Ventricular fibrillation B) Seizures C) Heart attack D) Rewarming shock
A) Ventricular fibrillation
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30) In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long? A) at least 60 seconds B) 20 to 30 seconds C) at least 10 seconds D) 15 to 20 seconds
A) at least 60 seconds
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31) Which of the following is not a classification of localized cold injury?
A) Hypothermia B) Frostbite C) Frostnip D) All of the above
A) Hypothermia
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32) The term gangrene means localized tissue:
A) swelling. B) discoloration. C) infection. D) death.
D) death.
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33) Localized cold injury occurs due to vasoconstriction and:
A) chemical imbalance in the tissues. B) blood clots. C) ice crystal formation in the tissues. D) loss of calcium.
C) ice crystal formation in the tissues.
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34) Which of the following best describes a localized cold injury with a clear line of demarcation of its limits?
A) Early frostnip B) Late frostbite C) Hypothermia D) Deep frostnip
A) Early frostnip
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35) The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors? A) White B) Blue or purple C) Red D) Black
A) White
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36) Which of the following should the EMT do during the treatment of localized cold injury?
A) Encourage the patient to use the affected part. B) Rub the affected area with snow.
C) Massage the affected area. D) Gradually warm the affected area.
D) Gradually warm the affected area.
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37) Your patient is a 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this patient?
A) Break blisters before wrapping both feet in sterile dressings.
B) Keep the patient cool to avoid rewarming the feet too quickly.
C) Gradually rewarm both feet. D) Massage the feet briskly.
C) Gradually rewarm both feet.
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38) Which of the following describes the condition of having an abnormally high body temperature?
A) Hyperthermia B) Heat exhaustion C) Perspiration D) Heat shock
A) Hyperthermia
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39) Heat cramps occur due to loss of which of the following substances?
A) Water B) Salt C) Magnesium D) Water and potassium
B) Salt
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40) You respond to a professional volleyball tournament for a potential heat stroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping? A) Heat exhaustion B) Drinking too many sports drinks
C) Sweating too much D) Cooling off too quickly
C) Sweating too much
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41) Heat stroke is caused by which of the following mechanisms?
A) Blockage of blood flow to the brain B) Extreme dilation of all the blood vessels
C) Failure of temperature regulation mechanisms D) Heat-induced swelling of brain tissue
C) Failure of temperature regulation mechanisms
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42) Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?
A) Have the patient stand outside the ambulance and slowly drink an electrolyte solution or sports drink.
B) Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask.
C) Give oxygen by nonrebreather mask and have the patient rest, monitoring the patient's improvement over time at the scene.
D) Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.
D) Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.
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43) You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and moist, and his shirt is wet with visible salt rings. You suspect:
A) heat cramps. B) heat stroke. C) heat exhaustion. D) myocardial infarction.
C) heat exhaustion
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44) You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is hot to the touch and dry, but his shirt is wet with visible salt rings. Which is the best treatment for the patient?
A) Apply high-concentration oxygen and rapidly transport to the nearest medical facility.
B) Have the patient sip water slowly to replace what he has lost.
C) Cool the patient with tepid water.
D) Have the patient drink at least 1 liter of water to replace what he has lost.
A) Apply high-concentration oxygen and rapidly transport to the nearest medical facility.
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45) When submerged in water, biological death may be delayed if the water temperature is below ________°F.
A) 70 B) 98.6 C) 50 D) 32
A) 70
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46) Regarding drowning in adults, which of the following statements is true?
A) Colder water improves survival chances in saltwater drowning but not in freshwater drowning.
B) Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.
C) The colder the water, the better the chances of survival in either saltwater or freshwater drowning.
D) The warmer the water, the better the chances of survival in saltwater drowning.
C) The colder the water, the better the chances of survival in either saltwater or freshwater drowning.
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47) Which of the following is often associated with water-related emergencies?
A) Hypothermia B) Cardiac arrest C) Alcohol use D) All of the above
D) All of the above
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48) You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find a 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are cervical spine precautions necessary?
A) The patient may have suffered a spinal injury by jumping in shallow water.
B) The patient may have suffered a cervical spine injury when pulled out of the water.
C) The patient may have been using the diving board after all and injured his cervical spine.
D) The patient may have hit his head on the side wall while swimming laps.
A) The patient may have suffered a spinal injury by jumping in shallow water.
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49) You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect?
A) Myocardial infarction B) Decompression sickness C) Air embolism D) Near drowning
C) Air embolism
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50) You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first action?
A) Insert an oropharyngeal airway. B) Transport the patient.
C) Place the patient on high-concentration oxygen by nonrebreather mask. D) Suction the airway.
D) Suction the airway.
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51) Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream?
A) Arterial thrombosis B) Arterial blood gases C) Hyperbaric arterial injury D) Arterial gas embolism
D) Arterial gas embolism
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52) Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive?
A) Arterial gas embolism B) Pulmonary embolism C) Decompression sickness D) Myocardial infarction
C) Decompression sickness
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53) Which of the following increases a scuba diver's risk of decompression sickness?
A) Taking cold or sinus medications before a dive B) Flying within several hours after a dive
C) Diving on a full stomach D) Breathing 100% oxygen before a dive
B) Flying within several hours after a dive
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54) You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?
A) Decompression sickness B) The bends C) Air embolism D) Pnemothorax
C) Air embolism
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55) You respond to a boat dock for a diving injury. You find a 22-year-old female patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when she unexpectedly came out of the water complaining of chest pains and then collapsed. The nearest hospital is 25 minutes away and the nearest specialty resource center with a hyperbaric chamber is 30 minutes away. What is the best decision when determining transport?
A) Transport the patient by ground to the specialty center.
B) Transport the patient by air medical to the specialty center.
C) Transport the patient to the nearest facility.
D) Transport the patient by air medical to the nearest facility.
A) Transport the patient by ground to the specialty center.
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56) You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do not know how to swim or consider yourself a poor swimmer, which of the following should you do first?
A) Row the boat out to the swimmer. B) Use the buoy to float out to the swimmer.
C) Find someone who can swim to try to swim out and save the swimmer.
D) Call for help and try to throw the buoy to the swimmer.
D) Call for help and try to throw the buoy to the swimmer.
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57) To rescue someone who has fallen through the ice, which of the following is the safest device to use?
A) Jet-ski B) Flat-bottomed aluminum boat C) Ladder D) Ring buoy
B) Flat-bottomed aluminum boat
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58) Which of the following can cause a wound with a characteristic lesion with a bite that is often painless?
A) Brown recluse spider B) Scorpion C) Hornet D) Black widow spider
A) Brown recluse spider
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59) Which of the following is acceptable in the management of a patient stung by a honey bee?
A) Treat for shock if you see signs it is developing. B) Take care not to pull the stinger out using tweezers.
C) Remove jewelry from any affected limbs. D) Encourage the patient to move around.
C) Remove jewelry from any affected limbs.
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60) You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states the patient is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment plan?
A) Place a constricting band around the arm to minimize the spread of the venom.
B) Assist the patient in administering her epinephrine auto-injector.
C) Treat the patient for shock and transport. D) Place the patient in the Trendelenburg position.
C) Treat the patient for shock and transport.
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61) You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is "really sick." As you approach, you notice that the patient appears to be in obvious distress and is diaphoretic and holding his right wrist. Which of the following is your highest priority?
A) Perform a primary assessment and identify any potential life threats.
B) Confirm the type of snake and contact medical control for specific instructions.
C) Immediately apply a constricting band to minimize the spread of the venom.
D) Confirm the location and status of the snake.
D) Confirm the location and status of the snake.
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62) Where should constricting bands be placed to reduce lymphatic flow after a venomous snake bite?
A) Directly over the bite B) 4 inches above and below the bite
C) 2 inches above and below the bite D) None of the above
C) 2 inches above and below the bite
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63) The purpose of a constricting band after a venomous snake bite is to impede the spread of which of the following? A) Lymph B) Arterial blood C) Venom D) Both A and C
C) Venom
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64) Of the following venomous snakes, which one usually has the highest incidence of a "dry bite"?
A) Coral snake B) Water moccasin C) Rattlesnake D) Copperhead
A) Coral snake
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65) Which of the following could worsen the effects of a snake bite?
A) Application of ice B) Cutting and suctioning out the venom
C) Constricting bands above and below the bite D) Having the patient lie still
A) Application of ice
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66) Which of the following types of snake is not a pit viper?
A) Water moccasin B) Rattlesnake C) Coral snake D) Copperhead
C) Coral snake
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67) Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following? A) Sterile saline solution B) Gasoline or kerosene C) Cold water D) Vinegar
D) Vinegar
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1) Which of the following best describes the term crowning?
A) Complete dilation of the cervix B) Presenting part of the baby being visible at the vaginal opening
C) Delivery of the head during a breech birth, completing delivery D) Discharge of bloody mucus
B) Presenting part of the baby being visible at the vaginal opening
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2) Which of the following describes a breech presentation?
A) The infant presents buttocks first. B) The infant presents with both feet first.
C) The infant presents face first. D) Both A and B
D) Both A and B
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3) Which of the following best describes placenta previa?
A) The placenta prematurely separates from the uterine wall.
B) The pregnancy is lost before the 20th week of gestation.
C) The umbilical cord is the presenting part.
D) The placenta is implanted over the opening of the cervix.
D) The placenta is implanted over the opening of the cervix.
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4) The condition in which the placenta separates from the uterine wall is known as which of the following?
A) Abruptio placentae B) Placenta previa C) Ectopic pregnancy D) Preeclampsia
A) Abruptio placentae
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5) You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8 months pregnant and has moderate, bright red bleeding with no abdominal pain. She says that her doctor was concerned about the location of the placenta. This condition is known as:
A) placenta disruption. B) abruptio placentae. C) unstable placenta. D) placenta previa.
D) placenta previa.
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6) The term for a baby developing inside the mother's womb after 8 weeks is:
A) infant. B) embryo. C) fetus. D) neonate.
C) fetus
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7) The muscular organ in which a baby develops during pregnancy is called the:
A) fetal membrane. B) placenta. C) uterus. D) amniotic sac.
C) uterus.
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8) What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients? A) Cervix B) Uterus C) Amnion D) Placenta
D) Placenta
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9) You are called for a woman who is about to deliver. During the labor process, your patient's water breaks. She experiences a rush of amniotic fluid and an increase in uterine contractions. The purpose of this amniotic fluid is to:
A) provide lubrication during the delivery of the baby. B) help maintain a constant fetal body temperature.
C) allow the fetus to float during development. D) All of the above
D) All of the above
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10) Which of the following describes the normal appearance of amniotic fluid?
A) A fluid containing blood and mucus B) Thin fluid, greenish-yellow in color
C) Clear and colorless fluid D) Thick fluid, greenish-black in color
C) Clear and colorless fluid
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11) By which of the following means does the fetal blood pick up nourishment from the mother?
A) Direct circulation B) Indirect circulation C) Diffusion D) Osmosis
C) Diffusion
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12) The muscle contraction mechanism that moves an egg down the fallopian tube toward the uterus is the same mechanism that moves:
A) air down the bronchial tubes to the alveoli. B) fluid into and out of the cell.
C) sweat to the surface of the skin. D) food from the esophagus to the stomach.
D) food from the esophagus to the stomach.
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13) Which of the following is true regarding a pregnant woman?
A) Her pulse rate should be lower than normal.
B) Her respirations usually remain the same during pregnancy.
C) Her blood pressure is usually higher during pregnancy.
D) Diabetes may be made worse during pregnancy.
D) Diabetes may be made worse during pregnancy.
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14) Which of the following may result from a woman in her third trimester of pregnancy lying in a supine position?
A) Fetal compromise B) Maternal hypotension
C) Maternal compensation for a decrease in blood pressure D) All of the above
D) All of the above
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15) Supine hypotensive syndrome is easily prevented by transporting all third-trimester patients in which of the following positions?
A) Supine with the head lower than the hips B) Lying on the left side
C) On the hands and knees with the hips elevated D) Tilted slightly onto the right side
B) Lying on the left side
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16) You have been called for a young female in labor. She is lying on the floor in obvious distress from labor pains. While you are assessing her for crowning, your partner is getting a set of vital signs. She tells you that she is getting dizzy and nauseated. Vital signs are pulse rate 120, respiratory rate 22, and blood pressure 98/62. You should be concerned that she has:
A) contracted food poisoning. B) supine hypotensive syndrome.
C) Braxton-Hicks contractions. D) placenta previa
B) supine hypotensive syndrome.
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17) During which stage of labor is the baby born?
A) Primary B) First C) Second D) Third
C) Second
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18) Which of the following best describes the events that occur during the first stage of labor?
A) Rupture of the amniotic sac B) Expulsion of the fetus through the birth canal
C) Expulsion of the placenta D) Thinning and dilation of the cervix
D) Thinning and dilation of the cervix
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19) You are assessing a patient in labor. Her contractions are 2 minutes apart, lasting 30 seconds with increasing pain. She states that she does not yet feel the urge to push. These signs indicate she has reached which stage of delivery? A) Third stage B) Second stage C) Fourth stage D) First stage
D) First stage
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20) You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks you to wait because she feels the need to use the bathroom. Which of the following is the best course of action?
A) Tell the patient she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital.
B) Advise the patient that this could be a sign of a serious complication, have her lie on her left side, apply high-concentration oxygen, and transport immediately.
C) Allow the patient to use the bathroom because it will make transport and delivery more comfortable.
D) Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible.
D) Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible.
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21) Which of the following is not relevant in determining whether or not delivery is imminent for a woman in labor?
A) Determining whether the patient feels as if she needs to move her bowels
B) Finding out how many times the patient has been pregnant
C) Phoning the patient's obstetrician for advice D) Asking how long ago the contractions began
C) Phoning the patient's obstetrician for advice
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22) Which of the following is an appropriate question to ask while evaluating a woman in labor?
A) Do you know who the father is and his medical history? B) When was the last time you were sexually active?
C) Is this your first pregnancy? D) None of the above
C) Is this your first pregnancy?
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23) When delivering a baby, you should do all of the following except:
A) have someone stay at the mother's head if possible. B) suction the mouth first, then the nose.
C) place your fingers in the armpit to assist with delivery by pulling on the baby.
D) position your gloved hands at the vaginal opening.
C) place your fingers in the armpit to assist with delivery by pulling on the baby.
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24) You have been called for a 32-year-old female who is in active labor. During your assessment and interview, you note that she is 37 weeks along, this is her first child, and her contractions are 5 minutes apart. She also tells you that her pregnancy is considered "high risk." Your first concern should be:
A) assembling your delivery kit. B) calling for a back-up unit.
C) getting to the hospital. D) preparing for the delivery.
C) getting to the hospital.
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25) You respond to a call for a patient in active labor with her second child. Your interview with the patient shows that she is 40 weeks pregnant and has been in active labor for several hours. You determine that her vital signs are all within normal limits. After your physical exam, you determine the baby is crowning. You should next:
A) begin transport and plan to deliver in the ambulance. B) prepare to deliver the baby on-scene.
C) delay delivery until arrival at the hospital. D) contact medical direction for orders.
B) prepare to deliver the baby on-scene.
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26) You have responded to a woman who has possible premature labor. She is 8 months pregnant and is experiencing labor pains. During your assessment, you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You should next:
A) time her contractions. B) complete a set of vital signs.
C) check for cervical dilation. D) check the level of the fundus.
A) time her contractions.
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27) Which of the following is the correct way to time the frequency of contractions in the pregnant woman?
A) From the beginning of a contraction to the end of the same contraction
B) From the end of one contraction to the beginning of the next
C) From the beginning of one contraction to the beginning of the next
D) After counting the number of contractions in a 15-minute period, multiply by 4
C) From the beginning of one contraction to the beginning of the next
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28) You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is, by your estimation, about 8 months pregnant. She tells you that she has been hiding her pregnancy. You are especially concerned about problems she might have during the delivery. Which of the following are findings indicate that there may be a need for neonatal resuscitation?
A) The mother has a blood pressure of 130/82. B) The mother does not intend to breastfeed.
C) The mother has not had prenatal care. D) The mother's water has already broken.
C) The mother has not had prenatal care.
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29) You have just delivered a full-term baby girl and she is doing well. You have dried her off and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the following is normally true regarding cutting the umbilical cord?
A) The cord should be cut immediately following delivery.
B) The infant must be breathing on his or her own before you cut the cord.
C) You must try to cut the cord before it stops pulsating.
D) You should hold the baby above the level of the mother when cutting the cord.
B) The infant must be breathing on his or her own before you cut the cord.
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30) Which of the following is not part of a basic obstetrics kit? A) Umbilical cord clamps or hemostats B) Surgical scissors C) Baby blanket D) Packet of suture material
D) Packet of suture material
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31) If assisting in a prehospital delivery while off-duty, which of the following would be the best choice for tying or clamping the umbilical cord?
A) Section of wire coat hanger B) Pair of shoelaces C) White cotton thread D) Clothespin
B) Pair of shoelaces
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32) Which of the following is the correct technique to check for crowning in the assessment of a woman in labor?
A) Ask the woman to "push" or "bear down" as you inspect the vaginal opening.
B) Place your hand on the woman's abdomen, just above the umbilicus, and check for the firmness of the uterus during contractions.
C) Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening. D) None of the above
C) Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening.
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33) When assisting with a delivery in the field, which of the following should be done as the baby's head begins to emerge from the vagina? A) Check for crowning. B) Advise the mother not to push or strain.
C) Apply gentle pressure to the head with your gloved hand. D) Pull on the baby.
C) Apply gentle pressure to the head with your gloved hand.
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34) If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first?
A) Use your fingers to tear the sac away from the baby's face.
B) Leave the sac intact until the entire body is delivered.
C) Use the scissors in the obstetrics kit to cut the sac away from the baby's head.
D) Call medical control before taking action.
A) Use your fingers to tear the sac away from the baby's face.
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35) Which of the following is not advisable following complete birth of the infant?
A) Dry the infant and wrap him in a blanket.
B) Keep the infant at the level of the mother's vagina until the cord is clamped and cut.
C) Place the infant on his side with his head slightly lower than his body.
D) Hold the infant by the ankles to allow the airway to drain.
D) Hold the infant by the ankles to allow the airway to drain.
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36) Which of the following should be done when the infant's head has been delivered?
A) Check to see if the umbilical cord is around the neck. B) Suction the mouth.
C) Suction the nose. D) All of the above
D) All of the above
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37) All of the following are signs of adequate breathing and circulation in the newborn except:
A) heart rate greater than 100. B) relaxation of the extremities.
C) cyanosis of only the hands and feet. D) vigorous crying.
B) relaxation of the extremities.
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38) You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as the head was delivered and again following complete delivery. The infant is not yet breathing. Which of the following is the correct sequence of interventions?
A) Perform a series of back blows and chest thrusts interposed with mouth-to-mouth ventilation.
B) Transport without further intervention.
C) Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse.
D) Begin bag-valve-mask ventilations, suction the airway with a rigid tonsil tip, and begin CPR.
C) Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse.
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39) When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body. A) 3 B) 12 C) 1 D) 7
D) 7
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40) Which of the following conditions should be present before the umbilical cord is cut?
A) The infant is breathing on his or her own. B) The cord is no longer pulsating.
C) The cord is clamped in two places. D) All of the above
D) All of the above
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41) Your patient is an infant who has just been delivered 3 weeks before her due date. She is breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and chest. Which of the following interventions should be done first?
A) Perform ventilations with a bag-valve-mask device and supplemental oxygen.
B) Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute.
C) Begin CPR with a compression rate of 120/minute.
D) Place a neonatal nonrebreather mask on the infant's face.
B) Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute.
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42) You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities. What is the newborn's APGAR score? A) 7 B) 10 C) 9 D) 8
C) 9
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43) Traditionally an APGAR score is taken at what time intervals after birth?
A) 5 and 10 minutes B) 2 and 7 minutes C) 1 and 5 minutes D) 1 and 6 minutes
C) 1 and 5 minutes
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44) Normal maternal blood loss during delivery of an infant usually does not exceed how much?
A) 100 cc B) 250 cc C) 1,000 cc D) 500 cc
D) 500 cc
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45) Which of the following should the EMT do to control maternal bleeding after delivery of the baby?
A) Apply direct pressure with a sanitary napkin over the vaginal opening.
B) Allow the infant to nurse, if possible. C) Massage the uterus until it is firm. D) All of the above
D) All of the above
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46) You have delivered a newborn and wrapped the baby in a dry blanket. During your reassessment of the mother, you note continued moderate vaginal bleeding. Care for this bleeding may involve all of the following except:
A) applying firm pressure with a sanitary napkin over the vaginal opening.
B) massaging the uterus to control bleeding.
C) having the mother squeeze her legs together to provide direct pressure. D) elevating the mother's feet.
C) having the mother squeeze her legs together to provide direct pressure
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47) You respond for an imminent delivery of a baby in the breech position. As you examine the mother, you see that the umbilical cord is protruding from the opening of the cervix. You realize that the most important care you can provide for this baby is to: A) keep the baby off of the cord. B) provide oxygen to the mother.
C) gently push the cord back into the vaginal space. D) wrap the cord to prevent heat loss.
A) keep the baby off of the cord
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48) If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done?
A) Clamp the cord in two places, but do not cut it until the baby is delivered.
B) Try to slip the cord over the baby's head and shoulder.
C) Transport emergently without further intervention. D) Immediately cut the cord before delivering the baby.
B) Try to slip the cord over the baby's head and shoulder.
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49) Which of the following is indicated in the prehospital management of a prolapsed umbilical cord?
A) Immediately clamp the cord in two places and cut it between the clamps.
B) Encourage the mother to push forcefully in order to speed delivery.
C) Use your gloved hand to push the umbilical cord back up through the cervix.
D) Place the mother in a head-down position with pillows under her hips.
D) Place the mother in a head-down position with pillows under her hips.
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50) Which of the following is true concerning prehospital delivery of twins?
A) There are always two placentas.
B) The umbilical cord of the first infant must not be cut until the second infant is born.
C) This is a true emergency and cannot be managed outside the hospital setting without additional help.
D) The infants will probably be smaller than a single infant and special attention should be paid to keeping them warm.
D) The infants will probably be smaller than a single infant and special attention should be paid to keeping them warm.
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51) By definition, a premature infant is one who is born before how many weeks of pregnancy?
A) 40 B) 37 C) 34 D) 28
B) 37
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52) Which of the following is appropriate when caring for a premature baby?
A) Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F
B) Deeply suctioning the airway with a rigid tonsil-tip
C) Applying high-concentration oxygen with a neonatal nonrebreather mask
D) Encouraging family members to hold the infant
A) Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F
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53) An infant's birth weight is considered low if it is less than ________ pounds.
A) 4.5 B) 2.5 C) 5.5 D) 3.5
C) 5.5
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54) Which of the following is true of premature infants?
A) They are at risk for respiratory difficulty. B) They are more susceptible to infection.
C) They can easily develop hypothermia. D) All of the above
D) All of the above
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55) Which of the following is the highest priority for the EMT when delivering an infant with meconium-stained amniotic fluid?
A) Checking for fever
B) Vigorously rubbing the infant's back immediately upon delivery to stimulate breathing
C) Being prepared to suction the infant immediately before he takes a breath D) None of the above
C) Being prepared to suction the infant immediately before he takes a breath
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56) Which of the following is a common sign of a pre-delivery emergency?
A) Contractions become more intense and closer together. B) The amniotic sac ruptures.
C) A sensation of lightening as the baby drops into the birth canal. D) There is profuse vaginal bleeding.
D) There is profuse vaginal bleeding.
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57) You are called for a woman with severe abdominal pain. During your assessment and interview, she tells you that she is sexually active and there is a chance she could be pregnant. Her vital signs are pulse 122, respirations 22, blood pressure 96/62, and skin cool and pale. You should immediately suspect:
A) placenta previa. B) ectopic pregnancy. C) appendicitis. D) internal bleeding.
B) ectopic pregnancy.
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58) Which of the following is true regarding ectopic pregnancies?
A) The fallopian tubes cannot stretch to accommodate a fetus.
B) The fertilized egg usually implants in the wall of the uterus.
C) It usually occurs during the second trimester. D) It may cause painless bright red bleeding.
A) The fallopian tubes cannot stretch to accommodate a fetus.
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59) Seizures due to complications of pregnancy generally occur during which of the following time periods?
A) In the first trimester B) In the second trimester
C) Before the mother even knows she is pregnant D) Late in pregnancy
D) Late in pregnancy
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60) What term is used to describe delivery of the fetus and placenta before the 20th week of pregnancy?
A) Spontaneous abortion B) Induced abortion C) Stillbirth D) Eclampsia
A) Spontaneous abortion
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61) Which of the following is true concerning trauma in the pregnant woman?
A) The mother's body will preferentially protect the life of the fetus over that of the mother.
B) She may lose up to 35 percent of her blood volume before exhibiting signs of shock.
C) The increase in blood volume during pregnancy makes shock an unlikely cause of death.
D) She may lose up to 15 percent of her blood volume before exhibiting signs of shock.
B) She may lose up to 35 percent of her blood volume before exhibiting signs of shock.
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62) Which of the following poses the greatest danger to the pregnant woman and her fetus when trauma occurs?
A) Neurogenic shock B) Distributive shock C) Hemorrhagic shock D) Supine hypotensive
C) Hemorrhagic shock
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63) Which of the following is true concerning a stillborn baby?
A) Infants born in cardiopulmonary arrest should not be resuscitated.
B) The parents should never be allowed to see the baby, especially if it has begun to deteriorate.
C) The death may occur weeks before delivery. D) Resuscitation must always be attempted.
C) The death may occur weeks before delivery.
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64) When performing chest compressions on a pregnant patient who has gone into cardiac arrest, what change do you need to make in the placement of your hands?
A) 0.5 to 1 inch lower on the sternum B) 0.5 to 1 inch higher on the sternum
C) 1 to 2 inches lower on the sternum D) 1 to 2 inches higher on the sternum
D) 1 to 2 inches higher on the sternum
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65) Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding?
A) Finding out if the patient is currently sexually active B) Monitoring for hypovolemic shock
C) Obtaining a thorough gynecological history D) Preventing infection
B) Monitoring for hypovolemic shock
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66) Which of the following is a cause of gynecological emergencies?
A) Soft-tissue trauma to the external genitalia B) Sexual assault
C) Disorders of the female reproductive organs D) All of the above
D) All of the above
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67) While treating a pregnant patient in cardiac arrest, which of the following is the best way to keep the fetus alive?
A) Transport the patient to the closest pediatric center.
B) Attempt to resuscitate the patient as you would any other cardiac arrest patient.
C) Do not use an AED to defibrillate the patient.
D) Do an emergency cesarean section of the fetus.
B) Attempt to resuscitate the patient as you would any other cardiac arrest patient.
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68) While treating a patient of sexual assault, which of the following sequences should your treatment follow?
A) Treat immediate life threats, treat psychological needs, and protect criminal evidence.
B) Maintain scene safety, treat immediate life threats, and treat only the secondary injuries that may become life threats in order to protect criminal evidence.
C) Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence.
D) Maintain scene safety, treat immediate life threats, allow the patient to shower if the patient is capable to help treat psychological needs, and transport.
C) Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence.
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1) What is the purpose of a tracheostomy in an ill patient?
A) To assist the patient with sleeping B) To assist the patient with waste removal
C) To assist the patient with breathing D) To assist the patient with feedings
C) To assist the patient with breathing
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2) Which of the following is true in regard to touching a patient who is being shocked with an automatic implanted cardiac defibrillator (AICD)?
A) The EMT will feel the shock, and it is very dangerous to the EMT.
B) The EMT cannot feel the shock of an AICD when delivered to the patient.
C) The EMT will feel the shock, but it is not very painful.
D) It depends on the AICD model as to whether or not the EMT can feel the shock.
B) The EMT cannot feel the shock of an AICD when delivered to the patient.
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3) Which of the following is not a role of dialysis in a renal failure patient?
A) Remove fluid from the body B) Filter and detoxify the blood
C) Remove waste from the body D) Stimulate blood cell production
D) Stimulate blood cell production
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4) Bariatrics is defined as the branch of medicine that deals with the cause, prevention, and treatment of which of the following diseases? A) Diabetes B) Sleep apnea C) Blindness D) Obesity
D) Obesity
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5) Which of the following refers to a condition that interferes significantly with a person's ability to engage in activities of daily living? A) Handicapped B) Disabled C) Terminal D) Disability
D) Disability
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6) Obesity is defined as a body mass index greater than: A) 35. B) 25. C) 30. D) 40.
C) 30.
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7) Which of the following best describes a disease such as deafness?
A) Acquired disease B) Congenital disease
C) Either a congenital or acquired disease D) Neither a congenital nor acquired disease
C) Either a congenital or acquired disease
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8) Which of the following best describes the origins of chronic obstructive pulmonary disease (COPD)?
A) Acquired disease B) Congenital disease
C) Either a congenital or acquired disease D) Neither a congenital nor acquired disease
A) Acquired disease
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9) Which of the following is the easiest way for an EMT to communicate with a patient with drastic hearing loss?
A) Slow down your speech so that the patient can read your lips. B) Write your questions using paper and pen.
C) Use a TDD/TYY telephone. D) Speak loudly and directly into the patient's ear.
B) Write your questions using paper and pen.
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10) Obesity increases the risk for which of the following health problems?
A) Liver disease B) Type 2 diabetes C) Respiratory problems D) All of the above
D) All of the above
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11) Which of the following serious health problems is related to homelessness?
A) Liver disease B) Heart disease C) Tuberculosis D) Hypertension
C) Tuberculosis
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12) Jarl is a male who is 5 foot 7 inches tall and weighs 250 pounds. What is Jarl's body mass index (rounded to the nearest tenth)? A) 35.2 B) 36.5 C) 38.4 D) 39.1
D) 39.1
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13) When transporting a patient who is morbidly obese to the hospital, it is important to monitor which of the following vital signs? A) Pulse rate B) Oxygen saturation C) Blood pressure D) Blood glucose level
B) Oxygen saturation
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14) Which of the following groups of people makes up the largest portion of the homeless population?
A) Females B) Veterans C) Children D) Families
B) Veterans
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15) At which of the following locations is an EMT likely to encounter a patient using an advanced medical device?
A) Nursing home B) Specialty care facilities C) Private residence D) All of the above
D) All of the above
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16) While on the scene of an emergency call involving a patient who is dependent upon a medical device for survival, the EMT can ask which of the following individuals about the specifics of the device?
A) Patient's family B) Patient C) Patient's home health aide or nurse D) All of the above
D) All of the above
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17) When preparing to move a patient who is using a specialty medical device from his house to the ambulance, which of the following questions would be appropriate to ask the family?
A) What worked best for moving the patient the last time he was transported by ambulance?
B) How do you normally move the patient?
C) Can you carry the patient to the ambulance since you know the best way to move the patient?
D) Both A and B are correct.
D) Both A and B are correct.
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18) You are on the scene of a pediatric patient who is on a specialized home monitoring system. This situation was not specifically addressed in your EMT class and your EMT partner has not encountered this situation, either. What is an advisable course of action?
A) Ask the parent or caregiver what has been done in the past to correct the situation.
B) Load the patient and rapidly transport the patient to the closest hospital for evaluation.
C) Contact medical control and ask to speak to a specialist for advice.
D) Request an advanced life support ambulance crew to respond for assistance.
A) Ask the parent or caregiver what has been done in the past to correct the situation.
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19) Which of the following situations are frequently problematic for patients who have tracheostomy tubes?
A) Tracheal tears B) Mucus buildup C) Air embolism D) Tube malplacement
B) Mucus buildup
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20) While transporting a patient who has an indwelling Foley catheter, it is important to keep the collection bag:
A) higher than the level of the patient. B) level with the patient.
C) lower than the level of the patient. D) with the patient's caregiver.
C) lower than the level of the patient.
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21) Which of the following is the best course of action for the EMT to take when caring for a patient with an AICD who goes into cardiac arrest?
A) The AED should be applied and used, but CPR should not be started while on-scene or transporting the patient.
B) No action beyond transport is required because the patient already has an implanted defibrillator.
C) CPR and an AED should be used as indicated while on-scene and transporting the patient.
D) CPR should be started, but the AED should not be used while on-scene or transporting the patient.
C) CPR and an AED should be used as indicated while on-scene and transporting the patient.
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22) You are on the scene of a home ventilator patient whose ventilator has experienced a mechanical failure. The patient is conscious and you have taken over the function of the ventilator with a bag-valve mask. As an EMT, you should verify the patient's comfort level for which of the following?
A) Ventilation volume B) Ventilation pressure C) Ventilation rate D) All of the above
D) All of the above
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23) During transport, where should the catheter bag be after loading the patient and stretcher into the ambulance if the patient has an indwelling urinary catheter?
A) In the patient's lap, but not higher than his heart B) On the ambulance floor
C) Hanging from the ceiling of the ambulance or IV pole higher than the patient
D) Lower than the patient, but not on the floor
D) Lower than the patient, but not on the floor
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24) Which of the following is the main advantage of peritoneal dialysis over hemodialysis?
A) Peritoneal dialysis is much faster. B) Peritoneal dialysis is more effective.
C) Peritoneal dialysis is likely to be done at the patient's home. D) Peritoneal dialysis is less prone to infection.
C) Peritoneal dialysis is likely to be done at the patient's home.
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25) Assessing blood pressure on a patient with an AV shunt, fistula, or graft could lead to which of the following?
A) Inaccurate blood pressure readings B) Uncontrollable hemorrhage in the extremity
C) Damage to the AV shunt, fistula, or graft, requiring surgery
D) Nothing, because there is no need to avoid assessing blood pressure in a patient's arm with an AV fistula, shunt, or graft.
C) Damage to the AV shunt, fistula, or graft, requiring surgery
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26) Which of the following is the correct position to use when transporting a patient who has a tracheostomy tube?
A) Shock position B) Prone C) Head slightly elevated D) Supine
C) Head slightly elevated
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27) A patient uses a home ventilator connected to his tracheostomy tube to breathe. Which of the following is the correct procedure to use when moving this patient to the ambulance?
A) Ventilate the patient's tracheostomy tube via a connected bag-valve mask at a normal rate and volume while the patient is disconnected from the ventilator.
B) Do nothing; there is no need to ventilate the patient between the house and the ambulance.
C) Ventilate the patient with mouth-to-mask ventilations at a normal rate and volume while the patient is disconnected from the ventilator.
D) Ventilate the patient's nose and mouth with a bag-valve mask at a normal rate and volume while the patient is disconnected from the ventilator.
A) Ventilate the patient's tracheostomy tube via a connected bag-valve mask at a normal rate and volume while the patient is disconnected from the ventilator.
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28) How does the pain felt by a patient when receiving a shock from a pacemaker compare to the pain felt when receiving a shock from an automatic implanted cardiac defibrillator (AICD)?
A) Pacemakers are painless and AICDs are painful. B) Both are painful.
C) Pacemakers are painful and AICDs are painless. D) Both are painless.
A) Pacemakers are painless and AICDs are painful.
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29) To determine the appropriate depth an EMT should insert a catheter tip into a tracheostomy tube in order to clear a blocked airway, the EMT should:
A) measure from the stoma to the carina. B) measure against the length of the obturator.
C) insert the catheter until the tip is no longer visible. D) multiply the internal diameter of the tracheal tube by 10.
B) measure against the length of the obturator.
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30) Where are automatic implanted cardiac defibrillators typically placed in patients who require one?
A) In the upper left chest B) In the upper right chest C) In the lower left chest D) In the lower right chest
A) In the upper left chest
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31) You are transporting a patient who is experiencing frequent discharges of her automatic implanted cardiac defibrillator (AICD). You are caring for the patient in the back of the ambulance en route to the hospital. To protect yourself from being shocked if the defibrillator discharges, you should:
A) wear protective gloves that cannot conduct electricity. B) make sure you do not touch the patient directly.
C) limit direct contact with the patient. D) not worry; the defibrillator does not pose a danger to others.
D) not worry; the defibrillator does not pose a danger to others.
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32) You are transporting a resident of a nursing home to the hospital for a complaint of abdominal pain that has lasted for 3 days. During your assessment, you note a tube protruding from the patient's nose, which is connected to a bag of milky-white fluid. This tube is known as a(n):
A) gastric tube. B) nasogastric tube. C) J-tube. D) endotracheal tube.
B) nasogastric tube.
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34) Chloe was born with a cardiac problem that she will have to manage the rest of her life. This disease is considered to be: A) acquired. B) autoimmune. C) congenital. D) genetic.
C) congenital.
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35) Which of the following is a characteristic of child abusers of special need patients?
A) They may be inappropriately unconcerned about the child.
B) They usually identify with the child's pain and suffering.
C) Alcohol and drug abuse are uncommon. D) They usually want the child's injuries treated.
A) They may be inappropriately unconcerned about the child.
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36) Which of the following statements is true regarding abuse and neglect of adults and elders with special needs?
A) The signs of abuse and neglect in adult and elder patients are easy to spot.
B) Signs of hunger and malnourishment are common signs of neglect.
C) Sexual abuse is never seen among elder patients with special needs.
D) Caregivers rarely interfere with assessment, treatment, or transport of patients.
B) Signs of hunger and malnourishment are common signs of neglect.
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37) When caring for patients with autism spectrum disorders (ASD), it is a good idea to do all of the following except: A) ask short, closed-ended questions whenever possible.
B) gather repeat vital signs at five-minute intervals even if the patient seems very stable.
C) provide simple, precise instructions about what you need the patient to do.
D) turn off as many pagers, radios, and noisy pieces of equipment as possible.
B) gather repeat vital signs at five-minute intervals even if the patient seems very stable.
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38) Which of the following is true of patients with autism spectrum disorders (ASD)?
A) They respond well to gentle, reassuring contact from EMTs.
B) They find faint background noise comforting.
C) They may have very high pain thresholds and tolerate excruciating injuries.
D) They cope well with change when that change occurs quickly.
C) They may have very high pain thresholds and tolerate excruciating injuries.
