EMS-119 CH50-53

Question 1

Vesicant agents inflict injury by causing:

a) central nervous system depression and respiratory failure.
b) parasympathetic nervous system stimulation and bradycardia.
c) destruction of the platelets, resulting in spontaneous hemorrhage.
d) burn-like blisters to form on the skin and in the respiratory tract

Answer 1

d) burn-like blisters to form on the skin and in the respiratory tract

Question 2

Which of the following statements regarding vesicant agent treatment is correct?

a) IV access should be deferred until the patient is at a burn center.
b) No antidotes exist for sulfur mustard or phosgene oxime exposure.
c) Aggressive airway support must occur prior to decontamination.
d) British anti-lewisite is carried by civilian EMS units.

Answer 2

b) No antidotes exist for sulfur mustard or phosgene oxime exposure.

Question 3

When sarin is on clothing, it has the effect of off-gassing, which means that:

a) the chemical soaks through clothing and penetrates the skin.
b) contamination of the patient is limited to a short period.
c) its vapors are continuously released over a period of time.
d) it rapidly transforms from a vapor to a liquid.

Answer 3

c) its vapors are continuously released over a period of time.

Question 4

Unlike G-series agents, VX is:

a) not classified as a nerve agent, although its effects are similar to those produced by nerve agents.
b) has a fruity odor, is significantly less lethal than sarin, and contains components that are easy to acquire.
c) so persistent that, given the proper conditions, it will remain relatively unchanged for weeks to months.
d) less lethal and persistent and is easily removed from the skin through decontamination.

Answer 4

c) so persistent that, given the proper conditions, it will remain relatively unchanged for weeks to months.

Question 5

The symptoms and medical management of patients poisoned by _____________ are identical to those of the nerve agents.

a) cyanogen chloride
b) pulmonary or choking agents
c) organophosphate insecticides
d) phosgene oxime and lewisite

Answer 5

c) organophosphate insecticides

Question 6

In contrast to the lesions associated with other skin disorders, the lesions associated with smallpox:

a) originate on the lower extremities.
b) remain isolated to the facial area.
c) are identical in size and shape.
d) are in various stages of development.

Answer 6

c) are identical in size and shape.

Question 7

Infection with the Ebola virus is characterized by:

a) the formation of cutaneous blisters.
b) a progressive onset of high fever.
c) internal and external hemorrhage.
d) paralysis of the respiratory muscles.

Answer 7

c) internal and external hemorrhage.

Question 8

In contrast to viruses and bacteria, neurotoxins:

a) have been used successfully as a weapon of mass destruction.
b) are not contagious, but do have a faster onset of symptoms.
c) can only enter the body through the inhalation route.
d) are characterized by a slow, insidious onset of symptoms.

Answer 8

b) are not contagious, but do have a faster onset of symptoms.

Question 9

Which of the following biologic agents is highly transmittable from person to person?

a) Botulinum
b) Yellow fever virus
c) Bubonic plague
d) Smallpox

Answer 9

d) Smallpox

Question 10

You are dispatched to a residence for a 50-year-old woman with respiratory distress. While you are assessing the patient, she tells you that she began experiencing flulike symptoms 4 days ago, shortly after delivering mail on the rural mail route for which she is responsible. Her blood pressure is 90/50 mm Hg, pulse rate is 120 beats/min, and respirations are 26 breaths/min and labored. Auscultation of her breath sounds reveals the presence of coarse crackles. This patient has MOST likely been exposed to:

a) botulinum toxin.
b) a neurotoxin.
c) anthrax.
d) smallpox.

Answer 10

c) anthrax.

Question 11

Terrorists who seek political, economic, or social freedom, and may seek to kill or evict foreigners or migrants are called:

a) separatists.
b) pathologic terrorists.
c) left-wing extremists.
d) right-wing extremists.

Answer 11

d) right-wing extremists.

Question 12

Which of the following statements regarding chemical agents is correct?

a) There is no effective antidote for any chemical agent at the present time.
b) The majority of chemical agents used by terrorists are naturally occurring.
c) Chemical agents are manmade substances that destroy living organisms.
d) Chemical agents can be weaponized only in the form of liquid or vapor.

Answer 12

c)

Chemical agents are manmade substances that destroy living organisms.

Question 13

Upon arriving at a scene involving a weapon of mass destruction, you should:

a) begin functioning as the incident commander.
b) don gloves, a mask, and a protective gown.
c) move any bystanders away from the scene.
d) stage upwind and uphill from the incident.

Answer 13

d) stage upwind and uphill from the incident.

Question 14

A biologic agent’s incubation period is especially important for the paramedic to understand because:

a) most biologic agents have an incubation period of less than 24 hours.
b) the incubation period is directly related to the duration of the illness.
c) the patient may be contagious despite the absence of signs and symptoms.
d) the incubation period determines how easily another person can be infected.

Answer 14

c) the patient may be contagious despite the absence of signs and symptoms.

Question 15

In contrast to alpha radiation, beta radiation:

a) travels slowly and is less penetrating.
b) requires a layer of clothing to stop it.
c) can easily penetrate the human body.
d) is easily stopped by a piece of paper.

Answer 15

b) requires a layer of clothing to stop it.

Question 16

The unified command system:

a) allows representatives from multiple jurisdictions and agencies to share command authority and responsibility.
b) can deplete the resources of multiple jurisdictions and agencies and should only be used during large disasters.
c) is a type of incident response in which command is established and maintained by the first agency on the scene.
d) mandates that a single person will maintain command authority, even if multiple jurisdictions respond.

Answer 16

a) allows representatives from multiple jurisdictions and agencies to share command authority and responsibility

Question 17

When personnel from other jurisdictions arrive at the scene of a disaster, they should:

a) begin secondary triage.
b) notify the incident commander.
c) turn their portable radios off.
d) report to the staging area.

Answer 17

d) report to the staging area.

Question 18

Which of the following is a benefit of a properly written after-action report following a man-made disaster?

a) Identifies those in need of postevent medical care
b) Provides a basis for retraining in specific areas
c) Helps law enforcement determine who is to blame
d) Allows EMS agencies to be reimbursed accordingly

Answer 18

d) Allows EMS agencies to be reimbursed accordingly

Question 19

In the case of many casualties, casualty collection points can be established in order to:

a) provide initial and secondary triage of all injured people.
b) render emergency treatment to those with critical injuries.
c) pick up lightly treated, stable patients by buses or trucks.
d) reunite uninjured people with their family members.

Answer 19

c) pick up lightly treated, stable patients by buses or trucks

Question 20

While planning for your response after a tsunami, you should primarily prepare to treat patients who:

a) were injured after being struck by or entangled in debris.
b) are in cardiopulmonary arrest secondary to drowning.
c) have massive sepsis due to contaminants found in the water.
d) have medical conditions that were exacerbated by trauma.

Answer 20

a) were injured after being struck by or entangled in debris.

Question 21

If a patient is found outside a building following an earthquake, you should only attempt to provide care to him or her if:

a) his or her position is at least 100 feet away from a building.
b) he or she is not trapped beneath any rubble, large or small.
c) your footing is good and the ground beneath you is stable.
d) you are wearing a self-contained breathing apparatus.

Answer 21

c) your footing is good and the ground beneath you is stable.

Question 22

Even after the initial danger is resolved following a volcanic eruption, it is MOST critical to make the public aware of the importance of:

a) multilayered clothing use.
b) skin burns caused by ashfall.
c) earthquakes and aftershocks.
d) wearing respiratory protection.

Answer 22

d) wearing respiratory protection.

Question 23

When functioning during cold weather, the paramedic should wear:

a) a HEPA respirator.
b) layered clothing.
c) tight-fitting clothing.
d) a single thick jacket.

Answer 23

b) layered clothing.

Question 24

During a pandemic, your agency has been called upon to be a point of distribution. This means that you will:

a) function as the initial collection point for potentially infected people.
b) house temporary supplies and provide inoculations and medications.
c) monitor patients for signs of disease for a period of up to 24 to 36 hours.
d) make the determination regarding which hospitals patients are taken to.

Answer 24

b) house temporary supplies and provide inoculations and medications.

Question 25

Numerous people have been injured during a civil disturbance. The dispatcher advises you of the safest route to the scene. You should:

a) ask the dispatcher to notify area hospitals to determine their capabilities for treating mass casualties.
b) remain at your station until law enforcement personnel advise that the scene is safe.
c) proceed to the scene, establish a staging area, and request law enforcement presence.
d) ascertain the location of the command post and establish communication with it.

Answer 25

d) ascertain the location of the command post and establish communication with it.

Question 26

The “all-hazards” approach to disaster planning involves:

a) protecting critical infrastructure from large-scale disasters.
b) table-top exercises that focus on worst case scenarios.
c) conducting comprehensive preplanning for all types of disasters.
d) communicating with federal officials regarding terrorist activity.

Answer 26

c) conducting comprehensive preplanning for all types of disasters.

Question 27

An EMS agency’s public information officer should be trained to:

a) direct media coverage away from a disaster.
b) use the media to the agency’s advantage.
c) release limited protected health information.
d) release anticipated actions of the agency

Answer 27

b) use the media to the agency’s advantage.

Question 28

Your assistance is requested at the scene of a large brush fire in which multiple agencies have responded. As soon as you and your partner arrive at the scene, you should:

a) set up an area where triage can occur.
b) report to the transportation section.
c) locate the staging or treatment area.
d) report to the fire chief for instructions.

Answer 28

c) locate the staging or treatment area.

Question 29

A category 1 hurricane has sustained winds that are:

a) between 86 and 110 mph.
b) between 74 and 95 mph.
c) between 131 and 155 mph.
d) between 39 and 74 mph.

Answer 29

b) between 74 and 95 mph.

Question 30

The number one killer of fire fighters at the scene of a fire is/are:

a) thermal burns.
b) cardiac events.
c) heatstroke.
d) inhalation injury.

Answer 30

b) cardiac events.

Question 31

Which of the following statements regarding violence is correct?

a) Violence is not isolated to a particular socioeconomic class.
b) Violence is higher in high-income socioeconomic groups.
c) Violence is lower in high-income socioeconomic groups.
d) Violence is higher in low-income socioeconomic groups.

Answer 31

a) Violence is not isolated to a particular socioeconomic class.

Question 32

All of the following are indicators of the potential for violence, EXCEPT:

a) clenching of the fists.
b) the use of profanity.
c) uncontrollable pacing.
d) a large body build.

Answer 32

d) a large body build.

Question 33

How should you position your ambulance upon arriving at the scene of a victim who was found slumped over the steering wheel of his or her car?

a) No more than 15 feet beyond the parked vehicle, with the steering wheel turned fully to the right
b) To the immediate right side of the parked vehicle, with the left side ambulance box lights on
c) More than 25 feet past the parked vehicle, with the rear load lights of the ambulance turned off
d) At least 21 feet behind the parked vehicle, at a 10° angle to the driver’s side, facing the shoulder

Answer 33

d) At least 21 feet behind the parked vehicle, at a 10° angle to the driver’s side, facing the shoulder

Question 34

If you unexpectedly find yourself in the middle of a domestic dispute, the situation would MOST likely deteriorate if you:

a) speak with a calm tone of voice.
b) show respect and courtesy.
c) use an authoritative voice.
d) maintain eye contact.

Answer 34

c) use an authoritative voice.

Question 35

Youths usually join a gang for all of the following reasons, EXCEPT:

a) a psychiatric illness.
b) belonging.
c) respect.
d) recognition.

Answer 35

a) a psychiatric illness

Question 36

After concealing yourself and reassessing your position, you should:

a) visualize any patients.
b) seek adequate cover.
c) distract the shooter.
d) remain where you are.

Answer 36

b) seek adequate cover.

Question 37

If you are under fire from a sniper who is on the roof of a building, and you are using a vehicle as cover, the MOST effective way of protecting yourself is to:

a) position yourself next to the front wheel so that the engine block and tire can both protect you.
b) break out one of the side windows, crawl into the vehicle, and lie prone across the front seat.
c) crawl under the vehicle, between the tires, but avoid the area of the vehicle near the gas tank.
d) crouch down between the wheels of the vehicle in order to make yourself as small a target as possible.

Answer 37

a) position yourself next to the front wheel so that the engine block and tire can both protect you.

Question 38

If someone continues to intentionally block you from reaching a critically injured patient despite your initial request that he or she move, you should:

a) abruptly step forward to make the person think you are going to move him or her.
b) use reasonable force to incapacitate the person so you can gain access to the patient.
c) take a side step and state, “If you don’t get out of my way, I’m calling the police!”
d) slowly back away from the person, return to the ambulance, and notify the police.

Answer 38

c) take a side step and state, “If you don’t get out of my way, I’m calling the police!”

Question 39

Proper documentation of an incident in which a patient was injured during a crime should include all of the following, EXCEPT:

a) your estimate of when the injury occurred.
b) the position of the patient upon your arrival.
c) the disposition of any evidence at the scene.
d) any incriminating statements made by others.

Answer 39

a)

your estimate of when the injury occurred.

Question 40

You are at the scene of a drive-by shooting in which a 19-year-old man was shot in the chest. Law enforcement personnel are at the scene. The patient is conscious, has an actively bleeding entry wound to his left anterolateral chest, and is breathing with difficulty. You should:

a) immediately place the patient on a long backboard, quickly move him to the ambulance, and begin treating his injury.
b) return to your ambulance and wait there until a law enforcement official advises you that the perpetrator is nowhere to be found.
c) ask a police officer to stand near you with his weapon drawn as you provide emergency medical treatment to the patient.
d) provide only the amount of care needed to prevent his condition from deteriorating and quickly move him to the ambulance

Answer 40

d) provide only the amount of care needed to prevent his condition from deteriorating and quickly move him to the ambulance

Question 41

You and your partner respond to a call for a domestic disturbance. You are both wearing high-level body armor. There are no indications of any weapons on the premises. What should you do?

a) Wait for law enforcement personnel to arrive and secure the scene.
b) Slowly enter the residence and make contact with the complainant.
c) Stand on each side of the front door and listen for sounds of violence.
d) Divert the actor while your partner makes contact with the complainant.

Answer 41

a) Wait for law enforcement personnel to arrive and secure the scene.

Question 42

When approaching a van at night to determine if the driver, who is reportedly unconscious, is in need of medical assistance, you should:

a) move 10 to 15 feet away from the passenger side and walk parallel to the van.
b) keep your flashlight turned off as you move along the left side of the van.
c) stay at least 5 feet away from the van until you are at a 45° angle to the A column.
d) approach the passenger side door, belly toward the van, and knock on the door.

Answer 42

a) move 10 to 15 feet away from the passenger side and walk parallel to the van.

Question 43

One aspect of the technique of contact and cover involves:

a) one paramedic assessing and providing care to the patient while the other paramedic physically blocks the view of the patient from an angry spouse to avoid escalating the potential for violence.
b) both paramedics providing emergency care to the patient while a law enforcement officer gathers information from another person and prevents the situation from escalating.
c) one paramedic trying to defuse the situation with a calm voice while the second paramedic discreetly returns to the ambulance to summon law enforcement personnel to the scene.
d) one paramedic making contact with the patient to provide care while the second paramedic obtains patient information from another person while gauging his or her level of tension.

Answer 43

d) one paramedic making contact with the patient to provide care while the second paramedic obtains patient information from another person while gauging his or her level of tension.

Question 44

Gangs predominantly survive through:

a) prostitution.
b) identity theft.
c) gun-running.
d) selling drugs.

Answer 44

d) selling drugs.

Question 45

If you are taken hostage, it is MOST important to:

a) take advantage of the fact that the captor is usually as surprised as you are.
b) assure the captor that you are a paramedic and that you can help.
c) control the instinctive anger that occurs when you are physically abused.
d) consider the safety of any other hostages and communicate with your captor.

Answer 45

c) control the instinctive anger that occurs when you are physically abused.

Question 46

The primary function of the tactical paramedic is to provide:

a) emergency medical treatment to hostages or those who are barricaded.
b) care for law enforcement teams who make entry into violent situations.
c) armed cover for SWAT teams who enter the scene of a mass shooting.
d) care for assailants who have been shot, stabbed, or otherwise injured.

Answer 46

b)

care for law enforcement teams who make entry into violent situations.

Question 47

All of the following are examples of real or physical evidence, EXCEPT:

a) a knife that has fingerprints on it.
b) body materials at a crime scene.
c) blood stains on a wall or window.
d) oral documentation by a witness.

Answer 47

d) oral documentation by a witness.

Question 48

At 10:20 PM, you are dispatched for a woman reportedly slumped over the steering wheel of her car alongside the highway. Upon arriving at the scene, you should:

a) park your ambulance at least 21 feet behind the patient’s vehicle.
b) turn your ambulance headlights off to minimize your visibility.
c) remain in the ambulance until law enforcement personnel arrive.
d) slowly drive by the parked vehicle to confirm that it is occupied.

Answer 48

a) park your ambulance at least 21 feet behind the patient’s vehicle.

Question 49

You are dispatched to a recreational vehicle (RV) park for an unconscious patient. When you arrive at the scene, another resident of the park tells you that the patient, a young man, is in his RV and will not answer the door. After safely entering the RV, you find the patient lying supine near the rear of the vehicle. From a distance, you can tell that he is not breathing. As you approach him, you see several bottles of Sudafed, a container of camping fuel, and a variety of glass containers with an unknown liquid in them. What should you do?

a) Quickly remove the patient from the vehicle if it is safe to do so, begin CPR away from the RV, and ask the resident to call the police.
b) Assess for a carotid pulse, perform CPR for 2 minutes, assess the patient’s cardiac rhythm, and defibrillate one time if he is in a shockable rhythm.
c) Suspect that the patient has ingested a variety of harmful chemicals, begin CPR, and request a backup team of paramedics.
d) Realize that you are in a methamphetamine drug lab, immediately exit the RV, and notify law enforcement personnel.

Answer 49

a) Quickly remove the patient from the vehicle if it is safe to do so, begin CPR away from the RV, and ask the resident to call the police.

Question 50

While interviewing a severely depressed woman, the patient suddenly lunges at you with her hands. It is not known if the patient has any weapons. Your MOST appropriate action should be to:

a) quickly move back until you are out of the woman’s reach, and then subdue her.
b) block her hands with your arm and strike her in the face with your closed fist.
c) strike the patient in the face with your metal clipboard and leave the scene.
d) throw your patient care form directly at the patient’s nose and egress rapidly.

Answer 50

d) throw your patient care form directly at the patient’s nose and egress rapidly.