EMT FINAL Flashcards by Skyler de Andrade

According to the National EMS Scope of Practice Model, an EMT should be able to:

A. administer epinephrine via the subcutaneous route.
B. insert a peripheral IV line and infuse fluids.
C. assist a patient with certain prescribed medications.
D. interpret a basic (ECG) rhythm and treat accordingly.

C. assist a patient with certain prescribed medications.

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An appropriate demonstration of professionalism when your patient is frightened, demanding, or unpleasant is to:

A. demand that the patient remain quiet and cooperative during transport.
B. continue to be nonjudgmental, compassionate, and respectful.
C. reassure the patient that everything will be all right, even if it will not be.
D. ignore the patient’s feelings and focus on his or her medical complaint.

B. continue to be nonjudgmental, compassionate, and respectful.

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An EMS provider who has extensive training in various aspects of advanced life support (ALS) is called a(n):

A. advanced EMT (AEMT)
B. EMR
C. EMT
D. paramedic

D. paramedic

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Cardiac monitoring, pharmacologic interventions, and other advanced treatment skills are functions of the:

A. paramedic
B. EMR.
C. EMT
D. AEMT

A. paramedic

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____ pressure is the pressure exerted by a liquid that occurs when blood moves through an artery at relatively high pressures.

A. Hydrostatic
B. Osmotic
C. Diffusion
D. Oncotic

B. Osmotic

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A 31 year old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should:
A. reassess the patient and document her response to the medication.
B. contact medical control and apprise him or her of what you did.
C. check the drug’s expiration date to ensure that it is still current
D. administer another treatment in 30 seconds if she is still in distress.

A. reassess the patient and document her response to the medication

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If a defibrillator manufacturer claims that its device terminates ventricular fibrillation on the first shock 95% of the time, you should:

A. avoid purchasing the device because this claim is unrealistic.
B. purchase the device based solely on the manufacturer’s claim.
C. determine which device the American Heart Association recommends.
D. recognize that this does not mean the device will save more lives.

D. recognize that this does not mean the device will save more lives.

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A. Contact med control and request permission to defibrillate.

B. Continue CPR and transport the patient to the closest appropriate hospital.

C. Deliver the shock followed by immediate resumption of CPR.

D. Avoid defibrillation because this will damage the patient’s AICD.

C. Deliver the shock followed by immediate resumption of CPR.

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As the bronchus divides into smaller bronchioles, the terminal ends of these smaller passages form the:

A. bronchi
B. Pleura
C. Capillaries
D. Alveoli

D. Alveoli

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Obtaining continuing medical education is the responsibility of the:

A. individual EMT.
B. EMS medical director.
C. EMS training officer.
D. State Bureau of EMS

A. individual EMT.

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The continuous quality improvement (CQI) process is designed to:

A. focus specifically on the quality of emergency care provided to the patient.
B. administer punitive actions to EMTs who do not follow local protocols.
C. identify areas of improvement and provide remedial training if needed.
D. ensure that all EMTs maintain licensure through the state EMS office.

C. identify areas of improvement and provide remedial training if needed.

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A 49 year old male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering supplemental oxygen if needed, you should:
A. ask him if he took his Viagra within the past 24 hours.
B. place him in a supine position and transport at once.
C. obtain physician approval to give the nitroglycerin.
D. administer one nitroglycerin and call medical control.

A. ask him if he took his Viagra within the past 24 hours.

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Dead space is the portion of the respiratory system that:

A. Receives oxygen but is unable to release carbon dioxide
B. Contains no alveoli and does not participate in gas exchange
C. Includes the alveoli and the capillaries surrounding the alveoli
D. Must be filled with air before gas exchange can take place

B. contains no alveoli and does not participate in gas exchange

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The determination that prompt surgical care in the hospital is more important than performing time-consuming procedures in the field on a major trauma patient is based mostly on:

A. EMS research
B. regional trauma guidelines
C. local protocols
D. the lead EMTs decision

A. EMS research

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The EMT certification exam is designed to:

A. ensure that EMTs are competent and have the same level of knowledge and skills
B. rank EMTs based on performance on the certification exam
C. provide EMTs with the best possible wage once certification is achieved
D. identify those EMTs who are prepared for advanced levels of training.

A. ensure that EMTs are competent and have the same level of knowledge and skills

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The standards are prehospital emergency care and the individuals who provide it are typically regulated by the:

A. American Heat Association
B. state office of EMS
C. regional trauma center
D. National Registry of EMTs

B. state office of EMS

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A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

A. assess the adequacy of his respirations

B. administer up to 3 doses of nitro

C. obtain vital signs and a SAMPLE history

D. administer up to 324 mg of baby aspirin

A. assess the adequacy of his respirations

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Which of the following criteria is required to become licensed and employed as an EMT?

A. demonstration of the ability to lift and carry at least 200 pounds
B. successful completion of a recognized bystander CPR course
C. a minimum of 60 college credit hours that focus on health care
D. proof of immunization against certain communicable diseases

D. proof of immunization against certain communicable diseases

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Oxygen and carbon dioxide pass across the alveolar membrane in the lungs through a process called:

A. Breathing
B. Osmosis
C. Diffusion
D. Ventilation

C. Diffusion

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A 62 year old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen, if needed, and contacting medical control, you should:
A. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg.
B. administer up to three doses of nitroglycerin before assessing his blood pressure.
C. administer the nitroglycerin unless he has taken Viagra within the past 72 hours.
D. begin immediate transport and request a rendezvous with a paramedic unit.

A. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg

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Which of the following descriptions most accurately portrays emergency medical services (EMS)?

A. a vast network of advanced life support (ALS) providers who provide definitive emergency care in the prehospital setting
B. a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured
C. A system composed exclusively of emergency medical responders (EMRs) and emergency medical technicians (EMTs) who are responsible for providing care to sick and injured patients
D. a team of paramedics and emergency physicians who are responsible for providing emergency care to critically injured patients

B. a team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured

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The axial skeleton is composed of the:

A. Bones that constitute the pelvic girdle
B. Arms, legs, and pelvis
C. Lower part of the torso and the legs
D. Skull, face thorax, and vertebral column

D skull, face, thorax, and vertebral column

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A 66 y/o female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours duration. Her BP is 140/90, pulse is 100 and irregular, respirations are 22, pulse ox is 92%. The patient does not have prescribed nitro, but her husband does. You should:

A. administer oxygen, give her 324 mg of aspirin, and assess her further

B. give her high flow oxygen, attach the AED, and transport at once

C. obtain a SAMPLE history and contact med control for advice

D. give her one nitro and reassess her systolic BP

A. administer oxygen, give her 324 mg of aspirin, and assess her further

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The carpal bones form the:

A. wrist
B. Hand
C.Foot
D. Ankle

A. Wrist

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Which of the following errors is an example of knowledge-based failure? A. an EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug B. an EMT gives the correct drug to a patient, although his protocols clearly state that he is not authorized to do so C. a patient is given nitroglycerin by an EMT who did not obtain proper authorization from medical control first D. due to an improperly applied cervical collar, a patient's spinal injury is aggrevated and he is permanently disabled

A. an EMT administers the wrong drug to a patient because she did not know the pertinent information about the drug

A by-product of involuntary muscle contraction and relaxation is: A. oxygen B. Nitrogen C. Lactid acid D. Heat

D. Heat

A 74 year old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4 mg tablets) before your arrival but still feels heaviness in her chest. You should: A. assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions. B. transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin. C. give her high flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport. D. recall that geriatric patients often take multiple medications and that interactions can occur with potentially negative effects.

D. recall that geriatric patients often take multiple medications and that interactions can occur with potentially negative effects

Which of the following is an example of a primary prevention strategy? A. community awareness programs that emphasize the dangers of drinking and driving B. teaching a group of new parents how to perform one- and two-rescuer infant CPR C. the construction of a guardrail on a dangerous curve following a fatal motor vehicle crash D. protecting a patient's spine from further injury after a fall from a significant height

A. community awareness programs that emphasize the dangers of drinking and driving

A patient has a blood pressure of 130/70 mm Hg. The "130" in this measurement represents: A. Atrial contraction B. Ventricular filling C. Ventricular contraction D. Ventricular relaxation

C. ventricular contraction

Which of the following scenarios involves the administration of ALS? A. a 48 year old patient whose airway is secured with a supraglottic device B. a 64 year old patient who is given aspirin for suspected cardiac chest pain C. a 61 year old patient who is receiving humidified supplemental oxygen D. a 53 year old patient who is assisted with his prescribed nitroglycerin

A. a 48 year old patient whose airway is secured with a supraglottic device

A person's bones will become brittle if he or she is deficient in: A. Magnesium B. Calcium C. sodium D. potassium

B. Calcium

Which of the following skills or interventions is included at every level of prehospital emergency training? A. oral glucose for hypoglycemia B. intranasal medication administration C. automated external defibrillation D. use of a manually triggered ventilator

C. automated external defibrillation

An increase in heart and contractility occurs due to stimulation of: A. Alpha-1 receptors B. Beta-2 receptors C. Beta-1 receptors D. Alpha-2 receptors

C. Beta-1 receptors

Which of the following statements regarding the NREMT is correct? A. the NREMT is the exclusive certifying body for EMTs B. the NREMT is a governmental agency that certifies EMTs C. the NREMT regulated EMS training standards D. the NREMT provides a national standard for EMS testing

D. the NREMT provides a national standard for EMS training

At rest, the normal adult heart rate should not exceed: A. 70 beats/min B. 80 beats/min C. 90 beats/min D. 100 beats/min

D. 100 beats/min

A 66 y/o woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 min ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive meds. When you assess her, you find that her BP is significantly higher in her left arm than in her right arm. What do these signs and symptoms most likely indicate? A. Dissecting aortic aneurysm B. Hypertensive emergency C. Unstable angina D. Acute myocardial infarction

A. Dissecting aortic aneurysm

Which type of medical direction do standing orders and protocols describe? A. direct B. off-line C. radio D. online

B. off-line

According to the National EMS Scope of Practice Model, an EMT would require special permission from the medical director and the state EMS office to: A. give aspirin to a patient with chest pain B. apply and interpret data from a pulse oximeter C. insert a peripheral intravenous catheter D. use an automatic transport ventilator

C. insert a peripheral intravenous catheter

Bile is produced by the liver and concentrated and stored in the: A. Pancreas B. Stomach C. Gallbladder D. Kidneys

C. Gallbladder

As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on: A. the transport time to the hospital B. an order from a paramedic C. the patient's condition D. medical director approval

D. medical director approval

Advil, Nuprin, and Motrin are trade (brand) names for the generic medication: A. aspirin B. nitrostat C. ibuprofen D. acetaminophen

C. ibuprofen

Bleeding is normally stopped by: A. Activation of platelets B. Arterial dilation C. capillary rupture D. increased white blood cells

A. Activation of platelets

EMRs such as firefighters, law enforcement officers, and park rangers are an integral part of the EMS system because: A. they often arrive at the scene before the ambulance and EMTs B. they can initiate certain ALS procedures before EMS arrival C. the average response time for the EMT crew is approximately 15 minutes D. they are usually trained to assist paramedics with certain procedures

A. they often arrive at the scene before the ambulance and EMTs

An example of an anti-inflammatory is: A. narcan B. oxygen C. nitroglycerin D. aspirin

D. aspirin

Breathing is often more difficult in older adults because the: A. Elasticity of the lungs decreases B. Surface area of the alveoli increases C. Diaphragm and intercostal muscles enlarge D. Overall size of the airway decreases

A. Elasticity of the lungs decreases

EMTs arrive at the scene of a patient who was "found down." A family member states that she gave nalaxone (Narcan) to the patient before the ambulance arrived. The EMTs should suspect that the patient: A. overdosed on an opioid drug B. has a history of allergic reactions C. experienced a prolonged seizure D. has a low blood glucose level

A. overdosed on an opioid drug

EMT training in nearly every state meets or exceeds the guidelines recommended by the: A. individual state's EMS protocols B. National Association of EMTs C. National Highway Traffic Safety Administration (NHTSA) D. National registry of EMTs

C. National Highway Traffic Safety Administration (NHTSA)

The _____ deals with the well-being of the EMT, career progression, and EMT compensation. A. EMS administrator or chief B. human resources department C. local public health department D. office of the medical director

B. human resources department

Breathing occurs as the result of a(n): A. Increase in oxygen, which decreases the pH of the cerebrospinal fluid B. Decrease in oxygen, which increases the pH of the cerebrospinal fluid C. Decrease in carbon dioxide, which increases the pH of the cerebrospinal fluid D. Increase In carbon dioxide, which decreases the pH of the cerebrospinal fluid

D. Increase in carbon dioxide, which decreases the pH of the cerebrospinal fluid

EMTs respond to a known heroin abuser who is unresponsive. If they give Narcan to this patient, the EMTs should recall that: A. the effects of Narcan last longer than most opioid drugs B. narcan should be administered in increments of 2 mg C. narcan should not be given if the patient's breathing is slow D. narcan administration could cause seizures in this patient

D. narcan administration could cause seizures in this patient

A critical incident stress debriefing should be conducted no longer than ____ hours following the incident. A. 72 B. 24 C. six D. 12

A. 72

A positive TB skin test indicates that: A. you have been exposed to TB B. you are actively infected with TB C. the TB disease is currently dormant but might later become active D. you have never been exposed to TB

A. you have been exposed to TB

How is nitroglycerin usually given by the EMT? A. sublingually B. injected C. inhaled D. orally

A. sublingually

Shortly after assisting a 65 year old female with her prescribed nitroglycerin, she begins complaining of dizziness and experience a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should: A. place her in a supine position B. transport her in a sitting position C. assist ventilation with a bag-value mask D. wait 5 minutes and reassess her blood pressure

A. place her in a supine position

Characteristics of eustress following dispatch to a high speed motor vehicle collision may include: A. increased self image from performing well under a challenging situation B. long term feelings of being overwhelmed by the nature of the call C. short term loss of energy due to the high physical demands of the job D. the inability to remain focused, because the task at hand is demanding

A. increased self image from performing well under a challenging situation

Cardiac output (CO) is affected by: A. Stroke volume and heart rate B. Blood pressure C. Stroke volume only D. Heart rate only

A. Stroke volume and heart rate

General adaptation syndrome is characterized by which of the following phases? A. reaction and resistance, euphoria, and physical exhaustion B. immediate reaction, psychological exhaustion, and recovery C. alarm response, reaction and resistance, and recovery D. delayed reaction, alarm response, and physical recovery

C. alarm response, reaction and resistance, and recovery

Contraction of the right ventricle causes: A. A return of blood from the pulmonary veins B. Ejection of blood into the systemic circulation C. closure of the mitral and aortic valves D. blood to flow into the pulmonary circulation

D. Blood flow into the pulmonary circulation

Hazards that are associated with a structural fire include all of the following, except: A. smoke and toxic gases B. risk of building collapse C. carbon dioxide deficiency D. high ambient temperatures

C. carbon dioxide deficiency

Subcutaneous injections deliver the medication: A. between the skin and the muscle B. through the mucosa under the tongue C. directly into the muscle tissue D. below the first layer of muscle

A. between the skin and the muscle

Prescription glasses do not provide adequate eye protection because they: A. have large, rounded lenses B. do not have shatterproof lenses C. offer little or no side protection D. are not secure with a strap

C. offer little or no side protection

During each heartbeat, ____ of blood is ejected from the adult heart, an amount called the stroke volume. A. 40 to 50 mL B. 100 to 120 mL C. 90 to 100 mL D. 70 to 80 mL

D. 70 to 80 mL

The capacity of an individual to cope with and recover from stress is called: A. distress B. eustress C. wellness D. resilience

D. resilience

To reverse the effects of a narcotic overdose you should administer: A. epipen B. tylenol C. advil D. narcan

D. narcan

The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to: A. wear socks made of heavy duty cotton B. avoid outer clothing with zippers C. wear a heavy, thick jacket or coat D. wear at least three layers of clothing

D. wear at least three layers of clothing

Hemoglobin is a molecule that attaches to ____ and carries oxygen A. erythrocytes B. leukocytes C. monocytes D. thrombocytes

A. erythrocytes

When gathering a patients medications, you find the following: isordil, lasix, nexium, and digoxin. Which of these medications can be obtained over the counter? A. nexium B. digoxin C. isordil D. lasix

A. nexium

The MOST important consideration at the scene of a hazardous materials incident is: A. calling the hazardous materials team B. identifying the hazardous material C. ensuring your personal safety D. evacuating the bystanders

C. ensuring your personal safety

The MOST serious consequences of drug of alcohol abuse among EMS personnel is: A. substandard or inappropriate patient care B. low morale and frequently missed shifts C. tension among coworkers and supervisors D. punitive action and the loss of a job

A. substandard or inappropriate patient care

How does respiration different from ventilation A. Respiration occurs when the diaphragm and intercostal muscles contract, whereas ventilations occurs when those same muscles relax B. Ventilation occurs when air is forced into the lungs, whereas respiration occurs when air is drawn or sucked into the lungs C. Respiration occurs when oxygen is delivered to the cells of the body, whereas ventilation occurs when carbon dioxide is removed D. Respiration s the process of gas exchange, whereas ventilation is the movement of air between the lungs and the environment

D. Respiration is the process of gas exchange, whereas ventilation is the movement of air between the lungs and the environment.

The simplest, yet most effective method of preventing the spread of an infectious disease is to: A.undergo annual testing for TB and hepatitis B. undergo an annual physical examination C. wash your hands in between patient contacts D. ensure your immunizations are up-to-date

C. wash your hands in between patient contacts

Which of the following clinical signs would necessitate the administration of narcan in a suspected narcotic overdose? A. tachycardia B hypertension C. slow respirations D. extreme agitation

C. slow respirations

The spread of HIV and hepatitis in the healthcare setting can usually be traced to: A. lack of proper immunizations B. noncompliance with standard precautions C. careless handling of sharps D. excessive blood splashing or splattering

C. careless handling of sharps

Vaccination against the hepatitis A virus is unnecessary if you: A. are older than 35 years of age B. received a hepatitis B vaccination C. have been infected with hepatitis A in the past D. have a weak immune system

C. have been infected with hepatitis A in the past

Which of the following is an example of a rules based medication error? A. the EMT administers a drug that is contraindicated for the patient B. the EMT administers a drug that is not approved by the medical director C. the EMT accidentally gives a higher drug dose than what is indicated D. the EMT administers the correct drug, but gives it by the wrong route

B. the EMT administers a drug that is not approved by the medical director

Vectorborne transmission of an infectious organism occurs via: A. animals or insects B. direct contact C. smoke or dust D. inanimate objects

A. animals or insects

If a patient's chest barley moves during inhalation, even if the patient's respiratory rate is normal, you should suspect that: A. Overall tidal volume is increased B. Expiratory reserve volume is decreased C. Minute volume is decreased D. Inspiratory reserve is increased

C. Minute volume is decreased

What should you do before attempting to access a patient trapped in a vehicle? A. check for other patients B.contact medical control C. ensure the vehicle is stable D. request another ambulance

C. ensure the vehicle is stable

When decontaminating the back of your ambulance after a call, you should: A. allow surfaces to air dry unless otherwise indicated in the product directions B. use a bleach or water solution at a 1:2 dilution ratio to thoroughly wipe all surfaces C. clean all surfaces and patient contact areas with a mixture of alcohol and water D. spray the contaminated areas and then immediately wipe the dry with a towel

A. allow surfaces to air dry unless otherwise indicated in the product directions

Which of the following is NOT a characteristic of epinephrine? A. dilates passages in the lungs B. secreted naturally by the adrenal glands C. decreases heart rate and blood pressure D. constricts the blood vessels

C. decreases heart rate and blood pressure

Which of the following infectious diseases confers no protection from reinfection after exposure? A. mumps B. syphilis C. chickenpox D. rubella

B. syphilis

Mean arterial pressure (MAP) is a product of: A. stroke volume and systemic vascular resistance B. Heart rate and stroke volume C. cardiac output and systemic vascular resistance D. Heart rate and systemic vascular resistance

C. cardiac output and systemic vascular resistance

Which of the following is the MOST significant in determining whether a person will become ill from certain germs? A. race B. immunity C. gender D. age

B. immunity

While assisting a paramedic in the attempted resuscitation of a 55 year old male in cardiac arrest, you should expect the paramedic to : A. give the patient activated charcoal to rule out a drug overdose B. administer drugs via the IV route to achieve the fastest effect C. give the patient nitroglycerin to increase his blood pressure D. withhold drug therapy until an intraosseous catheter is in place

B. administer drugs via the IV route to achieve the fastest effect

You have been working at the scene of a major building collapse for eight hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is MOST effectively managed by: A. allowing each worker to sleep in 15- to 30-minute increments B. conducting a critical incident stress debriefing the next day C. requesting a CISM team to provide on-scene peer support D. providing large amounts of caffeine to the rescue workers

C. requesting a CISM team to provide on-scene peer support

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

A. a drop in pressure within the chest cavity

the ___ is made up of the maxilla and zygoma, as well as the frontal bone of the cranium: A. mastoid B. orbit C. occiput D. sphenoid

B. orbit

the ____ plane separates the body into left and right halves: A. coronal B. midsagittal C. transverse D. sagittal

B. midsagittal

The ____ portion of the spinal column is joined to the illiac bones of the pelvis: A. lumbar B. sacrum C. coccyx D. thoracic

B. sacrum

the amount of air that remains in the lungs simply to keep them open is called the: A. residual volume B. tidal volume C. expiratory reserve volume D. inspiratory reserve volume

A, residual volume

As an EMT, it is important to remember that the signs and symptoms of cumulative stress: A. are most effectively treated with medications B. usually manifest suddenly and without warning C. might not be obvious or present all the time D. cannot be identified and can cause health problems.

C. might not be obvious or present all the time

Gloves, a mask, eye protection, and a face shield should be used: A. whenever you touch non-intact skin B. while handling needles or other sharps C. during routine cleaning of the ambulance D. when performing endoctracheal intubation

D. when performing endotracheal intubation

the area of the spinal column, descending order, are: A. cervical, thoracic, coccyx, lumbar, and sacral B. cervical, thoracic, sacral, lumbar, and coccyx C. cervical, lumbar, thoracic, and coccyx D. cervical, thoracic, lumbar, sacral, and coccyx

D. cervical,thoracic, lumbar, sacral, and coccyx

It is especially important for EMS personnel to develop non-adversarial relationships with their coworkers because they: A. must work together every third day B. depend on one another for their safety C. are highly prone to stress and burnout D. might have to bunk in the same room

B. depend on one another for their safety

The BEST way to reduce your risk of contracting a work-related disease following exposure is to: A. be evaluated by a physician within 72 hours following the exposure. B. vigorously wash the affected area with antimicrobial solution C. get vaccinated against the disease you think you were exposed to D. activate your department's infection control plan as soon as possible

D. activate your department's infection control plan as soon as possible

The artery that can be palpated on the arterial surface of the foot is the A. ventral pedis B. anterior tibial C. dorsalis pedis D. posterior tibial

C. dorsalis pedis

the autonomic nervous system controls all of the following functions, except: A. digestion B. blood dilation C. breathing D. breath sounds

D. breath sounds

the average adult has approximatley ____ of blood in his or her vascular system A. 3 L B. 4 L C. 5 L D. 6 L

D. 6 L

The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, except: A. family history of hepatitis B. vaccine safety and efficiacy C. record keeping and tracking D. postvaccine antibody titers

A. family history of hepatitis

the body's backup system of respiratory control, which is based on low concentrations of oxygen in the blood, is called: A. hypocarbic drive B. pneumotaxic drive C. oxyhemoglobin drive D. hypoxic drive

D. hypoxic drive

Acting in such a way as to make another person ear immediate bodily harm is called: A. libel B. assault C. negligence D. battery

B. assault

An EMT would MOST likely be held liable for abandonment if he or she: A. did not make provisions for continued care of an injured patient B. refused to care for a violent patient who is armed with a knife. C. remained at the hospital for 30 minutes to give a patient report D. terminated care of a competent adult patient at his or her request

A. did not make provisions for continued care of an injured patient.

the bones of the forearm are called: A. humerus and ulna B. tibia and radius C. radius and ulna D. radius and humerus

C. radius and ulna

As an EMT, the performance of your duties will be compared to that of: A. the medical director B. another EMT C. the general public D. a paramedic supervisor

B. another EMT

the bones that constitute the fingers and toes are called A. carpals B. metatarsals C. phalanges D. metacarpals

C. phalanges

the brain connects to the spinal cord through a large opening at the base of the skull called the A. foreman ovale B. vertebral foramen C. foramen Magnum D. spinous foramen

C. foramen magnum

For a do not resuscitate (DNR) order to be valid, it must: A. be dated within the previous 24 months B. be updated a minimum of every 6 months C. be signed by the local justice of the peace D. clearly state the patient's medical problem

D. clearly state the patient's medical problem

In the eyes of the courts, an incomplete or untidy patient care form indicates: A. potential falsification of the patient care form B. inadequate patient care was administered C. thorough documentation was not required D. the EMT was too busy providing patient care to fill out the form

B. inadequate patient care was administered

the cervical spine is composed of ____ vertebrae A. five B. six C. seven D. four

C. seven

Maintaining the chain of evidence at the scene of a crime should include: A. not cutting through holes in clothing that were caused by weapons B. quickly moving any weapons out of the patient's site C. placing the patient in a private area until the police arrive D. making brief notes at the scene and then completing them later

A. not cutting through holes in clothing that were caused by weapons

the circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called A. respiration B. metabolism C. cardiac output D. perfusion

D. perfusion

the descending aorta branches into the A. deep femoral arteries B. internal carotid arteries C. common iliac arteries D. external carotid arteries

C. common iliac arteries

The EMT's scope of practice within his or her local response area is defined by the: A. state EMS office B. local health district C. medical director D. EMS supervisor

C. medical director

The manner in which the EMT must act or behave when caring for a patient is called the: A. EMT oath B. scope of practice C. code of ethics D. standard of care.

D. standard of care

Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with HIV. The EMTs ignored the coworker's treatment of this patient and took no steps to prevent his behavior from happening again. This lack of action on the part of the two EMTs is considered: A. illegal and unethical B. legal and ethical C. illegal but ethical D. legal but unethical

D. legal but unethical

the diapghragm and intercostal muscles contract during A. exhalation B. respiration C. ventilation D. inhalation

D. inhalation

Which of the following general statements regarding consent is correct? A. patients who are intoxicated are generally allowed to refuse treatment B. expressed consent is valid only if given in writing by a family member C. a patient can consent to transport but can legally refuse treatment D. all patients older than 18 years can legally refuse treatment or transport

C. a patient can consent to transport but can legally refuse treatment

the exocrine gland of the pancreases secretes A. bile B. pancreatic juice C. insulin D. glucose

B. pancreatic juice

the kidneys and pancreases are called retroperitoneal organs because they A. sit in front of the liver, spleen, and stomach B. are located behind the abdominal cavity C. lie just anterior to the constovertebral angle D. are protected by the anterior rib cage

B. are located behind the abdominal cavity

Which of the following MOST accurately defines negligence? A. deviation from the standard of care that might result in further injury B. providing care that is consistent with care provided by other EMTs C. transport of a mentally incompetent patient against his or her will D. transferring patient care to a provider with a lower level of training

A. deviation from the standard of care that might result in further injury

Which of the following patients has decision-making capacity and can legally refuse emergency medical treatment? A. a confused young male who says he is the president B. a conscious and alert woman with severe abdominal pain C. a man who is staggering and states that he had three beers D. a diabetic woman who has slurred speech and is not aware of the date

B. a conscious and alert woman with severe abdominal pain

the large, flat, triangular bone that overlies the posterior thoracic wall is called the A. glenoid B. acromion C. scapula D. clavicle

C. scapula

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: A. has a poor relationship with his or her parents B. is mentally competent and able to refuse C. is self supporting and lives by him/herself D. possesses a valid driver's license

C. is self supporting and lives by him/herself

the largest portion of the brain is the _____, which is commonly referred to as the "grey matter" A. brain stem B. cerebrum C. diencephalon D. cerebellum

B. cerebrum

Putrefaction is defined as: A. seperation of the torso from the rest of the body B. profound cyanosis to the trunk and face C. blood settling to the lowest point of the body D. decomposition of the body's tissues

D. decomposition of the body's tissues

Which of the following scenarios MOST accurately depicts abandonment? A. an EMT gives a verbal report to an emergency room nurse B. a paramedic transfers patient care to an EMT C. an AEMT transfers patient care to a paramedic D. a physician assumes patient care from an EMT

B. a paramedic transfers patient care to an EMT

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

A. epiglottis

the major artery that supplies all other arteries with blood is the A. aorta B. carotid C. femoral D. brachial

A. aorta

the pelvic bones are formed by the fusion of the : A. ilium, pubis, and sacrum B. ilium, ishium, and pubis C. pubis and acetabulum D. sacrum and ischium

B. ilium, ishium, and pubis

the phase of the cardiac cycle in which the ventricles fill with the blood is called A. cardiac output B. diasole C. systole D. stroke volume

B. diastole

the primary function of the right atrium is to A. recieve blood from the pulmonary veins B. recieve blood from the vena cave C. pump blood to the lungs for reoxygation D. pump blood to the pulmonary artery

B. receive blood from the vena cava

the primary organ responsible for absorption of products of digestion A. pancreas B. small intestine C. gallbladder D. large intestine

B. small intestine

the smooth muscle that cause the artery to contract are found in the A. lumen B. tunica intima C. tunica adventitia D. tunica media

D. tunica media

the three bones that make up the shoulder girdle are the A. clavicle, scapula, and humerus B. acromion, clavicle, and scapula C. acromion, scapula, and humerus D. acromion, humerus, and clavicle

A. clavicle, scapula, and humerus

the vocal cords are located in the A. pharynx B. oropharynx C. larynx D. nasopharynx

C. larynx

the waste products of aerobic metabolism include A. ATP and glucose B. carbon dioxide and water C. uric acid and nitrogen D. glucose and lactid acid

B. carbon dioxide and water

urine is transported from the kidneys to the urinary bladder via the A. ureters B. uretha C. renal duct D. prostate

A. ureters

what happens when blood volume is lost from body: A. arterial blood is diverted to the skin and muscles B. widespread vasodilation causes blood pressure to decrease C. the arteries contract to increase the blood pressure D. the veins dilate to increase systemic perfusion

C. the arteries contract to increase the blood pressure

what is the function of platelets A. defense against invading organisms B. transport of oxygen and nutrients C. initial formation of a blood clot D. transport of cellular waste materials

C. initial formation of a blood clot

what is the function of the fallopian tubes A. to connect to the overies B. to transport a mature egg to the uterus C. to supply blood to the uterine lining D. to produce progesterone and estrogen

B. to transport a mature egg to the uterus

which layer of the skin is composed of fatty tissues and serves as an insulator for the body A. epidermis B. subcutaneous C. sebaceous D. dermal

B. subcutaneous

which of the following is a function of the upper airway A. relaxes smooth muscle in the bronchioles B. creates sounds from vocal cord vibration C. warms and humidifies inhaled air D. exchanges oxygen and carbon dioxide

C. warms and humidifies inhaled air

which of the following is most characteristic of adequate breathing in an adult A. use of the accessory muscles in the neck and cyanosis B. cool, clammy skin and retractions above the clavicles C. respirations of 20 breaths/min and bilateral chest movement D. respirations of 30 breaths/min and reduced tidal volume

C. respirations of 20 breaths/min and bilateral chest movement

which of the following is not a function of the skin A. sensory reception B. metabolic coordination C. temperature regulation D. pressure and pain perception

B. metabolic coordination

which of the following signs of respiratory distress is typically unique to infants and children A. unequal chest expansion B. seesaw respirations C. unequal breath sounds D. irregular breath pattern

B. seesaw respirations

which of the following skin layers contain sweat and oil glands, hair follicles, blood vessels, and nerve endings A. sebaceous B. dermis C. subcutaneous D. epidermis

B. dermis

Which of the following situations requires you to notify the appropriate authorities? A. cardiac arrest B. accidental knife wound C. attempted suicide D. drug overdose

C. attempted suicide

which of the following statements regarding agonal respirations is correct A. agonal respirations are characterized by fast, irregular breaths B. agonal respirations typically occur before the heart stops C. Agonal respirations result in excessive tidal volume D. agonal respirations are ineffective and need to be assisted

D. agonal respirations are ineffective and need to be assisted

Which of the following statements regarding Good Samaritan laws is correct? A. such laws do not protect EMTs who are off duty B. such laws guarantee that the EMT will not be held liable if he or she is sued C. such laws provide the EMT with absolute immunity from a lawsuit D. such laws will not protect the EMT in cases of gross negligence

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

A ____ receives messages and signals on one frequency and then automatically retransmits them on a second frequency A. repeater B. scanner C. decoder D. duplex

A. repeater

which of the following statements regarding plasma is correct A. plasma has no role in the body's blood-clotting mechanism B. approximately 45% of the blood is composed of plasma C. most of the body's plasma is contained within the large veins D. plasma transports the blood cells and nutrients

D. plasma transports the blood cells and nutrients

A patient's refusal of EMS treatment and/or transport must be: A. witnessed by a notary B. reported to the police C. authorized by a judge D. an informed refusal

D. an informed refusal

All information recorded on the PCR must be: A. reflective of your opinion B. a matter of public record C. considered confidential D. typewritten or printed

C. considered confidential

Any radio hardware containing a transmitter and a receiver that is located in a fixed location is called a: A. multiplex B. base station C. repeater D. mobile radio

B. base station

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

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

which of the following statements regarding the kidneys is correct A. both kidneys are located in the anterior abdominal cavity and lie in between the liver and the spleen B. because the kidneys require little oxygen, only 5% of the body's blood volume passes through them each minute C. a series of small blood vessels attach the kidneys directly to the superior vena cava and renal arteries D. the kidneys eliminate toxic waste products from the body and control the body's fluid balance

D. the kidneys eliminate toxic waste products from the body and control the body's fluid balance

Calming and reassuring an anxious patient can be facilitated by: A. withholding unpleasant information until arrival at the hospital B. positioning yourself at a level that is higher than the patient C. maintaining eye contact with the patient whenever possible D. using medical terminology to ensure the patient understands

C. maintaining eye contact with the patient whenever possible

Communicating with hearing-impaired patients can be facilitated by doing all of the following, except: A. placing yourself in a position to ensure that the patient can see your lips B. elevating the tone of your voice and exaggerating word pronunciation C. shining a light on your face when you are in a darkened environment D. providing pen and paper if the patient prefers to write his or her response

B. elevating the tone of your voice and exaggerating word pronunciation

During the alert and dispatch phase of EMS communications, the dispatcher's responsibilities include all of the following, except: A. coordinating responding EMS units with other public safety personnel B. discouraging the caller from providing care until the EMS unit arrives C. screening and assigning a priority to each call based on local protocols D. selecting and notifying the correct EMS response units and personnel

B. discouraging the caller from providing care until the EMS unit arrives

which of the following systems is responsible for releasing hormones that regulate body activities A. reproductive B. nervous C. endocrine D. skeletal

C. endocrine

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

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

which organ lies in the lateral and posterior portion of the left upper quadrant of the abdomen A. liver B. cecum C. stomach D. spleen

D. spleen

In which of the following manners should you act and speak with a patient? A. passive B. authoritative C. calm and confident D. loud and official

C. calm and confident

which set of nerves is responsible for carrying information from the body to the central nervous system A. sensory B. vertebral C. cranial D. motor

A. sensory

The patient care report (PCR) ensures: A. continuity of care B. availability of research data C. legal protection D. quality assurance

A. continuity of care

Two-way communication that requires the EMT to "push to talk" and "release to listen" describes which mode of communication? A. multiplex B. complex C. simplex D. duplex

C. simplex

worn-out blood cells, foreign substances, and bacteria are filtered from the blood by the A. Kidney B. spleen C. liver D. pancreas

B. spleen

When communicating with a visually impaired patient, you should: A. expect the patient to have difficulty understanding B. determine the degree of the patient's impairment C. possess as in-depth knowledge of sign language D. recall that most visually impaired patients are blind

B. determine the degree of the patient's impairment

When providing a patient report via radio, you should protect the patient's privacy by: A. not disclosing his or her name B. using coded medical language C. refraining from objective D. withholding medical history date

A. not disclosing his or her name

You are dispatched to a movie theater for a 39 year old female with signs and symptoms of a severe allergic reactions. As you are assessing her, she pulls an epinephrine auto-injector out of her purse and hands it to you. After confirming the drugs name and expiration date, you should: A. request an ALS ambulance to administer the drug B. ask her if she takes other medications C. administer the drug D. contact medical control

D. contact medical control

You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient supplemental oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should: A. immediately load the patient into the ambulance, begin transport, and reattempt to contact medical control when you receive a cell signal B. place her in a supine position, keep her warm, begin transport to the hospital, and request a paramedic intercept en route. C. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital. D. notify dispatch and request that a paramedic unit respond to the scene so they can administer epinephrine to the patient.

C. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital

You are treating a middle aged man with chest discomfort. He has a history of three previous heart attacks and takes nitroglycerin as needed for chest pain. You have standing orders to administer aspirin to patients with suspected cardiac-related chest pain or discomfort. While your partner is preparing to give oxygen to the patient you should: A. endure that the patients systolic blood pressure is at least 100 mm Hg because aspirin dilates the blood vessels and can cause a drop in blood pressure B. contact medical control apprise him or her of the patients chief complaint and vital signs, and request permission to give him aspirin C. confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin and document the time and dose given D. assist the patient in taking one of his prescribed nitroglycerins assess his vital signs and give him aspirin if he is still experiencing chest discomfort

C. confirm that the patient is not allergic to aspirin give him the appropriate dose of aspirin, and document the time and dose given.

A 16 year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should: A. recall that patients in this age group prefer not to be treated as adults B. inquire about the possibility of pregnancy in private, if possible C. obtain the majority of your information from one of her parents D. avoid asking questions that she will feel uncomfortable answering

B. inquire about the possibility of pregnancy in private, if possible

When replaying patient information via radio, communications should be: A. spoken in a loud voice B. coded and scripted C. lengthy and complete D. brief and easily understood

D. brief and easily understood

Which of the following incidents does NOT require a report to be filed with local authorities? A. spousal abuse B. animal bites C. cardiac arrest D. gunshot wounds

C. cardiac arrest

Which of the following statements regarding communication with a child is correct? A. unlike adults, children cannot see through lies or deceptions B. most children are intrigued by strangers wearing uniforms C. standing over a child often increases his or her level of anxiety D. the EMT should give the child minimal information to avoid scaring him or her

C. standing over a child often increases his or her level of anxiety

Which type of communications equipment functions as a radio receiver and searches across several frequencies? A. scanner B. mobile repeater C. simplex station D. duplex station

A. scanner

A 37 year old male is having a allergic reaction to penicillin. He does not have an epi auto injector and your protocols do not allow you to carry epi on the ambulance. How should you proceed with the treatment of this patient? A. administer oxygen, transport at once and request a paramedic intercept. B. Ask the patient if he has any diphenhydramine tablets that you can administer C. Quickly determine if there are any bystanders who may carry epi. D. remain at the scene with the patient and request a paramedic ambulance.

A. administer oxygen, transport at once, and request a paramedic intercept.

A 48 year old male is found unconscious in the garden by his wife. when you arrive at the scene and assess the man, you find that he is unresponsive, has labored breathing, and has hives over his entire trunk. you should: A. administer oxygen and position him on his side B. perform a detailed secondary assessment C. maintain his airway and assist his ventilations D. ask his wife if he has any known allergies

C. maintain his airway and assist his ventilations

A 25 year old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the results of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? A. intravenous fluid administration B. high flow oxygen administration C. full immobilization of her spine D. rapid transport to a trauma center

D. rapid transport to a trauma center

an infant or small child's airway can be occluded if it is overextended or overflexed because A. the occiput is proportionately large and the trachea is flexible B. the tongue is proportionately small and can fall back into the throat C. the back of the head is flat, which prevents a neutral position D. he or she has a long neck, which prevents the trachea prone to collapse

A. the occiput is proportionately large and the trachea is flexed

You could be sued for ____ if your radio report to the hospital describes the patient in a manner that injures his or her reputation. A. slander B. negligence C. assault D. libel

A. slander

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

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

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

D. follow standard precautions

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

A. "Do you have any heart problems or take any medications?"

at what age does separation anxiety typically peak in infants and small children A. 18 to 24 months B. 10 to 18 months C. 24 to 36 months D. 6 to 8 months

B. 10 to 18 months

After being dispatched on an emergency call, you should expect the dispatcher to provide you will all of the following information, EXCEPT: A. the general geographic location of the incident B. other agencies that are responding to the scene C. the number of patients involved in the incident D. the nature of the injury, illness, or incident

A. the general geographic location of the incident

Factors that contribute to a decline in the vital capacity of an elderly patient of an elderly patient include all of the following, except A. increased surface area available for air exchange B. a loss of respiratory muscle mass C. decreased residual volume D. increased stiffness of the thoracic cage

A. increased surface area available for air exchange

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

C. draw a single horizontal line through the error, initial it, and write the correct data next to it

Relative to an adult's airway anatomy, the child;s A. mouth and nose are proportionately larger B. trachea is smaller, softer, and less flexible C. pharynx is smaller and less deeply curved D. tongue takes up less space in the pharynx

C. pharynx is smaller and less deeply curved

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

A. acute myocardial infarction

After receiving online orders from medical control to perform a patient care intervention, you should: A. perform the intervention as ordered B. confirm the order in your own words C. repeat the order to medical control word for word D. ask the physician to repeat the order

C. repeat the order to medical control word for word

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

C. ask a family member, law enforcement officer, or bystanders to sign the form verifying that the patient refused to sign

The human body should be functioning at its optimal level between the ages of A. 19 and 25 years B. 18 and 22 years C. 25 and 35 years D. 21 and 30 years

A. 19 and 25 years

A 50 year old male was stung by a honeybee approximately 15 mins ago he presents with respiratory distress, facial swelling, and hypotension. after placing him on oxygen and administering his epi via auto injector, you note that his breathing has improved. additionally, his facial swelling is resolving and his blood pressure is stable your next action should be: A. visualize his airway to assess for oropharyngeal swelling B. notify medical control of the patients response to your treatment C. reassess his breathing and blood pressure in 15 mins D. record the time and dose of the injection and transport promptly

D. record the time and dose of the auto injection and transport promptly

the low normal systolic blood pressure for a 30-year old is A. 60 mm Hg B. 90 mm Hg C. 80 mm Hg D. 70 mm hG

B. 90 mm Hg

General guidelines for effective radio communications include all of the following, EXCEPT: A. using 10 codes to ensure radio traffic confidentiality B. holding the microphone about 2 to 3 inches from your mouth C. speaking in a clear, calm, monotone voice D. acknowledging a transmission as soon as possible

A. using 10 codes to ensure radio traffic confidentiality

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

B. prepare for immediate transport

The pulse rate of a child from ages 6 to 12 years Is approximately A. 60 to 100 beats/min B. 70 to 120 beats/min C. 100 to 150 beats/min D. 90 to 140 beats/min

B. 70 to 120 beats/min

The official transfer of patient care does not occur until the EMT: A. notifies the admitting clerk of the patient's arrival at the hospital B. gives a radio report to the receiving medical facility C. gives an oral report to the emergency room physician or nurse D. informs dispatch of the patient's arrival at the emergency department

C. gives an oral report to the emergency room physician or nurse

When obtaining patient care orders from a physician via a two-way radio, it is important to remember that: A. the use of 10 codes in an effective method of communication B. the physician's instructions are based on the information you provide C. the physician might or might not be located within your service area D. all orders should be carried out immediately and without question

B. the physician's instructions are based on the information you provide

the risk of bleeding in the skull, which increases with age, is most related to A. meningeal deterioration B. a decrease in neurons C. shrinkage of the brain D. blood vessel dilation

C. shrinkage of the brain

When you are communicating with an older patient, it is important to remember that: A. your questions should focus exclusively on the patient's obvious problem B. hostility and confusion should be presumed to be due to the patient's age C. speaking loudly and distinctly will ensure that the patient can hear you D. most older people think clearly and are capable of answering questions

D. most older people think clearly and are capable of answering

after administering 0.3 mg of epi via auto injector to a 22 year old female with an allergic reaction, you note improvement in her breathing and resolution of her hives. However, she still is anxious and tachycardia. you should: A. transport her rapidly, because it is obvious that she is having a severe reaction to the epi B. consider administering 0.15 mg of epi to completely resolve her allergic reaction C. contact medical control and obtain authorization to administer another 0.3 mg of epi D. monitor her closely but recall that anxiety and tachycardia are side effects of epi

D. monitor her closely but recall that anxiety and tachycardia are side effects of epi

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

B. assisted ventilation, thermal management, and elevation of the lower extremities

when assessing an 80-year-old patient in shock, it is important to remember that A. in older adults, it is especially common to observe a significant decreased In heart rate in response to shock B. it is common to see a more significant increase in heart rate than would be expected in younger adults C. the patient's cardiac output is able to increased by nearly 200% in response to the decrease in perfusion D. age-related changes in the cardiovascular system might make the patient less able to compensate for decreased perfusion

D. age-related changes in the cardiovascular system might make the patients less able to compensate for decreased perfusion

Which of the following has the weakest transmission signal and, as a result, is LEAST likely to be heard by the party being called? A. land-base repeater station B. handheld portable radio C. multiples base station D. mobile repeater station

B. handheld portable radio

Which of the following statements is NOT appropriate to document in the narrative section of a PCR? A. "General impression revealed that the patient was intoxicated." B. "Significant damage was noted to the front end of the vehicle." C. "The patient admits to smoking marijuana earlier in the day." D. "After oxygen was administered, the patient's breathing improved."

A. "General impression revealed that the patient was intoxicated."

Which of the following statements regarding standing orders is correct? A. standing orders only highlight the care that you may provide B. standing orders should be followed when physician contact is not possible C. standing orders have less legal authority than orders given via radio D. standing orders require you to contact medical control first before providing an intervention

B. standing orders should be followed when physician contact is not possible

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

B. immobilize his spine and perform a focused secondary exam

A female patient with a suspected head injury has slow, shallow breathing. The MOST appropriate treatment for her includes: A. ventilation assistance to maintain an ETCO2 of 30 to 25 mmHg B. administering oxygen via a nonrebreathing mask C. ventilation assistance to maintain an oxygen saturation of 90% D. hyperventilating her at 30 breaths/min

A. ventilation assistance to maintain an ETCO2 of 30 to 35 mmHg

Patients develop septic shock secondary to: A. weak vessel tone caused by nervous B. failure of the blood vessels to adequately dilate C. poor vessels function and severe volume loss D. an infection that weakens cardiac contractions

C. poor vessels function and severe volume loss

which of the following is a physical change that typically occurs in the adolescent age group A. the normal pulse rate steadily increases B. secondary sexual development begins C. muscle and bone growth both decrease D. the systolic blood pressure decreases

B. secondary sexual development begins

the adult epi auto injector delivers ____ mg of epi, and the infant child auto injector delivers ___ mg. A. 0.3; 0.15 B. 0.1;0.01 C. 0.01; 0.1 D. 0.03; 0.3

A. 0.3; 0.15

which of the following is an anatomic difference between children and adults A. the trachea of an infant is proportionately longer than an adult's trachea B. an infant's tongue is proportionately larger than an adult's tongue C. the rib cagee of an infant is less flexible than an adult's rib cage D. an infants head accounts for less body weight that an adult's head

B. an infant's tongue is proportionately larger than an adult's tongue

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: A. neurogenic shock B. vasovagal shock C. psychogenic shock D. neurologic shock

C. psychogenic shock

which of the following medications blocks the release of histamines? A. Albuterol (Ventolin) B. acetaminophen (Tylenol) C. epinephrine (adrenalin) D. diphenhydramine (benadryl)

D. diphenhydramine (benadryl)

which of the following physiologic actions does epi produce when given for an Allergic reaction? A. blocking of further histamine release B. Vasoconstriction and bronchodilation C. bronchodilation and vasodilation D. bronchoconstriction and vaso constriction

B. Vasoconstriction and bronchodilation

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

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

which of the following is not a common factor that would affect a 75-year-old patient's vital signs A. medications B. overall health C. medical conditions D. increased weight

D. increased weight

you are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epi you should: A. apply high flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once. B. apply high flow oxygen, obtain approval from medical control to assist him with his epi, and transport C. assess his ABC's and vital signs in 15 mins and allow him to drive himself to the hospital if he remains stable D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital

D. apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital

which of the following statements regarding age-related changes in the nervous system is correct A. interconnections between brain cells often prevent a loss of knowledge or skill, despite a loss of neurons B. generally speaking, the brain increases in size by 10% to 20% by the time a person reaches 80 years of age C. because of a decrease in the number of brain cells, a person's level of intelligence decreases with age D. the metabolic rate in the brain increases with age, but the consumption of oxygen decreases significantly

A. interconnections between brain cellss often prevent a loss of knowledge or skill, despite a loss of neurons

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

C. axial loading

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

D. retrograde amnesia

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

D. 3

A reflex arc occurs when: A. a sensory nerve sends a message to the brain, but the motor nerve fails to send the appropriate response to the body B. the motor nerves function automatically without receiving a message from the CNS C. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve D. the brain interprets sensory information that it receives from peripheral and cranial nerves and sends a signal to the muscles

C. a sensory nerve detects an irritating stimulus and bypasses the brain by sending a direct message to the motor nerve

which of the following statements regarding an infant's vital signs is correct A. an ifant's heart rate generally ranges between 70 and 110 beats/min B. by six months of age, an infant's normal tidal volume is 2 to 4 mL/Kg C. an infants normal heart rate increases by 10 beats /min each month D. an infants normal body temperature is typically higher than a preschooler's normal body temperature

D. an infants normal body temperature is typically higher than a preschooler's normal body temperature

A tight-fitting motorcycle helmet should be left in place unless: A. the patient must be placed onto a long backboard B. the patient complains of severe neck or back pain C. the helmet is equipped with a full face shield or visor D. it interferes with your assessment of the airway

D. it interferes with your assessment of the airway

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

B. assess distal neurovascular status in the extremities

You are transporting a 33 year old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: A. arrange for an ALS rendezvous B. repeat your secondary assessment C. reassess his condition in 5 minutes D. take his vital signs in 15 minutes

C. reassess his conditions in 5 minutes

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

C. intracerebral hematoma

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

C. a rapid, thready pulse

Common signs of a skull fracture include all of the following, EXCEPT: A. superficial scalp lacerations B. noted deformity to the skull C. ecchymosis around the eyes D. mastoid process bruising

A. superficial scalp lacerations

which of the following statements regarding middle adults is correct A. significant impairments in hearing and vision begin to occur in persons between the ages of 41 and 44 years B. cardiovascular health becomes an issue in this age group, as does the greater incidence of cancer C. women in the middle adult age group typically experiences menopause in their late 50s early 60s D. increased cholesterol levels in the middle age group often do not respond to exercise and diet

During your primary assessment of a 19-year-old unconscious male who experienced severe head trauma, you not that his respirations are rapid, irregular, and shallow. He has bloody secretions draining from his mouth and nose. You should: A. immobilize his spine and transport immediately B. pack his nostrils to stop the drainage of blood C. assist his ventilations with a bag valve mask D. suction his oropharynx for up to 15 seconds

D. suction his oropharynx for up to 15 seconds

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44 year old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should: A. assess the rate and quality of his pulse B. administer 100% supplemental ocygen C. immediately evaluate his airway D. apply direct pressure to the wound

D. apply direct pressure to the wound

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

B. instruct him to assist her ventilations while you perform a rapid assessment

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

C. 14

If you do not have the appropriate-size cervical collar, you should: A. use rolled towels to immobilize the patient's head B. ask the patient to keep his or her head in a neutral position C. place sandbags on either side of the patient's head D. defer cervical immobilization and apply lateral head blocks

A. use rolled towels to immobilize the patient's head

In the setting of a head injury, hypertension, bradycardia, and biot respirations indicate: A. internal bleeding in the chest B. an underlying skull fracture C. decreased cerebral blood flow D. herniation of the brain stem

D. herniation of the brain stem

In which of the following situations would the EMT be the LEAST likely to immobilize a patient's spine? A. no distracting injuries or evidence of intoxication B. unresponsive, but moving all extremities equally C. pain to the c-spine, but no numbness or tingling D. no spinal pain, but tingling in the extremities

A. no distracting injuries or evidence of intoxication

It would be MOST appropriate to perform a focused secondary assessment on a patient who: A. has blood draining from the ears following a head injury B. struck his or her head and is experiencing nausea or vomiting C. was restrained during a high-speed motor vehicle crash D. fainted and fell to the ground from a standing position

D. fainted and fell to the ground from a standing position

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

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

The____is the best-protected part of the CNS and controls the functions of the cardiac and respiratory systems A. cerebellum B. cerebral cortex C. spinal cord D. brain stem

D. brain stem

The cervical spine is composed of____vertebra. A. 6 B. 5 C. 7 D. 8

C. 7

The effectiveness of positive pressure ventilations when treating a head-injured patient can ONLY be determined by: A. a neurosurgeon or emergency department physician B. noting a decrease in the heart rate during ventilations C. reassessing the patient's blood pressure after 10 minutes D. immediate reassessment after the intervention

D. immediate reassessment after the intervention

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

C. cervical, thoracic, lumbar, sacral, and coccygeal

The GCS is used to assess: A. eye opening, verbal response, and motor response B. sensory response, pupil reaction, and heart rate C. verbal response, eye opening, and mental status D. mental status, eye opening, and respiratory rate

A. eye opening, verbal response, and motor response

The meninges, along with the cerebrospinal fluid (CSF) that circulates in between each meningeal later, function by: A. regenerating brain cells after they have been damaged B. delivering oxygen directly to the CNS C. producing leukocytes that protect the brain from infection D. acting as a shock absorber for the brain and spinal cord

D. acting as a shock absorber for the brain and spinal cord

A 19 year old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the mechanism of injury, what MOST likely occured? A. asystole secondary to massive intrathoracic hemorrhage due to traumatic rupture of the aorta B. collapse of both lungs due to fractured ribs that perforated the lung tissue and caused cardiac arrest C. fracture of the sternum that caused a rupture of the myocardium and led to a cardiac dysrhythmia D. ventricular fibrillation when the impact occured during a critical portion of the cardiac cycle

D. ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle

A 28 year old male was struck in the chest with a baseball bat during an altercation. He is conscious and alert and complains of severe chest pain. Your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. In addition to providing supplemental oxygen, you should: A. apply bulky dressings to the sternum B. prepare for immediate transport C. apply an AED and assess his BP D. determine if he has cardiac problems

B. prepare for immediate transport

A 37 year old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemmorhaging. You should: A. suspect a sever hemopneumothorax B. perform a secondary assessment C. aggressively manage his airway D. request a paramedic ambulance

C. aggressively manage his airway

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning, and the child has increasing respiratory distress. You should: Select one: A. reset the ventilator by unplugging it for 30 to 60 seconds. B. place a call to the home health agency treating this patient. C. disconnect the ventilator and apply a tracheostomy collar. D. attempt to troubleshoot the mechanical ventilator problem.

C. try repositioning the hearing aid or remove it and turn down the volume.

According to the “E” in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? Select one: A. Look for blood or other secretions in the tube. B. Listen to breath sounds to assess for a pneumothorax. C. Attempt to pass a suction catheter into the tube. D. Check the mechanical ventilator for malfunction.

D. Check the mechanical ventilator for malfunction.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): Select one: A. all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay. B. a healthcare facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. C. all healthcare facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. D. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.

A. all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay.

An important aspect in the assessment of a patient who experienced a previous brain injury involves: Select one: A. contacting the patient’s physician to determine the extent of the brain injury. B. speaking with the patient and family to establish what is considered normal for the patient. C. presuming that he or she has cognitive impairment until proven otherwise. D. recalling that most patients with a brain injury have other organ dysfunction.

B. speaking with the patient and family to establish what is considered normal for the patient.

As many as 40% of patients with Down syndrome have: Select one: A. diabetes mellitus. B. intracranial bleeding. C. a heart condition. D. unilateral paralysis.

C. a heart condition

Because a tracheostomy tube bypasses the nose and mouth: Select one: A. bleeding or air leakage might occur around the tube. B. secretions can build up in and around the tube. C. severe swelling of the trachea and bronchi can occur. D. the risk of a local infection is significantly high.

B. secretions can build up in and around the tube.

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: Select one: A. lower the pitch of your voice. B. speak in a monotone voice. C. increase the pitch of your voice. D. try basic sign language first.

A. lower the pitch of your voice.

By placing one hand on your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she: Select one: A. is nauseated. B. is hurt. C. needs help. D. is sick.

D. is sick.

Down syndrome is a genetic defect that occurs as the result of: Select one: A. a triplication of chromosome 21. B. a sperm that contains 24 chromosomes. C. a separation of chromosome 21. D. an extra pair of chromosomes.

A. a triplication of chromosome 21.

EMS personnel would most likely be called to the residence of a patient receiving home health care when the home care provider: Select one: A. has recognized a change in the patient’s health status. B. must confirm that a specific intervention is required. C. needs simple assistance in providing patient care. D. has a question that is specific to the patient’s condition.

has recognized a change in the patient’s health status.

EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers “feel like needles.” The EMTs should suspect: Select one: A. a cervical spine injury. B. a seizure. C. an intracranial hemorrhage. D. hydrocephalus.

a cervical spine injury.

EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless, apneic, and wearing an external defibrillator vest. In this situation, the EMTs should: Select one: A. perform CPR and leave the vest in place. B. apply the AED pads over the vests’ pads. C. wait 5 minutes prior to using the AED. D. quickly remove the vest and perform CPR.

perform CPR and leave the vest in place.

EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should: Select one: A. request an ALS ambulance to clamp the tubing. B. carefully remove the catheter and transport. C. gently manipulate the catheter to reduce the bleeding. D. apply direct pressure to the tubing and transport.

apply direct pressure to the tubing and transport.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: Select one: A. nerve damage. B. barotrauma. C. eardrum perforation. D. earwax accumulation.

nerve damage.

The tip of a central venous catheter rests in the: 51. Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? Select one: A. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient’s primary caregiver. B. Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition. C. Before performing an assessment of the patient’s ABCs, the EMT should ask the caregiver about the patient’s medical condition. D. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient’s illness.

Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.

When assessing or providing care to a patient with an intellectual disability, you should: Select one: A. be observant for signs of fear or reluctance from the patient. B. frequently reassure him or her that everything will be okay. C. move swiftly and deliberately to quickly accomplish the task. D. explain procedures while in the process of performing them.

be observant for signs of fear or reluctance from the patient.

When caring for patients with cerebral palsy, it is important to remember that: Select one: A. most patients can walk but have an unsteady gait. B. hearing aids are usually ineffective for patients with hearing loss. C. their limbs are often underdeveloped and prone to injury. D. they cannot walk and are totally dependent upon you.

their limbs are often underdeveloped and prone to injury.

When interacting with an intellectually disabled patient, the best approach is to: Select one: A. ask your team members to wait until you can establish a rapport with the patient. B. position yourself slightly above the patient’s level to reduce his or her anxiety. C. speak primarily with the patient’s family to establish the degree of disability. D. approach the patient as a team to reassure him or her that you are there to help.

ask your team members to wait until you can establish a rapport with the patient.

Which of the following statements regarding cerebral palsy is correct? Select one: A. Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis. B. Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay. C. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. D. A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator.

Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

A disposable oxygen humidifier should be considered for ambulance services that often transport patients for ___ hour(s) or more. Select one: A. 3 B. 1 C. 2 D. 4

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

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

A portable oxygen cylinder should have a minimum capacity of ____ of oxygen. Select one: A. 1,000 L B. 250 L C. 750 L D. 500 L

500 L

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

turn your emergency lights off and obey all traffic laws.

As soon as you leave the hospital and are en route back to your station, you should inform the dispatcher: Select one: A. whether you are back in service. B. of the name of the accepting physician. C. that you are prepared for another call. D. about the patient’s clinical condition.

whether you are back in service.

For every emergency request, the dispatcher should routinely gather and record all of the following information, except the: Select one: A. caller’s phone number. B. patient’s medical history. C. nature of the call. D. location of the patient(s).

patient’s medical history.

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

regularly using the siren as much as possible.

If you could only take two pieces of equipment with you to a patient’s side, you should choose the: Select one: A. cervical collar and long backboard. B. AED and portable suction unit. C. BVM and portable oxygen. D. oral airways and sterile dressings

AED and portable suction unit.

If you properly assess and stabilize a patient at the scene, driving to the hospital with excessive speed: Select one: A. is often necessary if the patient is critical. B. will decrease the driver’s reaction time. C. increases the patient’s chance for survival. D. is allowable according to state law.

will decrease the driver’s reaction time.

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

a patient has a time-dependent injury or illness, and traffic conditions would cause a significant delay in definitive care.

In which of the following situations would the EMTs most likely utilize a police escort? Select one: A. The EMTs are transporting a critical pediatric patient through traffic. B. The call is dispatched as an unresponsive patient with CPR in progress. C. The weather is treacherous, and there are numerous roads washed out. D. The EMTs are unfamiliar with the location, but the police officer is familiar with the location.

The EMTs are unfamiliar with the location, but the police officer is familiar with the location.

Minimum airway and ventilation equipment that should be carried on every ambulance include all of the following, except: Select one: A. adult and pediatric bag-valve masks. B. Combitubes, or laryngeal mask airways. C. mounted and portable suctioning units. D. various sizes of oral and nasal airways.

Combitubes, or laryngeal mask airways.

It is 10:30 pm, and you have requested air medical transport for a critically injured patient. When you arrive at the designated landing zone, you should: Select one: A. survey the area for power lines or other hazards. B. mark the landing site using personnel with flashlights. C. provide the flight crew with a patient status update. D. mark the proposed landing area with road flares.

survey the area for power lines or other hazards.

The least practical place to store a portable oxygen cylinder is: Select one: A. inside the jump kit. B. on the ambulance stretcher. C. in the driver’s compartment. D. near the side or rear door.

in the driver’s compartment.

The main objective of traffic control at the scene of a motor vehicle crash is to: Select one: A. prevent curious onlookers from observing the scene. B. facilitate a route for the media to access the scene. C. warn oncoming traffic and prevent another crash. D. get oncoming traffic past the scene as soon as possible.

warn oncoming traffic and prevent another crash.

The six-pointed Star of Life emblem identifies vehicles that: Select one: A. are equipped with supplies to manage a mass-casualty situation. B. have complied with state regulations for ambulance certification. C. are staffed by a minimum of one certified advanced EMT (AEMT). D. meet federal specifications as licensed or certified ambulances.

meet federal specifications as licensed or certified ambulances.

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

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

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

turn your headlights off.

When a helicopter must land on a grade (uneven ground), you should: Select one: A. move the patient to the aircraft as soon as it lands. B. approach the aircraft from the uphill side. C. approach the aircraft from the downhill side. D. attempt to approach the aircraft from behind.

approach the aircraft from the downhill side.

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

maintain spinal stabilization as she is extricated.

When parking your ambulance at the scene of a motor vehicle crash, you should position the ambulance: Select one: A. alongside the scene to rapidly access the patient(s). B. 50′ past the scene on the opposite side of the road. C. 50′ before the scene on the same side of the road. D. 100′ past the scene on the same side of the road.

100′ past the scene on the same side of the road.

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

immobilize him with a vest-style device.

A hiker was injured when he fell approximately 20′ from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The most appropriate method of immobilizing and moving the patient to the ambulance is to: Select one: A. apply a vest-style immobilization device and move him using a stair chair device. B. immobilize him to a long backboard and use the four-person carry to move him. C. immobilize him with a short backboard and place him on the ambulance stretcher. D. immobilize his spine with a long backboard and place him in a basket stretcher.

immobilize his spine with a long backboard and place him in a basket stretcher.

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

the battery has higher voltage than a traditional vehicle battery.

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

support the injured extremities and continue removal.

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, except: Select one: A. preparing all patients for transportation. B. assigning all patients a triage category. C. ongoing assessment of critical patients. D. keeping bystanders at a safe distance.

keeping bystanders at a safe distance.

Upon arrival at a motor vehicle crash, the EMT should: Select one: A. leave only the essential warning lights activated. B. turn off the emergency flashing lights and headlights. C. turn off the ambulance and set the emergency brake. D. park at least 300 feet away from the accident scene.

leave only the essential warning lights activated.

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should: Select one: A. immediately request additional resources. B. begin triage to determine injury severity. C. request law enforcement for traffic control. D. call medical control for further direction.

immediately request additional resources.

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

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

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

ask the incident commander where the ambulance should be staged.

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

direct your partner to begin ventilatory assistance.

Disentanglement involves: Select one: A. removing a patient from a dangerous position. B. extrication techniques that EMTs are trained in. C. the use of simple access tools such as a pry bar. D. gaining access to a patient in a crashed vehicle.

removing a patient from a dangerous position.

Extrication is defined as: Select one: A. removal from a dangerous situation or position. B. using heavy equipment to access a patient. C. dismantling an automobile to remove a victim. D. immobilizing a patient before moving him or her.

removal from a dangerous situation or position.

If a technical rescue team is required at the scene but is not present when you arrive, you should: Select one: A. remain with your ambulance until the rescue team arrives at the scene. B. have fire personnel initiate the rescue process if they are at the scene. C. check with the incident commander to ensure that the team is en route. D. don personal protective equipment and begin the rescue process.

check with the incident commander to ensure that the team is en route.

In contrast to simple access, complex access: Select one: A. involves forcible entry into a vehicle. B. often involves simply unlocking a door. C. is a skill commonly taught to EMTs. D. does not involve the breaking of glass.

involves forcible entry into a vehicle.

Once entrance and access to the patient have been provided, you should: Select one: A. administer high-flow oxygen. B. allow extrication to commence. C. perform a primary assessment. D. begin treating his or her injuries

perform a primary assessment.

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

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

The EMT’s role at the scene of a search and rescue attempt is to: Select one: A. stand by at the command post until the person is located. B. report to a location where the patient will be carried. C. accompany search team members and provide care. D. direct the search effort from a centralized location.

stand by at the command post until the person is located.

The reasons for rescue failure can be recalled by the mnemonic FAILURE. According to this mnemonic, the “U” stands for: Select one: A. unprepared to effectively manage the scene. B. underutilizing personnel at the scene. C. underestimating the logistics of the incident. D. undertrained to correctly utilize equipment.

underestimating the logistics of the incident.

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

is an ongoing process until the incident is terminated.

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

cut away all of the patient’s clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

A critical function of the safety officer is to: Select one: A. stop an emergency operation whenever a rescuer is in danger. B. monitor emergency responders for signs of stress and anxiety. C. determine the most efficient approach to extricate a victim. D. brief responders during the demobilization phase of an incident.

stop an emergency operation whenever a rescuer is in danger.

A patient in respiratory arrest at the scene of a multiple-casualty incident would typically be classified as a fourth priority (black tag; expectant) patient, unless: Select one: A. there are at least three other patients in respiratory arrest. B. he or she has external signs of severe thoracic trauma. C. he or she has signs of an injury to the cervical spine. D. there are enough resources to provide care for him or her.

there are enough resources to provide care for him or her.

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

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

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

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

According to the JumpSTART triage system, infants or children not developed enough to walk or follow commands, including children with special needs: Select one: A. are treated immediately in the primary triage area and then transported. B. should be taken to the treatment area for immediate secondary triage. C. are initially triaged on the basis of whether they have distal pulses. D. are the first to be transported, regardless of the severity of their injuries.

should be taken to the treatment area for immediate secondary triage.

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min, you should: Select one: A. assess neurologic status. B. assign an immediate category. C. look for posturing. D. assess for a distal pulse.

assess for a distal pulse.

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min? Select one: A. Assess for bilateral radial pulses. B. Administer high-flow oxygen. C. Assess his or her neurologic status. D. Triage the patient as delayed.

Assess for bilateral radial pulses.

According to the START triage system, which of the following patients should be triaged as an immediate priority (red tag)? Select one: A. Conscious, in severe pain, with radial pulses present B. Apneic, despite manually opening the airway C. Unresponsive with a respiratory rate of 34 breaths/min D. Conscious with a respiratory rate of 24 breaths/min

Unresponsive with a respiratory rate of 34 breaths/min

After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, except: Select one: A. recommendations for movement to the treatment area. B. the recommended transport destination for each patient. C. the number of patients that are in each triage category. D. the total number of patients that have been triaged.

the recommended transport destination for each patient.

As a triage supervisor, you: Select one: A. must prepare patients for transport before they leave the triage area. B. should communicate with area hospitals regarding their capabilities. C. must not begin treatment until all patients have been triaged. D. are responsible for providing initial treatment to all patients.

must not begin treatment until all patients have been triaged.

At a very large incident, the __________ section is responsible for managing the tactical operations usually handled by the incident commander on routine EMS calls. Select one: A. logistics B. operations C. planning D. finance

operations

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then: Select one: A. call for additional resources. B. establish command. C. begin the triage process. D. quickly identify the walking wounded.

establish command.

Burn patients without airway compromise and patients with multiple bone or joint injuries should be marked with a __________ triage tag at a mass-casualty incident. Select one: A. green B. black C. yellow D. red

yellow

During a HazMat incident, you are working in the treatment area. As patients are removed from the danger zone, you should: Select one: A. remain where you are and have the patients brought to you. B. quickly decontaminate the patients and begin assessing them. C. retrieve patients from the decontamination area and begin treatment. D. perform a rapid assessment and then have them decontaminated.

remain where you are and have the patients brought to you.

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

begin some form of positive-pressure ventilation.

General principles for approaching a potential HazMat incident include: Select one: A. parking the ambulance in a location that is upwind and downhill. B. taking standard precautions before entering any HazMat scene. C. maintaining a safe distance and viewing the scene with binoculars. D. asking for wind direction from dispatch and entering downwind.

asking for wind direction from dispatch and entering downwind.

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, except: Select one: A. any airway or breathing difficulty. B. severe medical problems. C. fractures of multiple long bones. D. uncontrolled or severe hemorrhage.

fractures of multiple long bones.

Level _____ hazardous materials would cause irritation on contact but only mild residual injury, even without treatment. Select one: A. 2 B. 0 C. 3 D. 1

Placards and labels on a storage container are intended to: Select one: A. provide specific information about the chemical being carried. B. broadly classify chemicals as being explosive or nonexplosive. C. give a general idea of the hazard inside that particular container. D. advise responders of the appropriate neutralizing measures.

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

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

smallpox

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

assist his ventilations with high-flow oxygen

All of the following are vesicant agents, except: Select one: A. phosgene oxime. B. sarin. C. lewisite. D. sulfur mustard.

sarin

All of the following biologic agents or diseases can be transmitted from person to person, except: Select one: A. viral hemorrhagic fevers. B. smallpox. C. ricin. D. pneumonic plague.

ricin

As the first arriving emergency responder at the scene of a suspected terrorist or weapon of mass destruction incident, you should request additional resources as needed and then: Select one: A. carefully inspect the area for the presence of secondary explosive devices. B. function as the incident commander until additional personnel arrive. C. remain where you are until additional ambulances arrive at the scene. D. direct your partner to begin triaging patients as you call medical control.

function as the incident commander until additional personnel arrive.

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

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

At present, the likelihood of a nuclear attack against the United States is very low because: Select one: A. the United States has an effective early warning system to detect an incoming nuclear missile. B. other than the United States, no other countries are currently in possession of nuclear weapons. C. all nuclear devices or weapons that different countries are in possession of are currently accounted for. D. terrorist nations do not have the ability to deliver a nuclear weapon via missile or bomb.

terrorist nations do not have the ability to deliver a nuclear weapon via missile or bomb.

Botulinum is: Select one: A. a potent bacterial neurotoxin. B. rarely associated with death. C. an acute viral infection. D. a disease of the leukocytes.

a potent bacterial neurotoxin

Continual reassessment of the scene at a suspected terrorist or weapon of mass destruction incident is most important because: Select one: A. weather conditions might change quickly. B. bystanders might destroy the evidence. C. terrorists are often at the scene after an attack. D. a secondary explosive device might detonate.

a secondary explosive device might detonate.

Early signs and symptoms of smallpox include all of the following, except: Select one: A. body aches. B. skin blisters. C. headaches. D. high fever.

skin blisters

Exposure to _________ would most likely result in immediate respiratory distress. Select one: A. lewisite B. tabun C. chlorine D. soman

chlorine

In determining the potential for a terrorist attack, you should routinely observe all of the following on every call, except: Select one: A. weather conditions. B. the type of call. C. victim’s statements. D. the location type.

weather conditions

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

atropine and pralidoxime chloride.

Initial signs and symptoms associated with viral hemorrhagic fevers include: Select one: A. joint pain and unequal pupils. B. headache and sore throat. C. acute onset of double vision. D. severe abdominal muscle spasms.

headache and sore throat

Nerve agents were first discovered while in search of a superior: Select one: A. detergent. B. pesticide. C. vaccine. D. antibiotic.

pesticide

Pulmonary hemorrhage and inner ear damage are examples of __________ blast injuries. Select one: A. miscellaneous B. tertiary C. primary D. secondary

primary

Signs and symptoms of exposure to a nerve agent include: Select one: A. salivation, pinpoint pupils, and diarrhea. B. dry mouth, dilated pupils, and headache. C. hypertension and severe pulmonary edema. D. tachycardia, flushed skin, and unequal pupils.

salivation, pinpoint pupils, and diarrhea

Symptoms of both inhaled and ingested ricin include: Select one: A. joint pain and bradycardia. B. dehydration and convulsions. C. liver necrosis and diarrhea. D. fever and headache.

fever and headache

The EMT should expect that a patient who was exposed to cyanide will have: Select one: A. an abnormally slow pulse rate. B. an abnormally slow respiratory rate. C. a normal pulse oximetry reading. D. skin that is cherry red and hot.

a normal pulse oximetry reading.

The incubation period for Ebola can be up to: Select one: A. 72 hours. B. 6 months. C. 21 days. D. 1 week.

21 days

During your assessment of a patient with blunt chest trauma, you note that the patient has shallow breathing and paradoxical movement of the left chest wall. You should: Select one: A. assist ventilations with a bag valve mask. B. make note of it and continue your assessment. C. request a paramedic to decompress the chest. D. apply high-flow oxygen via nonrebreathing mask.

assist ventilations with a bag valve mask.

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

Engorged jugular veins

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

provide ventilation assistance with a bag valve mask.

While jogging, a 19-year-old male experienced an acute onset of shortness of breath and pleuritic chest pain. He is conscious and alert with stable vital signs. Your assessment reveals that he has diminished breath sounds over the left side of the chest. You should: Select one: A. recognize that he needs a needle decompression. B. administer oxygen and transport to the hospital. C. circumferentially tape a dressing around his chest. D. immediately perform a rapid head-to-toe exam.

administer oxygen and transport to the hospital.

You are transporting a stable patient with a possible pneumothorax. The patient is receiving high-flow oxygen and has an oxygen saturation of 95%. During your reassessment, you find that the patient is now confused, hypotensive, and profusely diaphoretic. What is most likely causing this patient’s deterioration? Select one: A. A total collapse of the affected lung B. Blood accumulation in the pleural space C. Compression of the aorta and vena cava D. Hidden bleeding in the thoracic cavity

Compression of the aorta and vena cava

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

laceration of the aorta.

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

partially remove the dressing.

A flail chest occurs when: Select one: A. more than three ribs are fractured on the same side of the chest. B. multiple ribs are fractured on both sides of the thoracic cage. C. a segment of fractured ribs bulges during the inhalation phase. D. a segment of the chest wall is detached from the thoracic cage.

a segment of the chest wall is detached from the thoracic cage.

A patient who presents with profound cyanosis following a chest injury: Select one: A. is most likely experiencing severe blood loss. B. should be placed in Trendelenburg’s position. C. requires prompt ventilation and oxygenation. D. has most likely experienced a ruptured aorta.

requires prompt ventilation and oxygenation.

A rapid, irregular pulse following blunt trauma to the chest is most suggestive of a: Select one: A. ruptured aorta. B. pericardial tamponade. C. myocardial contusion. D. tension pneumothorax

myocardial contusion

A simple pneumothorax: Select one: A. is caused by penetrating chest trauma. B. often has a nontraumatic cause. C. is commonly caused by blunt chest trauma. D. heals on its own without any treatment.

is commonly caused by blunt chest trauma.

An open pneumothorax is: Select one: A. a fractured rib that perforates the tissue of the lung surface. B. an open chest wound through which air moves during breathing. C. the entry of air into the pleural space from a perforated lung. D. extreme pleural pressure that causes the lung to rupture.

an open chest wound through which air moves during breathing.

Elevation of the rib cage during inhalation occurs when: Select one: A. intrathoracic pressure decreases. B. abdominal contents descend. C. the intercostal muscles contract. D. the diaphragm descends.

the intercostal muscles contract.

Hemoptysis is defined as: Select one: A. vomiting blood. B. abnormal blood clotting. C. blood in the pleural space. D. coughing up blood.

coughing up blood

If a patient with a chest injury only inhales small amounts of air per breath, he or she: Select one: A. must increase his or her respiratory rate to maintain adequate minute volume. B. often breathes at a slower rate because of lung damage caused by the injury. C. will eliminate more carbon dioxide than if he or she were breathing deeply. D. will maintain adequate minute volume if his or her respiratory rate stays the same.

must increase his or her respiratory rate to maintain adequate minute volume.

If a person’s tidal volume decreases, but his or her respiratory rate remains unchanged: Select one: A. excess carbon dioxide will be eliminated. B. minute volume will remain unchanged. C. minute volume will increase. D. minute volume will decrease.

minute volume will decrease

Irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called: Select one: A. pleurisy. B. dyspnea. C. pneumothorax. D. pneumonitis.

pleurisy

Patients with rib fractures will commonly: Select one: A. prefer to lie in a supine position. B. breathe rapidly and shallowly. C. develop a sucking chest wound. D. take a series of deep breaths.

breathe rapidly and shallowly

Pneumothorax is defined as: Select one: A. blood collection within the pleural space. B. accumulation of air between the lungs. C. blood collection within the lung tissue. D. accumulation of air in the pleural space.

accumulation of air in the pleural space.

Signs and symptoms of a tension pneumothorax include all of the following, except: Select one: A. collapsed jugular veins. B. profound cyanosis. C. unilaterally absent breath sounds. D. altered mental status.

collapsed jugular veins.

Subcutaneous emphysema is an indication that: Select one: A. air is escaping into the chest wall from a damaged lung. B. blood is slowly accumulating within the tissue of the lung. C. at least half of one lung has completely collapsed. D. your patient is experiencing a pericardial tamponade.

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

The ________ nerves supply the diaphragm. Select one: A. costal B. phrenic C. vagus D. intercostal

phrenic

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

transport him in the position in which you found him.

A 40-year-old male presents with severe abdominal pain after blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, except: Select one: A. promptly transporting him to the hospital. B. covering him with a warm blanket. C. giving him small sips of plain water. D. administering supplemental oxygen.

giving him small sips of plain water.

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

applying direct pressure with a dry, sterile dressing.

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

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

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should: Select one: A. apply oxygen via a nonrebreathing mask. B. ventilate the patient with a bag-mask device. C. open the patient’s airway. D. apply direct pressure to the wound.

apply direct pressure to the wound.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her airbag deployed. You should: Select one: A. perform a head-to-toe assessment while she is in the car. B. carefully assess her upper chest for seatbelt-related injuries. C. lift the airbag and look for deformity to the steering wheel. D. extricate her immediately and transport to a trauma center.

lift the airbag and look for deformity to the steering wheel.

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

law enforcement is at the scene.

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should: Select one: A. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min. B. perform a comprehensive secondary assessment to determine why his clinical status has changed. C. reassess his vital signs and then notify the receiving hospital of the change in his clinical status. D. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag valve mask.

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

closely monitor him and reassess him frequently.

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

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

A sign of kidney damage after blunt trauma is: Select one: A. hemoptysis. B. hematuria. C. hematochezia. D. hematemesis.

hematuria

Accumulation of blood in the abdominal cavity will most likely cause: Select one: A. diffuse bruising. B. referred pain. C. nausea or vomiting. D. distention.

distention

All of the following are hollow abdominal organs, except the: Select one: A. ureters. B. stomach. C. bladder. D. spleen.

spleen

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

prompt transport to the hospital is essential.

Bruising to the right upper quadrant of the abdomen after blunt trauma is most suggestive of injury to the: Select one: A. liver. B. kidney. C. spleen. D. stomach.

liver

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

a poorly placed lap belt

Contraction or tensing of the abdominal muscles to ease pain is called: Select one: A. guarding. B. flexing. C. withdrawing. D. referring.

guarding

Difficulty breathing and a sunken appearance of the anterior abdominal wall is most indicative of a ruptured: Select one: A. aorta. B. stomach. C. spleen. D. diaphragm.

diaphragm

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

intra-abdominal bleeding.

Early bruising following abdominal trauma often manifests as: Select one: A. dark purple marks. B. gross distention. C. localized pain. D. red areas of skin.

red areas of skin

Peritonitis usually occurs when: Select one: A. bacteria or viruses invade the walls of the gastrointestinal tract. B. solid abdominal organs bleed secondary to penetrating trauma. C. hollow abdominal organs are damaged and spill their contents. D. the vessels that supply the abdominal organs become inflamed.

hollow abdominal organs are damaged and spill their contents.

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

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

The mesentery is: Select one: A. a layer of thick skeletal muscles that protects the abdominal organs. B. a complex network of blood vessels that supply blood to the liver. C. a membranous fold that attaches the intestines to the walls of the body. D. the point of attachment between the small and large intestines.

a membranous fold that attaches the intestines to the walls of the body.

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

should be assumed to be a sign of shock.

When a hollow organ is punctured during a penetrating injury to the abdomen: Select one: A. it commonly protrudes through the injury site. B. peritonitis might not develop for several hours. C. it will bleed profusely and rapidly cause shock. D. the abdomen will become instantly distended.

peritonitis might not develop for several hours.

A 17-year-old female dislocated her patella while playing soccer. Her knee is flexed, and she complains of severe pain. You should: Select one: A. keep her knee flexed and secure it with padded board splints. B. gently straighten her knee and apply a padded board splint. C. make one attempt to return the patella to its normal position. D. flex her knee slightly more and assess for distal circulation.

keep her knee flexed and secure it with padded board splints.

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

immobilize the injury with a sling and swathe.

A 20-year-old male collided with another player during a hockey game and complains of severe pain to the left shoulder. Assessment reveals that the clavicle is bulging anteriorly at the shoulder. The EMT should suspect: Select one: A. dislocation of the glenohumeral joint. B. separation of the acromioclavicular joint. C. multiple fractures of the proximal humerus. D. posterior dislocation of the shoulder.

separation of the acromioclavicular joint.

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

bind his legs together on the backboard, keep him warm, and transport without delay.

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

stabilize her head and perform a primary assessment.

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

pressure in the fascial compartment is elevated.

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse is barely palpable. His vital signs are stable, and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should: Select one: A. gently straighten the elbow and apply an air splint. B. apply a heat pack to the elbow to reduce swelling. C. splint the elbow in the position found and transport. D. gently manipulate the elbow to improve circulation.

splint the elbow in the position found and transport.

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

posterior hip dislocation.

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

apply padded board splints to both sides of the leg.

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

place her onto a scoop stretcher, pad around her left hip with pillows, and secure her to the scoop with straps.

A Colles fracture involves a fracture of the: Select one: A. distal radius. B. radius and ulna. C. proximal radius. D. distal ulna.

distal radius

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

apply a tourniquet just below the shoulder.

After direct trauma to the left upper back, a 44-year-old male presents with diaphoresis and restlessness. His blood pressure is 100/50 mm Hg, his pulse rate is 120 beats/min and weak, and his respirations are 24 breaths/min and labored. Your assessment reveals abrasions and contusions over the left scapula. You should: Select one: A. hyperventilate him with a bag valve mask and monitor his oxygen saturation. B. apply high-flow oxygen, consider spinal precautions, and transport without delay. C. focus your assessment on his scapulae and clavicles and apply high-flow oxygen. D. apply high-flow oxygen, perform a detailed secondary assessment, and transport.

apply high-flow oxygen, consider spinal precautions, and transport without delay.

An open fracture is most accurately defined as a fracture in which: Select one: A. a bullet or other projectile shatters the underlying bone. B. fractured bone ends protrude through the skin. C. the bone is broken but does not penetrate the skin. D. an external wound is present over the fracture site.

an external wound is present over the fracture site.

Applying ice to and elevating an injured extremity are performed to: Select one: A. reduce pain and swelling. B. maintain extremity perfusion. C. enhance tissue circulation. D. prevent further injury.

reduce pain and swelling.

Bones are connected to other bones by bands of tough fibrous tissues called: Select one: A. bursa. B. cartilage. C. tendons. D. ligaments.

ligaments

Care for a patient with a fractured tibia and suspected compartment syndrome includes: Select one: A. keeping the leg at the level of the heart. B. applying chemical hot packs to the leg. C. applying traction to maintain distal pulses. D. immobilizing the leg with an air splint.

keeping the leg at the level of the heart.

Deformity caused by a fracture would most likely be masked by: Select one: A. swelling. B. crepitus. C. guarding. D. ecchymosis.

swelling

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

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

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

immobilizing her to a backboard and rapidly transporting.

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

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

Femoral shaft fractures can result in up to _____ mL of internal blood loss. Select one: A. 1,500 B. 4,000 C. 2,000 D. 1,000

1000

If a dislocated shoulder has spontaneously reduced before your arrival, the only way to confirm the injury is by noting: Select one: A. the patient history. B. bruising to the shoulder. C. distal circulation. D. the presence of deformity.

the patient history

In general, musculoskeletal injuries should be splinted before moving the patient unless: Select one: A. deformity and swelling are present. B. transport time is less than 15 minutes. C. the patient is in severe pain. D. the patient is clinically unstable.

the patient is clinically unstable.

In moving joints, the ends of the bones are covered with: Select one: A. muscular fascia. B. synovial tendons. C. gliding cartilage. D. articular cartilage.

articular cartilage

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

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

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

assess for a carotid pulse for up to 60 seconds.

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

supine positioning, splinting the leg, and transporting.

A frostbitten foot can be identified by the presence of: Select one: A. soft, smooth skin. B. gross deformity. C. blanching of the skin. D. mottling and blisters.

mottling and blisters

A patient with a core body temperature of 95°F (35°C) will most likely experience: Select one: A. loss of consciousness. B. rapid breathing. C. a slow pulse. D. muscle stiffness.

rapid breathing

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

90°F (32°C).

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

administer oxygen and epinephrine and prepare for rapid transport.

All of the following snakes are pit vipers, except for the: Select one: A. coral snake. B. copperhead. C. cottonmouth. D. rattlesnake.

coral snake

For sweating to be an effective cooling mechanism: Select one: A. the body must produce at least 1 L per hour. B. several layers of clothing must be worn. C. the relative humidity must be above 90%. D. it must evaporate from the body.

it must evaporate from the body

Heat loss from the body through respiration occurs when: Select one: A. air temperature is greater than body temperature. B. warm air is exhaled into the atmosphere. C. the core body temperature is greater than 98°F (37°C). D. cool air is inhaled and displaces warm air.

warm air is exhaled into the atmosphere.

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

the body’s heat-eliminating mechanisms are overwhelmed.

Hypothermia can worsen internal bleeding secondary to: Select one: A. a decreased heart rate. B. cardiac arrhythmias. C. blood-clotting abnormalities. D. severe muscular rigidity

blood-clotting abnormalities.

Hypothermia occurs when the core body temperature falls below: Select one: A. 90°F (32°C). B. 98°F (37°C). C. 88°F (31°C). D. 95°F (35°C).

95°F (35°C).

Most of the serious injuries associated with scuba diving are caused by: Select one: A. too rapid of a descent. B. alcohol consumption. C. too rapid of an ascent. D. cold water temperature.

too rapid of an ascent.

Patients with generalized hypothermia are at an increased risk of a local cold injury because: Select one: A. peripheral vasodilation brings warm blood to the skin’s surface. B. the patient is usually unable to escape the cold ambient temperature. C. the major muscles of the body become rigid during hypothermia. D. blood is shunted away from the extremities to the body’s core.

blood is shunted away from the extremities to the body’s core.

Rough handling of a hypothermic patient with a pulse might cause: Select one: A. pulseless electrical activity. B. ventricular tachycardia. C. ventricular fibrillation. D. profound bradycardia.

ventricular fibrillation.

Shivering is a mechanism in which the body generates heat by: Select one: A. decreasing the metabolic rate. B. decreasing the use of oxygen. C. increasing the metabolic rate. D. retaining excess carbon dioxide.

increasing the metabolic rate.

Signs and symptoms of an air embolism include all of the following, except: Select one: A. dysphasia. B. joint pain. C. dizziness. D. pale skin.

pale skin

Signs of late heatstroke include: Select one: A. nausea and vomiting. B. a weak, rapid pulse. C. hot, moist skin. D. a change in behavior.

a weak, rapid pulse

The body’s natural protective mechanisms against heat loss are: Select one: A. shivering and vasodilation. B. respiration and constriction of blood vessels in the skin. C. vasodilation and respiration. D. constriction of blood vessels in the skin and shivering.

constriction of blood vessels in the skin and shivering.

To assess a patient’s general body temperature, pull back on your glove and place the back of your hand on his or her skin at the: Select one: A. abdomen. B. forehead. C. neck. D. chest.

abdomen

Which of the following conditions would be the least likely to increase a person’s risk of hypothermia? Select one: A. Severe infection B. Head injury C. Spinal cord injury D. Hyperglycemia

hyperglycemia

Which of the following medications increases a person’s risk of a heat-related emergency? Select one: A. Diuretics B. Aspirin C. Tylenol D. Motrin

Diuretics

Which of the following would be the least likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)? Select one: A. Shivering stops B. Mental status decreases C. Finger motion ceases D. Muscle activity increases

muscle activity increases

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should: Select one: A. immediately secure him to a longboard. B. begin ventilations with a barrier device. C. open his airway with the jaw-thrust maneuver. D. move him as a unit to a supine position.

move him as a unit to a supine position.

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should: Select one: A. elevate her legs to improve brain perfusion and keep her warm. B. insert an oral airway and ventilate her with a bag-valve mask. C. place her on her side, administer high-flow oxygen, and transport. D. administer oral glucose for presumed hypoglycemia and transport.

place her on her side, administer high-flow oxygen, and transport.

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: Select one: A. ventilate her with a bag-mask device. B. place her in a left lateral recumbent position. C. position her supine and elevate her legs 12 inches. D. carefully place sterile gauze into her vagina.

place her in a left lateral recumbent position.

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should: Select one: A. administer a nebulized bronchodilator to improve the status of her breathing. B. monitor her en route to the hospital and call medical control if she worsens. C. crush up an antihistamine tablet and place it in between her cheek and gum. D. request permission from medical control to give another dose of epinephrine.

D. request permission from medical control to give another dose of epinephrine.

A 38-year-old woman was bitten by fire ants while at the park. Your primary assessment reveals that she is semiconscious; has labored breathing; and has a rapid, thready pulse. She has a red rash on her entire body, and her face is swollen. You should: Select one: A. assist her ventilations with 100% oxygen. B. place her supine with her legs elevated. C. perform a rapid secondary assessment. D. locate the area where the fire ants bit her.

A. assist her ventilations with 100% oxygen.

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called: Select one: A. a wheal. B. urticaria. C. purpura. D. a pustule.

A. a wheal.

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include: Select one: A. adrenaline and histamines. B. the bee venom itself. C. histamines and leukotrienes. D. leukocytes and epinephrine.

C. histamines and leukotrienes.

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT: Select one: A. flushing of the skin. B. drying of the eyes. C. persistent dry cough. D. abdominal cramps.

B. drying of the eyes.

Epinephrine is indicated for patients with an allergic reaction when: Select one: A. a paramedic is present at the scene. B. the patient is anxious and tachycardic. C. wheezing and hypotension are present. D. the reaction produces severe urticaria.

C. wheezing and hypotension are present.

Immediately after giving an epinephrine injection, you should: Select one: A. record the time and dose given. B. notify medical control of your action. C. properly dispose of the syringe. D. reassess the patient’s vital signs.

C. properly dispose of the syringe.

The effects of epinephrine are typically observed within _________ following administration. Select one: A. 30 seconds B. 1 minute C. 1 hour D. 30 minutes

B. 1 minute

The foreign substance responsible for causing an allergic reaction is called a(n): Select one: A. leukotriene. B. histamine. C. antibody. D. allergen.

D. allergen.

The stinger from a honeybee should be: Select one: A. squeezed with tweezers and removed. B. scraped away from the skin. C. left in place and covered. D. irrigated with copious amounts of water.

B. scraped away from the skin.

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: Select one: A. carefully insert a sterile trauma dressing into her vagina. B. elevate her legs six to eight inches and cover her with a blanket. C. place her legs together and position her on her left side. D. firmly massage the uterine fundus with a circular motion.

firmly massage the uterine fundus with a circular motion.

If a baby is born at 7:52, the second Apgar score should be calculated at: Select one: A. 7:53. B. 8:00. C. 7:57. D. 7:59.

7:57

If a pregnant patient must be placed onto a backboard, you should: Select one: A. elevate the head of the board six inches to prevent breathing impairment. B. elevate the right side of the board with rolled towels or blankets. C. place a folded towel behind her head to make it easier to breathe. D. raise the foot of the board 12 inches in order to maintain blood pressure.

elevate the right side of the board with rolled towels or blankets.

Most medical models base a pregnant woman’s due date: Select one: A. on the last day of her last menstrual cycle. B. on the first day of her last menstrual cycle. C. two weeks after her last menstrual cycle. D. two weeks before her last menstrual cycle.

on the first day of her last menstrual cycle.

Supine hypotensive syndrome occurs when: Select one: A. the superior vena cava is compressed by the uterus. B. a supine position kinks the ascending aorta. C. blood pressure decreases as a result of hypovolemia. D. the pregnant uterus compresses the inferior vena cava.

the pregnant uterus compresses the inferior vena cava.

The leading cause of maternal death during the first trimester of pregnancy is: Select one: A. massive brain damage secondary to a prolonged seizure. B. internal bleeding caused by a ruptured ectopic pregnancy. C. unrecognized or untreated supine hypotensive syndrome. D. blunt trauma to the abdomen during a motor vehicle crash.

internal bleeding caused by a ruptured ectopic pregnancy.

The only indications for placing your gloved fingers in the vagina during delivery are: Select one: A. nuchal cord and presentation of an arm or leg. B. breech presentation and prolapsed umbilical cord. C. limb presentation and severe vaginal hemorrhage. D. vertex presentation and delivery of the placenta.

breech presentation and prolapsed umbilical cord.

The presence of meconium in the amniotic fluid indicates: Select one: A. that the fetus is at least four weeks premature. B. that the baby’s airway might be obstructed. C. an expected finding in full-term infants. D. that full newborn resuscitation will be needed.

that the baby’s airway might be obstructed.

The term “bloody show” is defined as: Select one: A. any volume of blood that is expelled from the vagina after the amniotic sac has ruptured and contractions have begun. B. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug. C. mild vaginal bleeding that occurs within the first 30 minutes after the onset of the second stage of the labor process. D. the normal amount of vaginal bleeding that occurs within the first 24 hours following delivery of the baby and placenta.

the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

The third stage of labor begins when the: Select one: A. placenta is fully delivered. B. baby is expelled from the vagina. C. umbilical cord has been clamped. D. cervix is completely dilated.

baby is expelled from the vagina.

The vagina and the neck of the uterus comprise the: Select one: A. fundus. B. birth canal. C. cervix. D. womb.

birth canal.

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased, and she is tachycardic. The EMT should suspect: Select one: A. pulmonary embolism. B. acute pulmonary edema. C. intrauterine bleeding. D. spontaneous pneumothorax.

pulmonary embolism.

Upon delivery of an infant’s head, you note that the umbilical cord is wrapped around its neck. You should: Select one: A. provide free-flow oxygen to the infant and transport. B. immediately clamp and cut the umbilical cord. C. first attempt to slip the cord gently over the infant’s head. D. give high-flow oxygen to the mother and transport.

first attempt to slip the cord gently over the infant’s head.

A 2-month-old infant was found unresponsive in his crib by his mother. When you arrive, you determine that the infant is apneic and pulseless. His skin is pale and cold and his arms are stiff. You should: Select one: A. begin high-quality CPR and transport immediately. B. begin high-quality CPR and request an ALS ambulance. C. inform the child’s mother that her son is deceased. D. request the medical examiner to perform an autopsy.

inform the child’s mother that her son is deceased.

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures but has had a recent ear infection. You should: Select one: A. cool the child with tepid water and transport to the hospital. B. allow the mother to drive her daughter to the hospital. C. suspect that the child has meningitis and transport at once. D. place the child in cold water to attempt to reduce her fever.

cool the child with tepid water and transport to the hospital.

A 4-year-old, 16-kg female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should: Select one: A. determine why the ingestion occurred. B. administer 16 g of activated charcoal. C. place her supine and elevate her legs. D. monitor her airway and give oxygen.

monitor her airway and give oxygen.

A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the most indicative of decompensated shock? Select one: A. Pulse rate greater than 120/min B. Capillary refill time of 4 seconds C. Blood pressure of 70/40 mm Hg D. Respiratory rate of 30 breaths/min

Blood pressure of 70/40 mm Hg

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant’s mother tells you that he has not had a soiled diaper in over 12 hours. The infant’s heart rate is 140 beats/min, and his anterior fontanelle appears to be slightly sunken. You should suspect: Select one: A. hypovolemic shock. B. mild dehydration. C. moderate dehydration. D. severe dehydration.

moderate dehydration

A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should: Select one: A. carefully look into his mouth and remove the object if you see it. B. deliver a series of five back blows and then reassess his condition. C. encourage him to cough, give oxygen as tolerated, and transport. D. place the child in a supine position and perform abdominal thrusts.

encourage him to cough, give oxygen as tolerated, and transport.

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: Select one: A. grunting. B. wheezing. C. rhonchi. D. stridor.

stridor

A viral infection that might cause obstruction of the upper airway in a child is called: Select one: A. croup. B. asthma. C. bronchitis. D. epiglottitis.

croup

After a head injury, which of the following is more common in children than in adults? Select one: A. Loss of consciousness B. Seizures and hypoxia C. Nausea and vomiting D. Spinal cord injury

nausea and vomiting

After determining that an infant or child has strong central pulses, you should: Select one: A. not rule out compensated shock. B. assess his or her respiratory effort. C. assume the child is hypertensive. D. conclude that the child is stable.

not rule out compensated shock

After squeezing the end of a child’s finger or toe for a few seconds, blood should return to the area within: Select one: A. 5 seconds. B. 3 seconds. C. 4 seconds. D. 2 seconds.

2 seconds

After using the pediatric assessment triangle (PAT) to form your general impression of a sick or injured child, you should: Select one: A. perform a hands-on assessment of the ABCs. B. assess the child’s heart rate and skin condition. C. evaluate the child’s baseline vital signs. D. obtain a SAMPLE history from the parents.

perform a hands-on assessment of the ABCs.

All of the following are normal findings in an infant or child, except: Select one: A. belly breathing. B. fear or anxiety. C. head bobbing. D. quiet breathing.

head bobbing

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious but clearly restless. Her heart rate is 130 beats/min, and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should: Select one: A. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital. B. begin immediate ventilation assistance and ensure that you squeeze the bag forcefully to open her bronchioles. C. begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min. D. continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol.

be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: Select one: A. retracting the intercostal muscles. B. grunting. C. assuming a tripod position. D. wheezing.

grunting

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it might: Select one: A. result in a soft-tissue injury. B. result in airway swelling. C. cause the child to vomit. D. depress the gag reflex.

cause the child to vomit.

Before assessing the respiratory adequacy of a semiconscious infant or child, you must: Select one: A. ensure that the airway is patent and clear of obstructions. B. routinely suction the mouth to remove oral secretions. C. ensure that his or her head is in a hyperextended position. D. insert a nasopharyngeal or oropharyngeal airway adjunct.

ensure that the airway is patent and clear of obstructions.

Blood pressure is usually not assessed in children younger than _____ years. Select one: A. 4 B. 6 C. 3 D. 5

Burns in children are commonly caused by all of the following, except: Select one: A. hot items on a stovetop. B. scalding water in a bathtub. C. entrapment in a structural fire. D. exposure to caustic chemicals.

entrapment in a structural fire.

Capillary refill time is most reliable as an indicator of end-organ perfusion in children younger than: Select one: A. 4 years. B. 8 years. C. 10 years. D. 6 years.

6 years

Cardiac arrest in the pediatric population is most commonly the result of: Select one: A. lethal cardiac rhythm disturbances. B. a complete airway obstruction. C. a congenital cardiovascular defect. D. failure of the respiratory system.

failure of the respiratory system.

Causes of infant death that might be mistaken for SIDS include all of the following, except: Select one: A. severe infection. B. child abuse. C. meningitis. D. hyperglycemia.

hyperglycemia

Common causes of seizures in children include all of the following, except: Select one: A. infection. B. poisonings or ingestion. C. hyperglycemia. D. electrolyte imbalances

hyperglycemia

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are: Select one: A. more vascular even though they are proportionately smaller. B. lower in the abdominal cavity, where the muscles are not as strong. C. proportionately larger and situated more anteriorly. D. spaced further apart, which causes them to shift following trauma

proportionately larger and situated more anteriorly.

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the: Select one: A. abdominal organs force the diaphragm upward. B. rib cage is rigid and provides little flexibility. C. intercostal muscles are not well developed. D. upper airway is smaller and easily collapsible.

intercostal muscles are not well developed.

A “silent” heart attack occurs when: Select one: A. the usual chest pain is not present. B. the patient minimizes the chest pain. C. a sudden dysrhythmia causes death. D. sweating is the only presentation.

the usual chest pain is not present.

A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Because this patient is probably in shock, what is the most likely explanation for the absence of tachycardia? Select one: A. The effects of her antihypertensive medication B. Deterioration of the cardiac conduction system C. Intrathoracic bleeding and cardiac compression D. Failure of the parasympathetic nervous system

The effects of her antihypertensive medication

A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should: Select one: A. apply a cold pack to his leg. B. administer high-flow oxygen. C. position the patient supine. D. suspect severe pneumonia.

administer high-flow oxygen.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious but diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect: Select one: A. an aortic aneurysm. B. a strangulated bowel. C. myocardial infarction. D. acute appendicitis.

an aortic aneurysm.

A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? Select one: A. History of deep venous thrombosis B. Frequent urinary tract infections C. The patient is prescribed an inhaler D. The patient’s abdomen is swollen

History of deep venous thrombosis

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and is normally alert. When you assess this patient, it is important to note that: Select one: A. the patient is experiencing delirious behavior, which suggests a new health problem. B. because of her age and medical history, you should suspect Alzheimer disease. C. her mental status is likely the result of hypoglycemia and you should give her sugar. D. dementia typically presents as an acute onset of deterioration of cognitive function.

the patient is experiencing delirious behavior, which suggests a new health problem.

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect: Select one: A. acute hyperglycemia. B. hypovolemic shock. C. a subdural hematoma. D. a systemic infection.

a systemic infection.

An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has most likely experienced a(n): Select one: A. idiopathic fracture. B. comminuted fracture. C. pathologic fracture. D. compression fracture.

pathologic fracture.

As a person ages, the heart might enlarge as a result of: Select one: A. an overall decrease in blood volume. B. chronically increased afterload. C. widespread vascular dilation. D. decreased blood return to the heart.

chronically increased afterload.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: Select one: A. rely exclusively on family members for the medical history. B. perform a rapid assessment on all geriatric patients you treat. C. attempt to differentiate between chronic and acute problems. D. limit your physical examination to the area of pain or injury.

attempt to differentiate between chronic and acute problems.

Causes of delirium in the older patient include all of the following, except: Select one: A. low blood sugar level. B. Alzheimer disease. C. decreased cerebral perfusion. D. acute hypovolemia.

Alzheimer disease.

Clouding of the lenses of the eyes is called: Select one: A. cataracts. B. conjunctivitis. C. retinitis. D. glaucoma.

cataracts

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: Select one: A. baseline respiratory distress. B. air-trapping within the alveoli. C. a decreased ability to cough. D. an increased risk of COPD.

a decreased ability to cough.

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient’s daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient’s pulse rate is 80 beats/min and irregular, and she is conscious and alert. The EMTs should suspect that the patient: Select one: A. experienced a vasovagal response. B. has an abdominal aortic aneurysm. C. took too much of her medication. D. has a gastrointestinal hemorrhage.

experienced a vasovagal response.

In contrast to a living will, a “do not resuscitate” (DNR) order becomes valid when: Select one: A. it is signed by three or more physicians. B. the patient develops cardiac arrest. C. the patient is in a healthcare setting. D. the patient has a terminal illness.

the patient develops cardiac arrest.

In contrast to delirium, dementia: Select one: A. is the result of an acute condition. B. is reversible with certain treatment. C. often develops over a period of days. D. is usually considered irreversible.

is usually considered irreversible.

In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because: Select one: A. any change in position causes blood to be shunted to the brain. B. the aging process results in an overall increase in blood volume. C. their red blood cells are destroyed at a faster than normal rate. D. the body is less able to adapt the BP to rapid postural changes.

the body is less able to adapt the BP to rapid postural changes.

Motor nerve neuropathy is characterized by: Select one: A. loss of balance, muscle weakness, and spasms. B. constipation, low blood pressure, and bradycardia. C. loss of bladder control and sensitivity to touch. D. numbness, tingling, and severe muscle pain.

loss of balance, muscle weakness, and spasms.

Talking about an elderly patient in front of him or her to other members of the family: Select one: A. is usually beneficial because the patient’s cognitive skills are typically impaired. B. might cause the patient to think that he or she has no say in making decisions. C. will anger the patient and result in his or her refusal to accept care or transport. D. often causes the patient to become paranoid and untrusting of your help.

might cause the patient to think that he or she has no say in making decisions.

The leading cause of death in the geriatric patient is: Select one: A. hypertension. B. arthritis. C. altered mental status. D. heart disease.

heart disease.

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: Select one: A. paranoia. B. delirium. C. dementia. D. delusion.

dementia

The stooped posture of some older people, which gives them a humpback appearance, is called: Select one: A. scoliosis. B. miosis. C. kyphosis. D. arthritis.

kyphosis

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving, and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should: Select one: A. begin assisting her ventilations with a bag-valve mask while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation. B. open her airway with the head tilt–chin lift maneuver, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia. C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing. D. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment.

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should: Select one: A. immediately seek out a family member or other caregiver. B. begin his or her assessment after gathering any medication bottles. C. observe for conditions that might make the residence unsafe. D. talk to the patient after performing his or her primary assessment.

observe for conditions that might make the residence unsafe.

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is most important to: Select one: A. recall that the patient is at risk for negative medication interactions. B. look up all of the medications before providing care to the patient. C. contact each of the physicians whose names are on the medications. D. ask the patient to explain what each medication is used for.

recall that the patient is at risk for negative medication interactions.

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

Energy transmission to the spine

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

stabilize her entire spine.

A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment, you should be MOST alert for: Select one: A. injury to the cervical spine. B. alterations in his mental status. C. damage to internal structures. D. potential airway compromise.

potential airway compromise.

A 40-year-old unrestrained female impacted the steering wheel of her vehicle with her chest when she hit a tree while traveling at 45 mph. She is conscious and alert, but is experiencing significant chest pain and shortness of breath. Which of the following injuries is the LEAST likely? Select one: A. Cardiac contusion B. Multiple rib fractures C. Pulmonary contusion D. Head injury

head injury

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

Compression of the head against the roof

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

assess for an exit wound.

Approximately 25% of severe injuries to the aorta occur during: Select one: A. lateral collisions. B. rear-end collisions. C. frontal collisions. D. rollover collisions.

lateral collisions

During your assessment of a patient who experienced a blast injury, you note that he has a depressed area to the front of his skull. This injury MOST likely occurred: Select one: A. as a result of flying debris. B. when the patient was hurled against a stationary object. C. by inhaling toxic gases. D. as a direct result of the pressure wave.

when the patient was hurled against a stationary object.

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

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

intracranial bleeding

Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash. Select one: A. lumbar and sacral B. thoracic and sacral C. lumbar and coccygeal D. thoracic and lumbar

thoracic and lumbar

Two of the MOST common mechanisms of injury for blunt trauma are: Select one: A. falls and motor vehicle collisions. B. motor vehicle collisions and stabbings. C. gunshot wounds and vehicle ejections. D. low-caliber gunshot wounds and falls.

falls and motor vehicle collisions.

When a driver is in a car equipped with an airbag, but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the airbag deploys upon impact. Select one: A. door B. steering wheel C. windshield D. dashboard

door

Which of the following injuries would MOST likely occur as a direct result of the third collision in a motor vehicle crash? Select one: A. Aortic rupture B. Extremity fractures C. Flail chest D. Forehead lacerations

aortic rupture

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

Collision of two passenger bodies within the same vehicle

Which of the following statements regarding gunshot wounds is correct? Select one: A. The size of a bullet has the greatest impact on the injury produced. B. High-velocity bullets will cause less severe internal injuries. C. The speed of a bullet has the greatest impact on the injury produced. D. Low-velocity bullets will cause the greatest amount of trauma.

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

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

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

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

bruising of the heart muscle.

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

neck and facial injuries.

Your patient has a Glasgow Coma Scale (GCS) score of 13, a systolic blood pressure of 80 mm Hg, and a respiratory rate of 8 breaths/min. His revised trauma score (RTS) is: Select one: A. 10. B. 8. C. 9. D. 11.

When the speed of a motor vehicle doubles, the amount of kinetic energy: Select one: A. quadruples. B. is not affected. C. triples. D. doubles.

quadruples

When treating a patient who experienced a pulmonary blast injury, you should: Select one: A. avoid giving oxygen under positive pressure. B. administer large amounts of intravenous fluid. C. use a demand valve to ventilate the patient. D. suspect an accompanying cardiac tamponade.

avoid giving oxygen under positive pressure.

Which of the following findings would be LEAST suggestive of the presence of high-energy trauma? Select one: A. Intrusion into the vehicle B. Steering wheel collapse C. Deployment of the airbag D. Dismounted seats

Deployment of the airbag

Which of the following interventions is the MOST critical to the outcome of a patient with multisystem trauma? Select one: A. Rapid transport to a trauma center B. Early administration of oxygen C. Intravenous fluid administration D. Elevation of the lower extremities

Rapid transport to a trauma center

Which of the following would MOST likely occur as the direct result of the second collision in a motor vehicle crash? Select one: A. Caved-in passenger door B. Deformed steering wheel C. Intrathoracic hemorrhage D. Collapsed dashboard

Deformed steering wheel

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

preparing for immediate transport.

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

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

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should: Select one: A. elevate his legs, keep him warm, and transport. B. assess his blood pressure to detect hypotension. C. apply a compression device around his pelvis. D. stabilize his pelvis by placing him onto his side.

apply a compression device around his pelvis.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately two days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be most suspicious that this patient is experiencing: Select one: A. an aortic aneurysm. B. acute appendicitis. C. gastrointestinal bleeding. D. intrathoracic hemorrhaging

gastrointestinal bleeding.

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

Apply a topical hemostatic agent with direct pressure.

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

assist the patient’s ventilations.

After applying a pressure dressing to a laceration on a patient’s arm, you notice that blood is slowly beginning to saturate it. You should: Select one: A. splint the arm and keep it below heart level. B. place additional dressings over the wound. C. apply a tourniquet proximal to the wound. D. replace the dressing with another dressing.

place additional dressings over the wound.

After blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the: Select one: A. pancreas. B. spleen. C. gallbladder. D. kidneys.

spleen

All of the following should be addressed during the primary assessment except: Select one: A. slow, shallow breathing. B. airway obstruction. C. capillary bleeding. D. severe hemorrhage.

capillary bleeding.

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

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

Which of the following findings would be the most significant when assessing a patient with possible internal bleeding? Select one: A. The patient has not eaten in 24 hours. B. The patient has a history of hypertension. C. The patient had a stroke five years prior. D. The patient takes rivaroxaban (Xarelto).

The patient takes rivaroxaban (Xarelto).

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

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

Which of the following occurs after tissues are injured? Select one: A. Platelets collect at the injury site. B. Local blood vessels begin to dilate. C. Red blood cells become less sticky. D. Red blood cells separate from plasma.

Platelets collect at the injury site.

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is most important to recall that: Select one: A. the patient is at risk for vomiting and aspiration. B. many medications interfere with blood clotting. C. a detailed exam is needed to determine the cause. D. hypertensive.

the patient is at risk for vomiting and aspiration.

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. Select one: A. 250 mL B. 2 L C. 1 L D. 500 mL

1 L

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

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

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

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

Capillaries link the arterioles and the: Select one: A. venules. B. cells. C. veins. D. aorta.

venules

Early signs and symptoms of intra-abdominal bleeding include: Select one: A. bruising only. B. widespread ecchymosis. C. pain and distention. D. significant hypotension.

pain and distention

Hypovolemic shock occurs when: Select one: A. at least 10% of the patient’s blood volume is lost. B. low fluid volume leads to inadequate perfusion. C. the clotting ability of the blood is enhanced. D. the patient’s systolic BP is less than 100 mm Hg.

low fluid volume leads to inadequate perfusion.

In nontrauma patients, an early indicator of internal bleeding is: Select one: A. rapid, shallow breathing. B. a decreasing blood pressure. C. dizziness upon standing. D. a rapid, thready pulse.

dizziness upon standing.

In older patients, the first indicator of nontraumatic internal bleeding might be: Select one: A. a heart rate over 120 beats/min. B. a low blood pressure. C. diaphoresis and pale skin. D. weakness or dizziness.

weakness and dizziness

Which of the following body systems or components is the least critical for supplying and maintaining adequate blood flow to the body? Select one: A. Adequate blood in the vasculature B. An intact system of blood vessels C. The filtering of blood cells in the spleen D. An effectively pumping heart

The filtering of blood cells in the spleen

Which of the following organs can tolerate inadequate perfusion for two to three hours? Select one: A. Brain B. Skeletal muscle C. Kidneys D. Heart

Skeletal muscle

Which of the following splinting devices would be most appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Air splint B. Vacuum splint C. Cardboard splint D. Sling and swathe

Air splint

A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines, this patient has burns that cover _____ of his body surface area. Select one: A. 18% B. 27% C. 45% D. 36%

18%

A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival, the man’s arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be most concerned that this patient has: Select one: A. compartment syndrome. B. internal hemorrhage. C. damage to the radial nerve. D. a severe closed fracture.

compartment syndrome

A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries, how should you care for his wound? Select one: A. Cover the exposed bowel and keep his legs in a straight position. B. Cover it with moist, sterile gauze and secure with an occlusive dressing. C. Irrigate it with sterile water and cover it with a dry dressing. D. Carefully replace the exposed bowel into the abdomen and transport

Cover it with moist, sterile gauze and secure with an occlusive dressing.

A 38-year-old male was electrocuted while attempting to wire a house. Your assessment reveals that he is unresponsive, pulseless, and apneic. A coworker has shut off the power to the house. You should: Select one: A. fully immobilize his spinal column. B. assess for entry and exit wounds. C. begin CPR and apply the AED. D. begin CPR and transport at once.

begin CPR and apply the AED.

A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should: Select one: A. apply ice to the hematoma. B. palpate his radial pulses. C. perform a neurologic exam. D. administer high-flow oxygen.

administer high-flow oxygen.

A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head, face, and anterior trunk. What percentage of her body surface area has been burned? Select one: A. 27% B. 18% C. 30% D. 36%

30%

A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound, you should: Select one: A. replace the avulsed flap to its original position and cover it with a sterile dressing. B. thoroughly irrigate the wound with sterile water and cover it with a sterile dressing. C. carefully probe the wound to determine if the bleeding is venous or arterial. D. carefully remove the avulsed flap and wrap it in a moist, sterile trauma dressing.

replace the avulsed flap to its original position and cover it with a sterile dressing.

A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-foot steel rod impaled in his left leg. You should: Select one: A. stabilize the steel rod, control the bleeding, begin CPR, and rapidly transport to a trauma center. B. remove the steel rod, control the bleeding, apply an automated external defibrillator, begin CPR, and transport to a trauma center. C. control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately. D. control the bleeding, carefully remove the steel rod, begin CPR, and transport as soon as possible.

control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately.

A teenage boy who was involved in a bicycle accident has a puncture wound where the bicycle kickstand impaled his leg. The most appropriate method for treating this injury is to: Select one: A. unbolt the kickstand from the bike frame and stabilize it with bulky dressings. B. remove the kickstand in a circular motion and apply a dry, sterile dressing. C. leave the kickstand attached to the bike until the physician can remove it safely. D. cut the kickstand off just above the skin, and stabilize it with sterile dressings.

unbolt the kickstand from the bike frame and stabilize it with bulky dressings.

A utility worker was trimming branches and was electrocuted when he accidentally cut a high-power line. He fell approximately 20 feet and is lying unresponsive on the ground; the power line is lying across his chest. You should: Select one: A. manually stabilize his head as your partner assesses for breathing. B. rapidly assess the patient after ensuring that the power line is not live. C. apply insulated gloves and assume manual control of his cervical spine. D. quickly but carefully move the patient away from the power line.

rapidly assess the patient after ensuring that the power line is not live.

According to the rule of palm method for estimating the extent of a patient’s burns, the palm of the patient’s hand is equal to _____ of his or her total body surface area. Select one: A. 4% B. 2% C. 6% D. 1%

An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand, which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should: Select one: A. advise the child that he will need rabies shots. B. ask the child’s father to try to locate the dog. C. report the incident to the appropriate authorities. D. administer oxygen via a nonrebreathing mask.

report the incident to the appropriate authorities.

As you approach a young male who was involved in an industrial accident, you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should: Select one: A. apply high-flow oxygen and assess his injuries. B. open his airway and assess his breathing status. C. assess his pulse for rate, regularity, and quality. D. perform an immediate head-to-toe assessment.

open his airway and assess his breathing status.

Burns are classified according to: Select one: A. extent and location. B. depth and extent. C. location and pain. D. degree and location.

depth and extent

Burns to pediatric patients are generally considered more serious than burns to adults because: Select one: A. pediatric patients have a proportionately larger volume of blood. B. most burns in children are the result of child abuse. C. pediatric patients are more prone to hyperthermia. D. pediatric patients have more surface area relative to total body mass

pediatric patients have more surface area relative to total body mass.

Common signs and symptoms of an airway burn include all of the following, except: Select one: A. soot around the mouth. B. singed nasal hair. C. hoarseness. D. chest pressure.

chest pressure

During an altercation in a bar, two patrons got into a fist fight. The first patient, a 44-year-old female, was struck in the mouth and refuses EMS care. The second patient, a 39-year-old female, has a small laceration to her left knuckle and also refuses EMS care. Which of the following statements regarding this scenario is correct? Select one: A. The patient struck in the mouth should be immobilized. B. The 44-year-old female is at high risk for an infection. C. The 39-year-old female is at high risk for an infection. D. You should contact the police and have the patients arrested.

The 39-year-old female is at high risk for an infection.

During the normal wound-healing process, bleeding might occur from even a minor injury because: Select one: A. new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries. B. there is a substantial decrease in the number of platelets in and around the wound, which increases the risk of bleeding. C. bacteria and other microorganisms invade the wound site and damage the capillaries, which makes them more prone to bleeding. D. histamines released by the immune system constrict the blood vessels, which increases the pressure within them.

new capillaries that stem from intact capillaries are delicate and take time to become as stable as the preexisting capillaries.

During your assessment of a 22-year-old male who was assaulted, you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should: Select one: A. administer oxygen and prepare for rapid transport. B. perform a focused physical exam of his abdomen. C. conclude that he is experiencing intracranial bleeding. D. place him in a sitting position and give him oxygen

administer oxygen and prepare for rapid transport.

During your assessment of a patient who was shot in the abdomen, you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is most consistent with a: Select one: A. handgun. B. .22-caliber pistol. C. .357 magnum. D. shotgun.

shotgun

For electricity to flow through the body and cause damage: Select one: A. a complete circuit must exist between the electrical source and the ground. B. the part of the body that is in contact with the electrical source must be dry. C. the person must make direct physical contact with the source of electricity. D. an insulator must exist between the electrical source and the patient.

a complete circuit must exist between the electrical source and the ground.

In which of the following patients should you remove an impaled object? Select one: A. A semiconscious patient with an ice pick impaled in the chest B. An apneic patient with a shard of glass impaled in the abdomen C. A pulseless and apneic patient with a knife impaled in the back D. A conscious and alert patient with a fishhook impaled in the eye

A pulseless and apneic patient with a knife impaled in the back

Patients with full-thickness (third-degree) burns generally do not complain of pain because: Select one: A. he or she is generally not conscious. B. the nerve endings have been destroyed. C. blister formation protects the burn. D. subcutaneous vessels are usually clotted.

the nerve endings have been destroyed.

Regarding the pediatric rule of nines, the: Select one: A. head is proportionately smaller than an adult’s head. B. arms are proportionately larger than an adult’s arms. C. legs are proportionately smaller than an adult’s legs. D. thorax is proportionately larger than an adult’s thorax.

legs are proportionately smaller than an adult’s legs.

When a person is exposed to a cold environment: Select one: A. the skin becomes flushed secondary to peripheral vasodilation. B. sweat is produced and is warmed when the vessels constrict. C. blood vessels dilate and divert blood to the core of the body. D. peripheral vessels constrict and divert blood away from the skin.

peripheral vessels constrict and divert blood away from the skin.

A 29-year-old male has an anterior nosebleed after he was accidentally elbowed in the nose. He is conscious and alert with adequate breathing. The most appropriate care for this patient includes: Select one: A. placing him supine and pinching his nostrils together. B. leaning him forward and pinching his nostrils together. C. packing the nasopharynx with moist, sterile dressings. D. applying a gauze pad in between his lower lip and gum.

leaning him forward and pinching his nostrils together.

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

conjunctivitis

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

suction her oropharynx.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should: Select one: A. use tweezers to try to remove the object. B. transport her to the emergency department. C. thoroughly flush her ear with sterile saline. D. remove the peanut with a cotton-tipped swab.

transport her to the emergency department.

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

cover both of his eyes and transport to the hospital.

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

padding between the ear and the scalp.

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

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

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

fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

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

rapidly transporting her to the hospital.

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

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

Abnormal variations in pupil size and reaction would most likely be observed in a patient with: Select one: A. a brain injury. B. conjunctivitis. C. retinitis. D. contact lenses.

a brain injury

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

a blow-out fracture

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, and subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n): Select one: A. collapsed trachea. B. laryngeal fracture. C. crushed cricoid. D. esophageal tear.

laryngeal fracture.

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

spinal column injury.

The optic nerve endings are located within the: Select one: A. pupil. B. cornea. C. sclera. D. retina.

retina

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

has a history of eye surgeries.

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

apply direct pressure above and below the wound.

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

turn the backboard onto its side

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

direct pressure using dry, sterile dressings.

Facial injuries should be identified and treated as soon as possible because: Select one: A. of the risk for airway problems. B. bleeding must be controlled early. C. swelling might mask hidden injuries. D. the spine might be injured as well.

of the risk for airway problems.

Frequent reassessments of the patient with face or neck injuries are most important because: Select one: A. they lend credibility to your documentation. B. rapid facial swelling might mask hidden injuries. C. such injuries can affect the respiratory system. D. hospital staff require frequent patient updates.

such injuries can affect the respiratory system.

The Adam’s apple is: Select one: A. below the thyroid cartilage and forms the upper part of the trachea. B. the upper part of the larynx that is formed by the thyroid cartilage. C. the small indentation in between the thyroid and cricoid cartilages. D. the lower part of the larynx that is formed by the cricoid cartilage.

the upper part of the larynx that is formed by the thyroid cartilage.

The conjunctiva are kept moist by fluid produced by the: Select one: A. lacrimal gland. B. optic chiasma. C. corneal duct. D. posterior orbit.

lacrimal gland

The cricoid cartilage: Select one: A. lies superior to the cricothyroid membrane in the neck. B. is the only complete circular cartilage of the trachea. C. lies superior to the thyroid cartilage in the neck. D. is easier to see and palpate than the thyroid cartilage.

is the only complete circular cartilage of the trachea.

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient’s wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Avoid defibrillation because this will damage the patient’s AICD. B. Continue CPR and transport the patient to the closest appropriate hospital. C. Contact medical control and request permission to defibrillate. D. Deliver the shock followed by immediate resumption of CPR.

Deliver the shock followed by immediate resumption of CPR.

With increasing age, the heart must work harder to move the blood effectively because: A. the blood vessels become stiff. B. the arteries dilate significantly. C. the blood thickens as a person ages. D. diastolic blood pressure decreases.

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is: A. lactic acid. B. pyruvic acid. C. carbon dioxide. D. carbon monoxide.

You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that: A. assisted ventilations in infants often need to be forceful to inflate their lungs. B. the infant’s proportionately small tongue often causes an airway obstruction. C. an infant’s head should be placed in a flexed position to prevent obstruction. D. small infants are nose breathers and require clear nasal passages at all times.

Pulmonary edema and impaired ventilation occur during: A. anaphylactic shock. B. cardiogenic shock. C. neurogenic shock. D. septic shock.

In contrast to secure attachment, anxious-avoidant attachment occurs when a child: A. becomes acutely anxious in the presence of strangers or in unfamiliar surroundings. B. shows little emotional response to a parent or caregiver following repeated rejection. C. reaches out and explores because he or she knows that the parents are there as a safety net. D. clings to a parent or caregiver because he or she knows that the person can be trusted.

In preconventional reasoning, children A. look for approval from their peers and society. B. blame their actions on what they have observed in older children. C. act almost purely to avoid punishment and to get what they want. D. make decisions based on their conscience.

The average pulse rate of persons between 19 and 40 years of age is typically: A. 70 beats/min. B. 60 beats/min. C. 90 beats/min. D. 80 beats/min.

Which of the following statements regarding psychosocial development in the adolescent age group is correct? A. Family conflict decreases as the adolescent gains control of his or her own life. B. Because they think rationally, adolescents are at the lowest risk for suicide. C. Antisocial behavior and peer pressure peak around 14 to 16 years of age. D. Adolescents are less fixated on their public image than younger children.

Shock is the result of: A. temporary dysfunction of a major organ. B. widespread constriction of the blood vessels. C. hypoperfusion to the cells of the body. D. the body’s maintenance of homeostasis.

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

Which of the following clinical signs is unique to anaphylactic shock? A. Wheezing B. Hypotension C. Dizziness D. Pallor

Which of the following injuries would MOST likely cause obstructive shock? A. Cardiac tamponade B. Simple pneumothorax C. Liver laceration D. Spinal cord injury

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

Which of the following is the ONLY action that can prevent death from a tension pneumothorax? A. Positive-pressure ventilation with a bag-valve mask B. Decompression of the injured side of the chest C. Rapid administration of intravenous fluids D. Early administration of high-flow oxygen

A critical aspect of the rapid extrication technique is to: A. move the patient as quickly as you possibly can. B. apply a vest-style device before moving the patient. C. extricate the patient with one coordinated move. D. maintain stabilization of the spine at all times.

Which of the following patients is in decompensated shock? A. A 28-year-old female with pale skin and rapid, shallow respirations B. A 23-year-old restless male with cool, clammy skin and tachycardia C. A 20-year-old female with absent radial pulses and dilated pupils D. A 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg

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

Which of the following statements regarding anaphylactic shock is correct? A. Sensitized people will experience less severe reactions upon subsequent exposure. B. Anaphylactic shock occurs immediately after a person is sensitized to an allergen. C. Subsequent exposure after sensitization often produces a more severe reaction. D. Anaphylactic shock is caused by immune system failure due to a toxic exposure.

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

A team of EMTs and paramedics are attempting to resuscitate a man who is in cardiac arrest while his wife and son are present. Which of the following should occur during the resuscitation attempt? A. A law enforcement officer should prepare the family for the patient’s death and contact the funeral home. B. One EMT should update the family on the interventions that have been performed and how the patient has responded. C. Each member of the resuscitation team should update the family at various intervals throughout the attempt. D. Communication with the family should be minimal until the final outcome of the resuscitation attempt is known.

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

After ________ minutes without oxygen, permanent brain damage is possible. A. 7 B. 1 to 2 C. 2 to 3 D. 4 to 6

In most instances, you should move a patient on a wheeled ambulance stretcher by: A. pushing the foot of the stretcher while your partner guides the head. B. slightly lifting the stretcher to prevent unnecessary patient movement. C. retracting the undercarriage and carrying the stretcher to the ambulance. D. pushing the head of the stretcher while your partner guides the foot.

After establishing that an adult patient is unresponsive, you should: A. apply the AED and deliver a shock, if needed. B. immediately begin chest compressions. C. manually open the airway. D. assess for breathing and a pulse.

It is essential that you ____________ your equipment to prevent the spread of disease. A. properly store B. decontaminate C. throw out D. incinerate

Several attempts to adequately open a trauma patient’s airway with the jaw-thrust maneuver have been unsuccessful. You should: A. suction the airway and reattempt the jaw-thrust maneuver. B. carefully perform the head tilt–chin lift maneuver. C. try opening the airway by lifting up on the chin. D. tilt the head back while lifting up on the patient’s neck.

The direct carry is used to transfer a patient: A. with multiple long bone injuries. B. with a possible cervical spine injury. C. who cannot be placed on a backboard. D. from a bed to the ambulance stretcher.

Signs of a sudden severe upper airway obstruction include all of the following, EXCEPT: A. inability to speak. B. grasping the throat. C. acute cyanosis. D. forceful coughing.

The impedance threshold device (ITD) may improve circulation during active compression-decompression CPR by: A. drawing all of the air out of the lungs in between chest compressions, which causes positive intrathoracic pressure and a reduction of blood return to the right side of the heart. B. maintaining increased intrathoracic pressure during the downward stroke of each chest compression, which forces more blood from both of the ventricles. C. maximizing the amount of air in the lungs following chest recoil, which hyperinflates the lungs and forces more blood from the ventricle during each compression. D. limiting the amount of air that enters the lungs during the recoil phase between chest compressions, which results in negative intrathoracic pressure and improved cardiac filling.

The first rule of safe lifting is to: A. keep your back in a straight, vertical position. B. always lift with your palms facing down. C. spread your legs approximately 20″ apart. D. keep your back in a slightly curved position.

The main benefit of using a mechanical piston device for chest compressions is: A. its ability to be used with any patient, regardless of age, weight, or body size. B. the elimination of the need to place a firm, flat device under the patient. C. the minimal training required to correctly operate the device. D. the elimination of rescuer fatigue that results from manual compressions.

The MOST appropriate treatment for a patient with a mild upper airway obstruction includes: A. performing five back slaps and five abdominal thrusts. B. advising the patient not to make any attempts to cough. C. administering oxygen and transporting immediately. D. visualizing the airway and removing the obstruction.

The most serious consequence of a poorly planned or rushed patient move is: A. causing patient anxiety or fear. B. unnecessarily wasting time. C. confusion among team members. D. injury to you or your patient.

When ventilating an apneic adult with a bag-mask device, you should deliver each breath: A. over a period of about 2 to 3 seconds. B. while watching for adequate chest rise. C. every 2 to 3 seconds (20 to 30 breaths/min). D. quickly to ensure adequate ventilation.

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

Which of the following is considered an obvious sign of death and would not require the initiation of CPR? A. Dependent blood pooling B. Pulselessness and apnea C. Severe cyanosis to the face D. Agonal respiratory effort

To avoid injury when pushing a patient or other object, you should: A. avoid pushing the patient with your elbows fully extended. B. push from the area of your body between the knees and hips. C. push the patient from an overhead position if possible. D. kneel if you are pushing an object that is above waist level.

Which of the following is NOT an indication to stop CPR once you have started? A. Care is transferred to a bystander. B. You are physically exhausted. C. Pulse and respirations return. D. A physician directs you to do so.

To minimize the risk of injuring yourself when lifting or moving a patient, you should: A. flex at the waist instead of the hips. B. keep the weight as close to your body as possible. C. avoid the use of log rolls or body drags. D. use a direct carry whenever possible.

Which of the following statements regarding the use of an AED in children is correct? A. AEDs are not used in pediatric patients because they do not experience ventricular fibrillation. B. AEDs are only effective in pediatric patients if severe trauma is the cause of their cardiac arrest. C. If the patient is less than 1 year of age, an AED is preferred over a manual defibrillator. D. AEDs can be used safely on infants and children by using pediatric pads and an energy reducer.

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

While rescuer one is finishing his or her fifth cycle of 30 compressions, rescuer two should: A. give two breaths and prepare to start compressions. B. suction the patient’s mouth and give two more ventilations. C. assess for a carotid pulse for 15 seconds. D. move to the opposite side of the patient’s chest.

When moving a conscious, weak patient down a flight of stairs, you should: A. place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair. B. collapse the undercarriage of the wheeled stretcher and carefully carry the patient down the stairs on the stretcher. C. assist the patient in walking down the stairs and place him or her on the wheeled stretcher at the bottom of the stairs. D. secure the patient to a scoop stretcher and carry him or her headfirst down the stairs to the awaiting stretcher.

You are off duty at a park when you witness an apparently healthy 12-year-old child suddenly collapse. There are no bystanders around, and your mobile phone is in your car. After confirming that the child is in cardiac arrest, you should: A. perform CPR for 2 minutes and then call 9-1-1. B. perform chest compressions only until a bystander arrives. C. deliver five rescue breaths before starting chest compressions. D. call 9-1-1 and then return to begin CPR on the child.

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

You should attempt to maintain a chest compression fraction of at least: A. 80% B. 40% C. 50% D. 60%

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

Which of the following is the most appropriate device to use when immobilizing a patient with a suspected spinal injury? A. Scoop stretcher B. Wheeled stretcher C. Long backboard D. Portable stretcher

Your partner is performing one-rescuer CPR on a middle-aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medication patch over the same area where one of the AED pads will be placed. You should: A. move the patch to another area of the patient’s chest and then properly apply the AED pad. B. remove the medication patch, wipe away any medication residue, and apply the AED pad. C. apply the AED pad at least 1 inch away from the medication patch to avoid skin burns. D. continue CPR until you can determine the name of the medication contained in the patch.

Which of the following steps is not proper procedure when performing an emergency move? A. Using a long-axis body drag during the move B. Pulling the patient on a blanket or similar object C. Pulling the patient’s clothing in the shoulder area D. Lifting the patient by the belt to move him or her

A 60-year-old man is found to be unresponsive, pulseless, and apneic. You should: A. begin CPR until an AED is available. B. determine if he has a valid living will. C. withhold CPR until he is defibrillated. D. start CPR and transport immediately.

With proper technique, you and your partner should be able to safely lift a patient who weighs up to ______ pounds. A. 220 B. 150 C. 190 D. 175

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

A patient should be placed in the recovery position when he or she: A. is semiconscious, injured, and breathing adequately. B. is unresponsive, uninjured, and breathing adequately. C. has a pulse but is unresponsive and breathing shallowly. D. has experienced trauma but is breathing effectively.

A team of EMTs is caring for a critically injured patient. The team leader advises the EMT that transport will not begin until the patient’s closed forearm fracture is splinted. Utilizing the crew resource management model, the EMT should: A. ensure that the entire team is aware that transport will be delayed for splinting. B. repeat the request back to the team leader and then splint the patient’s arm. C. disregard the team leader’s request and contact medical control for guidance. D. advise the team leader that immediate transport is more important than splinting.

Complications associated with chest compressions include all of the following, EXCEPT: A. gastric distention. B. a fractured sternum. C. liver laceration. D. rib fractures.

After assuming care of a cardiac arrest patient from an EMT, the paramedic should remember that: A. BLS efforts must continue throughout the patient care continuum. B. ALS interventions are the core interventions around which BLS care is provided. C. the BLS care provided by the EMT is the “first steps” of ALS care. D. ALS interventions are fundamentally more critical than BLS interventions.

CPR retraining is the MOST effective when it: A. occurs every 24 months. B. involves hands-on practice. C. is delivered by computer. D. is self-paced and brief.

An effective team leader should: A. refrain from any direct patient care. B. perform all difficult interventions. C. help the team accomplish goals. D. command his or her team.

A sign of respiratory distress seen in the neck is: A. muscular atrophy. B. muscular twitches. C. muscular definition. D. accessory muscle use.

EMTs and other health care providers function as a true team when they work: A. dependently. B. independently. C. interdependently. D. under standing orders.

Early signs and symptoms of viral hepatitis include all of the following, EXCEPT: A. pain in the muscles and joints. B. vomiting, fever, and fatigue. C. loss of appetite and a cough. D. jaundice and abdominal pain.

Health care teams that infrequently train and work together: A. are unable to accomplish their tasks. B. often work better under pressure. C. can create delays in patient care. D. need less-explicit verbal direction.

In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve: A. applying a pulse oximeter probe to the finger to determine if peripheral perfusion is adequate. B. taking a blood pressure and determining if the patient is alert and oriented or confused. C. palpating the carotid pulse to determine the approximate rate and checking capillary refill time. D. checking the radial pulse and noting the color, temperature, and condition of the skin.

In contrast to viral hepatitis, toxin-induced hepatitis: A. typically does not cause yellow skin. B. is not a communicable disease. C. is a far more transmittable disease. D. can be prevented with a vaccination.

In contrast to a health care group, a health care team: A. is not assigned specific roles. B. works interdependently. C. works independently. D. does not function under protocols.

Premature diagnosis during a call can be due to what error? A. Anchoring B. Bias C. Streamlining D. Overconfidence

Ten days after treating a 34-year-old patient with tuberculosis, you are given a tuberculin skin test, which yields a positive result. This MOST likely indicates that: A. you contracted the disease by casual contact instead of exposure to secretions. B. the disease is dormant in your body, but will probably never cause symptoms. C. you were exposed to another infected person prior to treating the 34-year-old patient. D. you are actively infected with tuberculosis and should be treated immediately.

The determination of whether a medical patient is a high-priority or low-priority transport is typically made: A. upon completion of a detailed secondary assessment. B. once the patient’s baseline vital signs are known. C. as soon as the patient voices his or her chief complaint. D. after the primary assessment has been completed.

The effectiveness of pit crew CPR is dependent on: A. a team leader who is capable of performing all of the patient care tasks. B. defining clear roles and responsibilities before the call is received. C. rapidly assessing the patient before assigning roles and responsibilities. D. protocols that allow the EMT to function without medical control.

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

Urticaria is the medical term for: Select one: A. hives. B. swelling. C. a wheal. D. burning.

A. hives.

Which of the following is an example of closed-loop communication? A. The EMT requests permission from medical control to assist a patient with his prescribed nitroglycerin. B. The team leader assigns the EMT a task, and the EMT repeats the request back to the team leader. C. EMTs decide not to attempt resuscitation because the patient has rigor mortis and is cold to the touch. D. The EMT corrects the team leader, who states that chest compressions should be greater than 3 inches deep.

The greatest danger in displaying a personal bias or “labeling” a patient who frequently calls EMS is: A. discouraging the patient from calling EMS in the future. B. demeaning or humiliating the patient and his or her family. C. overlooking a potentially serious medical condition. D. making the entire EMS system look unprofessional.

Which of the following would the EMT MOST likely be asked to do when assisting a paramedic with endotracheal intubation? A. Placement of the endotracheal tube B. Preoxygenation with a BVM C. Visualization of the vocal cords D. Suction under direct laryngoscopy

Three months after returning home from West Africa, a 50-year-old man begins experiencing a fever, cough, and muscle aches. The EMT should suspect: A. influenza. B. whooping cough. C. Ebola. D. hepatitis.

When administering epinephrine via auto-injector, you should hold the injector in place for: Select one: A. 8 seconds. B. 15 seconds. C. 3 seconds. D. 10 seconds.

C. 3 seconds.

Which of the following would the paramedic be LEAST likely to ask the EMT to do? A. Assess blood glucose B. Intubate a patient C. Obtain vital signs D. Apply a tourniquet

When an auto-injector is used to give epinephrine, the primary injection site is the: Select one: A. medial portion of the thigh. B. medial part of the buttocks. C. lateral portion of the thigh. D. lateral portion of the arm.

C. lateral portion of the thigh.

When caring for a patient who takes numerous medications, it is best to: A. let the hospital staff retrieve the patient’s medical records, which should show a list of his or her current medications. B. send the patient’s medications to the hospital with a family member or other person who will safeguard them. C. take all of the patient’s medications with you to the hospital and document them on your patient care report. D. document the medications on your patient care report, but leave them at home so they do not get misplaced.

Which step in EMS decision making comes after a patient has been transferred? A. Data gathering B. Team communication C. Outcome evaluation D. Planning

A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: Select one: A. oxygen at 2 L/min via nasal cannula. B. placing her in an upright position. C. ventilations with a BVM. D. nitroglycerin for her chest pain.

placing her in an upright position.

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: Select one: A. alert the receiving hospital and perform CPR for the duration of the transport. B. defibrillate with the AED while continuing transport to the hospital. C. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. D. stop the ambulance, begin CPR, and attach the AED as soon as possible.

stop the ambulance, begin CPR, and attach the AED as soon as possible.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one: A. leave the battery attached to the monitor and remove the vest. B. perform ventilations only and allow the vest device to defibrillate. C. remove the battery from the monitor and then remove the vest. D. remove the battery from the monitor and leave the vest in place.

remove the battery from the monitor and then remove the vest.

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? Select one: A. Uncontrolled hypertension B. Obstructive lung disease C. Acute myocardial infarction D. Thoracic aortic aneurysm

Acute myocardial infarction

A patient with a left ventricular assist device (LVAD) tells you that the device’s pump flow is continuous. Which of the following should you expect to encounter during your assessment? Select one: A. Absence of a palpable pulse B. High systolic blood pressure C. Distention of the jugular veins D. Low diastolic blood pressure

Absence of a palpable pulse

A patient with atherosclerotic heart disease experiences chest pain during exertion because: Select one: A. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. B. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. C. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. D. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: Select one: A. placing a stent inside the coronary artery to keep it from narrowing. B. bypassing the coronary artery with a vessel from the chest or leg. C. dilating the affected coronary artery with a small inflatable balloon. D. scraping fatty deposits off of the lumen of the coronary artery.

dilating the affected coronary artery with a small inflatable balloon.

Acute coronary syndrome (ACS) is a term used to describe: Select one: A. the exact moment that a coronary artery is completely occluded. B. a severe decrease in perfusion caused by changes in heart rate. C. a group of symptoms that are caused by myocardial ischemia. D. the warning signs that occur shortly before a heart attack.

a group of symptoms that are caused by myocardial ischemia.

After assisting your patient with prescribed nitroglycerin, you should: Select one: A. perform a secondary assessment before administering further doses. B. reassess his or her blood pressure within 5 minutes to detect hypotension. C. place the patient in a recumbent position in case of fainting. D. avoid further dosing if the patient complains of a severe headache

reassess his or her blood pressure within 5 minutes to detect hypotension.

After the AED has delivered a shock, the EMT should: Select one: A. assess for a carotid pulse. B. transport the patient at once. C. re-analyze the cardiac rhythm. D. immediately resume CPR.

immediately resume CPR.

An acute myocardial infarction (AMI) occurs when: Select one: A. myocardial tissue dies secondary to an absence of oxygen. B. coronary artery dilation decreases blood flow to the heart. C. the entire left ventricle is damaged and cannot pump blood. D. the heart muscle progressively weakens and dysfunctions.

myocardial tissue dies secondary to an absence of oxygen.

Cardiac output may decrease if the heart beats too rapidly because: Select one: A. the volume of blood that returns to the heart is not sufficient with fast heart rates. B. a rapid heartbeat causes a decrease in the strength of cardiac contractions. C. there is not enough time in between contractions for the heart to refill completely. D. as the heart rate increases, more blood is pumped from the ventricles than the atria

there is not enough time in between contractions for the heart to refill completely.

Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. severe headache. B. hypotension. C. hypertension. D. bradycardia.

hypertension

Common signs and symptoms of a hypertensive emergency include: Select one: A. pallor, cool skin, and a temporary loss of hearing. B. tachycardia, pain behind the eyes, and weakness. C. syncope, a weak pulse, and bleeding from the ears. D. a bounding pulse, a severe headache, and dizziness.

a bounding pulse, a severe headache, and dizziness.

Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. pain exacerbated by breathing. B. sudden unexplained sweating. C. shortness of breath or dyspnea. D. irregular heartbeat.

pain exacerbated by breathing.

Defibrillator pads are placed on the patient’s chest: Select one: A. with one pad to the right of the upper sternum and the other pad just to the right of the right nipple. B. with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit. C. with one pad to the left of the upper sternum and the other pad to the right lower chest below the armpit. D. with one pad to the left of the upper sternum and the other pad just to the right of the left nipple.

with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a “no shock advised” message. This indicates that: Select one: A. the AED has detected asystole. B. she has a pulse and does not need CPR. C. she is not in ventricular fibrillation. D. the AED detected patient motion.

she is not in ventricular fibrillation.

In contrast to AMI, a dissecting aortic aneurysm: Select one: A. usually presents gradually, often over a period of hours. B. is typically preceded by other symptoms, such as nausea. C. often presents with pain that is maximal from the onset. D. is more commonly associated with pressure in the chest.

often presents with pain that is maximal from the onset.

In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest: Select one: A. does not require the EMT to stand clear when it shocks. B. will only deliver a shock if ventricular fibrillation occurs. C. does not warn when a shock is about to be delivered. D. delivers high-energy shocks, similar to an AED.

delivers high-energy shocks, similar to an AED.

Ischemic heart disease is defined as: Select one: A. decreased blood flow to one or more portions of the myocardium. B. death of a portion of the heart muscle due to a decrease in oxygen. C. absent myocardial blood flow due to a blocked coronary artery. D. decreased blood flow to the heart muscle due to coronary dilation.

decreased blood flow to one or more portions of the myocardium.

Risk factors for AMI that cannot be controlled include: Select one: A. lack of exercise. B. family history. C. excess stress. D. hyperglycemia.

family history

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seems to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include: Select one: A. assisting him with his migraine medication and transporting without lights and siren. B. placing him in a supine position and transporting with lights and siren to a stroke center. C. dimming the lights in the back of the ambulance and transporting without lights and siren. D. applying warm compresses to the back of his neck and transporting with lights and siren.

dimming the lights in the back of the ambulance and transporting without lights and siren.

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? Select one: A. He has experienced seizures since he was 20. B. His Glasgow Coma Scale (GCS) score is 15. C. He is currently not prescribed any medications. D. His wife states that this was his “usual” seizure.

He is currently not prescribed any medications.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority? Select one: A. Documenting all of his current medications B. Administering glucose to rule out hypoglycemia C. Obtaining a complete set of baseline vital signs D. Asking his wife when she noticed the symptoms

Asking his wife when she noticed the symptoms

A generalized (tonic-clonic) seizure is characterized by: Select one: A. a core body temperature of greater than 103°F (40°C). B. a blank stare and brief lapse of consciousness. C. unconsciousness for greater than 30 minutes. D. severe twitching of all the body’s muscles.

severe twitching all the body’s muscles.

A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. aphasia. B. dysphagia. C. dysphasia. D. dysarthria.

dysarthria

An area of swelling or enlargement in a weakened arterial wall is called: Select one: A. a thrombus. B. atherosclerosis. C. an aneurysm. D. an embolism.

an aneurysm

During the primary assessment of a semiconscious 70-year-old female, you should: Select one: A. insert a nasopharyngeal airway and assist ventilations. B. immediately determine the patient’s blood glucose level. C. ensure a patent airway and support ventilation as needed. D. ask family members if the patient has a history of stroke.

ensure a patent airway and support ventilation as needed.

Interruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: A. an acute arterial rupture. B. cerebral vasodilation. C. an embolism. D. a thrombus.

cerebral vasodilation.

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should: Select one: A. assist ventilations, perform a rapid exam, and prepare for immediate transport. B. place a bite block in her mouth in case she has a seizure and transport at once. C. apply oxygen via a nonrebreathing mask, place her on her left side, and transport. D. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.

assist ventilations, perform a rapid exam, and prepare for immediate transport.

Which of the following conditions is NOT a common cause of seizures? Select one: A. Acute alcohol withdrawal B. Poisoning or overdose C. Acute hypoglycemia D. Hypotension

Hypotension

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Select one: A. Intracranial bleeding B. Hypoglycemia C. Hypovolemia D. A postictal state

Hypovolemia

Which of the following is a metabolic cause of a seizure? Select one: A. Head trauma B. Poisoning C. Massive stroke D. A seizure that causes the patient to stare blankly

Poisoning

Which of the following MOST accurately describes a focal-onset aware seizure? Select one: A. A generalized seizure without incontinence B. A seizure that is not preceded by an aura C. A seizure that begins in one extremity D. A seizure that causes the patient to stare blankly

A seizure that begins in one extremity

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? Select one: A. A rapidly improving level of consciousness B. Hyperventilation and hypersalivation C. A gradually decreasing level of consciousness D. Confusion and fatigue

Confusion and fatigue

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever? Select one: A. A 3-month-old female who was born prematurely B. A 35-year-old female in the later stages of AIDS C. A 17-year-old male with anxiety D. An 88-year-old male with chronic renal problems

A 17-year-old male with anxiety

Which of the following symptoms would lead the EMT to believe that a patient’s headache is caused by sinus congestion? Select one: A. The pain is worse when bending over. B. There is associated neck stiffness. C. There is numbness in the extremities. D. The headache began suddenly.

The pain is worse when bending over.

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: Select one: A. an occluded cerebral artery. B. acute hypoglycemia. C. a ruptured cerebral artery. D. a complex partial seizure.

a ruptured cerebral artery.

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: Select one: A. repeat the arm drift test, but move the patient’s arms into position yourself. B. repeat the arm drift test and ensure that her palms are facing downward. C. defer this part of the test and assess her for facial droop and slurred speech. D. instruct the patient to keep her eyes open and then repeat the arm drift test.

repeat the arm drift test, but move the patient’s arms into position yourself.

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: Select one: A. high-flow oxygen and transport. B. oral glucose gel and transport. C. ventilatory assistance and transport. D. recovery position and transport.

recovery position and transport.

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: Select one: A. assess the patient for a facial droop and hemiparesis. B. perform CPR for 5 minutes before applying the AED. C. initiate CPR and attach an AED as soon as possible. D. obtain a blood glucose sample to rule out hypoglycemia.

initiate CPR and attach an AED as soon as possible.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient’s girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to: Select one: A. determine if the patient is a known alcohol abuser. B. ask her how long the patient has been taking his medication. C. obtain a description of how the seizure developed. D. determine when he was last seen by his physician.

obtain a description of how the seizure developed.

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should: Select one: A. give her small cups of water to drink and observe for further seizure activity. B. place her in the recovery position and transport her with lights and siren. C. administer one tube of oral glucose and prepare for immediate transport. D. monitor her airway and breathing status and assess her blood glucose level.

monitor her airway and breathing status and assess her blood glucose level.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: Select one: A. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. B. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device. C. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. D. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter.

maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: Select one: A. transport the child to the hospital and reassure the mother en route. B. cover the child with wet towels and give oxygen via nasal cannula. C. call medical control and request permission to give the child aspirin. D. advise the mother to take her child to the doctor the following day.

transport the child to the hospital and reassure the mother en route.

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of: Select one: A. 14 B. 13 C. 15 D. 12

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect: Select one: A. esophagitis. B. esophageal varices. C. acute pancreatitis. D. Mallory–Weiss tear.

Mallory–Weiss tear.

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to: Select one: A. protect her airway from aspiration. B. rapidly transport her to the hospital. C. give her high-flow supplemental oxygen. D. keep her supine and keep her warm.

protect her airway from aspiration.

A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is: Select one: A. acute cholecystitis. B. pancreatitis. C. acute cystitis. D. appendicitis.

acute cholecystitis

A 47-year-old male presents with severe abdominal pain of 3 hours’ duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to: Select one: A. determine the exact location and cause of his pain. B. be alert for signs and symptoms of shock. C. assess his blood pressure to determine perfusion adequacy. D. transport him in a supine position.

be alert for signs and symptoms of shock.

Which of the following MOST accurately defines an allergic reaction? Select one: A. Destruction of the immune system by an external substance B. A direct negative effect on the body by an external substance C. A release of erythrocytes in response to a foreign substance D. An exaggerated immune system response to any substance

D. An exaggerated immune system response to any substance

A young female presents with costovertebral angle tenderness. She is conscious and alert with stable vital signs. Which of the following organs is MOST likely causing her pain? Select one: A. Gallbladder B. Pancreas C. Liver D. Kidney

Kidney

Pain that is localized to the lower back and/or lower abdominal quadrants is MOST suggestive of: Select one: A. acute pancreatitis. B. acute appendicitis. C. an aortic aneurysm. D. a kidney infection.

an aortic aneurysm

Patients with acute abdominal pain should not be given anything to eat or drink because: Select one: A. substances in the stomach increase the risk of aspiration. B. it will create referred pain and obscure the diagnosis. C. digestion prevents accurate auscultation of bowel sounds. D. food will rapidly travel through the digestive system.

substances in the stomach increase the risk of aspiration.

Peritonitis may result in shock because: Select one: A. severe pain causes systemic dilation of the vasculature. B. intra-abdominal hemorrhage is typically present. C. fluid shifts from the bloodstream into body tissues. D. abdominal distention impairs cardiac contractions.

fluid shifts from the bloodstream into body tissues.

When assessing a patient with abdominal pain, you should: Select one: A. visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition. B. ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area. C. palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful. D. observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

Which of the following statements regarding gastrointestinal bleeding is correct? Select one: A. Lower gastrointestinal bleeding results from conditions such as Mallory–Weiss syndrome. B. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself. C. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe. D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

You are dispatched to an apartment complex for a young male with abdominal pain. Your priority upon arriving at the scene should be to: Select one: A. quickly gain access to the patient. B. notify the dispatcher of your arrival. C. assess the scene for potential hazards. D. place a paramedic ambulance on standby.

assess the scene for potential hazards.

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should: Select one: A. leave him in a sitting position, keep him warm, and prepare for immediate transport. B. perform a detailed secondary assessment and then transport him to a dialysis center. C. place him in a supine position, elevate his lower extremities, and transport at once. D. treat for shock and request a paramedic unit to respond to the scene and assist you.

leave him in a sitting position, keep him warm, and prepare for immediate transport.

A strangulated hernia is one that: Select one: A. is reducible if surgical intervention occurs within 2 hours. B. can be pushed back into the body cavity to which it belongs. C. spontaneously reduces without any surgical intervention. D. loses its blood supply due to compression by local tissues.

loses its blood supply due to compression by local tissues.

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect: Select one: A. strangulated hernia. B. aortic aneurysm. C. acute pancreatitis. D. kidney stones.

aortic aneurysm.

Chronic renal failure is a condition that: Select one: A. causes dehydration from excessive urination. B. can be reversed with prompt treatment. C. is often caused by hypertension or diabetes. D. occurs from conditions such as dehydration.

is often caused by hypertension or diabetes.

Erosion of the protective layer of the stomach or duodenum secondary to overactivity of digestive juices results in: Select one: A. cholecystitis. B. ileus. C. an ulcer. D. appendicitis.

an ulcer

Esophageal varices MOST commonly occur in patients who: Select one: A. have uncontrolled diabetes. B. have weak immune systems. C. consume a lot of alcohol. D. have a history of esophagitis.

consume a lot of alcohol.

Most patients with abdominal pain prefer to: Select one: A. sit fully upright because it helps relax the abdominal muscles. B. sit in a semi-Fowler position with their knees slightly bent. C. lie in a supine position with their knees in a flexed position. D. lie on their side with their knees drawn into the abdomen.

lie on their side with their knees drawn into the abdomen.

Pain that may be perceived at a distant point on the surface of the body, such as the back or shoulder, is called: Select one: A. radiating pain. B. visceral pain. C. referred pain. D. remote pain.

referred pain

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of: Select one: A. gastroenteritis. B. pancreatitis. C. appendicitis. D. cholecystitis.

appendicitis

Solid abdominal organs include the: Select one: A. urinary bladder, colon, and ureters. B. stomach and small intestine. C. gallbladder and large intestine. D. spleen, kidneys, and pancreas.

spleen, kidneys, and pancreas.

The kidneys help to regulate blood pressure by: Select one: A. eliminating toxic waste products from the body. B. removing sodium and water from the body. C. accommodating a large amount of blood volume. D. retaining key electrolytes, such as potassium.

removing sodium and water from the body.

The MOST common and significant complication associated with an acute abdomen is: Select one: A. internal bleeding. B. peritonitis. C. high fever. D. severe pain.

peritonitis

The principal symptom in both infectious and noninfectious gastroenteritis is: Select one: A. vomiting. B. diarrhea. C. dysuria. D. high fever.

diarrhea

Which of the following conditions is more common in women than in men? Select one: A. Cholecystitis B. Cystitis C. Pancreatitis D. Hepatitis

Cystitis

Which of the following assessment findings is MOST indicative of a cardiovascular problem? A. Use of the accessory muscles B. Unequal breath sounds C. Jugular venous distention D. Palpable pain to the epigastrium

A 19-year-old male complains of “not feeling right.” His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads “error” after several attempts to assess his blood glucose level. You should: Select one: A. contact medical control and administer oral glucose. B. transport only with close, continuous monitoring en route. C. request a paramedic ambulance to administer IV glucose. D. assist him with his insulin injection and reassess him.

contact medical control and administer oral glucose.

A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow, and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should: Select one: A. transport immediately. B. treat her for hyperglycemia. C. administer oral glucose. D. provide ventilatory support.

provide ventilatory support.

A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid, shallow breathing. His pulse is rapid and weak, and his skin is cyanotic. The EMT should: Select one: A. place a thin layer of oral glucose between his cheek and gums. B. administer oxygen by nasal cannula and assess his blood glucose level. C. position the patient on his side and give oxygen via nonrebreathing mask. D. assist the patient’s ventilations with a bag-valve mask.

assist the patient’s ventilations with a bag-valve mask.

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma, and the patient’s blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: Select one: A. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital. B. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. C. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. D. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.

suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis? Select one: A. Deep and rapid breathing B. Rapid and weak pulse C. Hypotension and tachycardia D. Restlessness and irritability

Deep and rapid breathing

A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? Select one: A. Pulmonary embolism B. Diabetic ketoacidosis C. Congestive heart failure D. Severe hypoglycemia

Pulmonary embolism

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one: A. an acute stroke. B. a heart attack. C. hyperglycemia. D. hypoglycemia

a heart attack

A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: Select one: A. open and maintain her airway and assess breathing. B. administer oral glucose between her cheek and gum. C. administer 100% oxygen via a nonrebreathing mask. D. assess for the presence of a medical identification tag

open and maintain her airway and assess breathing.

In contrast to hypoglycemia, hyperglycemia: Select one: A. can only be corrected in the hospital setting. B. is a rapidly developing metabolic disturbance. C. commonly results in excess water retention. D. is rapidly reversible if oral glucose is given.

can only be corrected in the hospital setting.

Insulin functions in the body by: Select one: A. increasing circulating blood glucose. B. enabling glucose to enter the cells. C. metabolizing glucose to make energy. D. producing new glucose as needed.

enabling glucose to enter the cells.

Ketone production is the result of: Select one: A. acidosis when blood glucose levels are low. B. blood glucose levels higher than 120 mg/dL. C. rapid entry of glucose across the cell membrane. D. fat metabolization when glucose is unavailable.

fat metabolization when glucose is unavailable.

You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes: Select one: A. dextrose. B. insulin. C. oxygen. D. glucagon.

insulin

You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include: Select one: A. applying a nonrebreathing mask at 15 L/min. B. administering one to two tubes of oral glucose. C. assisting the patient with his diabetic medication. D. performing a rapid exam and obtaining vital signs.

applying a nonrebreathing mask at 15 L/min.

You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: Select one: A. calm him down so you can assess him. B. contact medical control for instructions. C. retreat at once and call law enforcement. D. be assertive and talk the patient down.

retreat at once and call law enforcement.

A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient’s clinical presentation, you should suspect that she: Select one: A. is significantly hyperglycemic. B. has a urinary tract infection. C. has a low blood glucose level. D. has overdosed on her insulin.

is significantly hyperglycemic.

Classic signs and symptoms of hypoglycemia include: Select one: A. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. B. warm, dry skin; irritability; bradycardia; and rapid respirations. C. cool, clammy skin; weakness; tachycardia; and rapid respirations. D. warm, dry skin; hunger; abdominal pain; and deep, slow respirations.

cool, clammy skin; weakness; tachycardia; and rapid respirations.

Diabetes is MOST accurately defined as a(n): Select one: A. abnormally high blood glucose level. B. lack of insulin production in the pancreas. C. disorder of glucose metabolism. D. mass excretion of glucose by the kidneys.

disorder of glucose metabolism.

Diabetic ketoacidosis occurs when: Select one: A. blood glucose levels rapidly fall. B. insulin is not available in the body. C. the pancreas produces excess insulin. D. the cells rapidly metabolize glucose.

insulin is not available in the body.

Excessive eating caused by cellular “hunger” is called: Select one: A. polydipsia. B. dysphasia. C. dyspepsia. D. polyphagia.

polyphagia

Hemoglobin is: Select one: A. a key component of the blood and is produced in response to an infection. B. found within the red blood cells and is responsible for carrying oxygen. C. the fluid portion of the blood that transports cells throughout the body. D. essential for the formation of clots, such as when vessel damage occurs.

found within the red blood cells and is responsible for carrying oxygen.

In general, oral glucose should be given to any patient who: Select one: A. is unresponsive, even in the absence of a history of diabetes. B. has a blood glucose level that is less than 100 mg/dL. C. has an altered mental status and a history of diabetes. D. has documented hypoglycemia and an absent gag reflex.

has an altered mental status and a history of diabetes.

Patients with thrombophilia are at an increased risk for: Select one: A. pulmonary embolism. B. acute arterial rupture. C. hemorrhagic stroke. D. various cancers.

acute arterial rupture

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT: Select one: A. glyburide (Micronase). B. diet and exercise. C. supplemental insulin. D. tolbutamide (Orinase).

supplemental insulin.

Patients with uncontrolled diabetes experience polyuria because: Select one: A. low blood glucose levels result in cellular dehydration. B. excess glucose in the blood is excreted by the kidneys. C. they drink excess amounts of water due to dehydration. D. high blood sugar levels cause permanent kidney damage.

excess glucose in the blood is excreted by the kidneys.

Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT: Select one: A. requesting permission from medical control. B. checking the medication’s expiration date. C. ensuring the absence of a gag reflex. D. assessing the patient’s mental status.

ensuring the absence of a gag reflex

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately? Select one: A. Systemic vasodilation B. Severe hypotension C. Diffuse urticaria D. Upper airway swelling

D. Upper airway swelling

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should: Select one: A. administer naloxone via the intranasal route. B. insert a nasal airway and ventilate with a bag-mask device. C. administer naloxone via the intramuscular route. D. position the patient on his side and transport without delay.

B. insert a nasal airway and ventilate with a bag-mask device.

You and your partner enter the residence of an elderly couple, both of whom are found unconscious in their bed. There is no evidence of trauma. As you begin your assessment, you and your partner notice the smell of natural gas in the residence. Which of the following should be your most appropriate action? A. Quickly exit the residence and request the fire department to move the patients. B. Perform a rapid assessment and then move the patients from their residence. C. Rapidly remove the patients from their residence using a blanket or clothes drag. D. Request another ambulance to assist with lifting and moving the patients.

Which of the following conditions often requires transport to a hospital with specialized capabilities that may not be available at the closest hospital? A. Seizures and infection B. Stroke and heart attack C. Cardiac arrest and shock D. Diabetes and migraines

You have two patients who were involved in a motor vehicle crash when their SUV struck a tree—one with neck and back pain, and the other with a deformed left femur. The patient with the deformed femur states that he does not want to be placed on a hard board, nor does he want a collar around his neck. What is the most appropriate and practical method of securing these patients and placing them into the ambulance? A. Apply a traction splint to the patient with the deformed femur and place him on the wheeled stretcher; place the patient with neck and back pain on the squad bench immobilized with a cervical collar and scoop stretcher. B. Immobilize the patient with neck and back pain on a long backboard and place him on the wheeled stretcher; place the patient with the deformed femur on a folding stretcher secured to the squad bench. C. Immobilize the patient with neck and back pain on a long backboard and place him on the squad bench; allow the patient with the deformed femur to sit on the wheeled stretcher. D. Immobilize both patients with a cervical collar and long backboard based on the mechanism of injury; place one on the wheeled stretcher and the other on the squad bench.

Which of the following statements regarding the human immunodeficiency virus (HIV) is correct? A. HIV is far more contagious than hepatitis B and is easily transmitted in the health care setting. B. The risk of HIV infection is greatest when deposited on a mucous membrane or directly into the bloodstream. C. The risk of HIV infection is high, even if an infected person’s blood comes in contact with your intact skin. D. Most patients who are infected with HIV experience chronic symptoms that vary in duration and severity.

You suspect that a 75-year-old man has internal injuries after he fell and struck his ribs and abdomen on the corner of a table. When assessing and treating an injured patient of this age, you must recall that: A. it is not uncommon to observe heart rates in excess of 150 beats/min in elderly patients with internal injuries. B. his ability to physiologically compensate for his injury might be impaired due to an inability to increase cardiac output. C. functional blood volume in patients of this age steadily increases due to increased production of red blood cells. D. blood pressure is usually adequately maintained because the blood vessels of older people can contract easily.

You and your EMT partner arrive at the residence of a 50-year-old man who complains of weakness. Your primary assessment reveals that he is critically ill and will require aggressive treatment. The closest hospital is 25 miles away. You should: A. manage all threats to airway, breathing, and circulation and consider requesting an ALS unit. B. load him into the ambulance, begin transport, and perform all treatment en route to the hospital. C. perform a detailed secondary assessment, assess his vital signs, and then transport rapidly. D. administer oxygen via nonrebreathing mask and obtain as much of his medical history as possible.

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A. apply direct pressure to the wound. B. elevate his legs and keep him warm. C. administer 100% supplemental oxygen. D. ensure that his airway is patent.

You have just completed your primary assessment of a 48-year-old man with crushing chest pain and difficulty breathing. The patient has been given 324 mg of aspirin and is receiving supplemental oxygen. As you begin your secondary assessment, you note that his mental status has deteriorated and he is now bradycardic. You should: A. request an ALS unit to respond to the scene. B. continue with your secondary assessment. C. insert a nasal airway and assist his breathing. D. prepare the patient for immediate transport.

A 3-year-old female ingested several leaves from a plant in the living room. The child’s mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. After completing your primary assessment of the child, you should: Select one: A. induce vomiting with syrup of ipecac. B. immediately transport the child to the hospital. C. administer 25 g of activated charcoal. D. contact the regional poison control center.

D. contact the regional poison control center.

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: A. tilt the patient’s head back and lift up on his chin. B. apply a pressure dressing to the patient’s arm. C. open his airway with the jaw-thrust maneuver. D. apply a cervical collar and suction his airway.

Your patient’s symptoms include high fever, cough, vomiting, bloody diarrhea, and shortness of breath. Which of the following should you suspect? A. Hepatitis B B. MERS-CoV C. Influenza D. Whooping cough

A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child’s mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should: Select one: A. administer high-flow supplemental oxygen. B. administer 15 g of activated charcoal. C. give the child milk to absorb the Tylenol. D. contact medical control for guidance.

B. administer 15 g of activated charcoal.

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient’s wife tells you that he is a heavy drinker and that he might have had a seizure shortly before your arrival. This patient is most likely experiencing: Select one: A. alcohol intoxication. B. acute schizophrenia. C. delirium tremens. D. acute hypovolemia.

C. delirium tremens.

Activated charcoal is given to patients who have ingested certain substances because it: Select one: A. induces vomiting and empties the stomach. B. binds to the substance and prevents absorption. C. decreases absorption of poisons into the lungs. D. is a direct antidote for many toxic substances.

B. binds to the substance and prevents absorption.

As you enter the residence of a patient who has possibly overdosed, you should: Select one: A. be alert for personal hazards. B. look for drug paraphernalia. C. quickly gain access to the patient. D. observe the scene for drug bottles.

A. be alert for personal hazards.

Your primary assessment of an elderly woman reveals that she is conscious and alert, but is experiencing difficulty breathing. She has a history of emphysema, hypertension, and congestive heart failure. As you assess the patient’s circulatory status, you should direct your partner to: A. administer oxygen with the appropriate device. B. retrieve the stretcher and prepare for transport. C. assess her oxygen saturation and blood pressure. D. perform a head-to-toe secondary assessment.

A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: A. acute pancreatitis. B. liver dysfunction. C. renal insufficiency. D. gallbladder disease.

An index of suspicion is MOST accurately defined as: A. your awareness and concern for potentially serious underlying and unseen injuries or illness. B. determining the underlying cause of a patient’s medical condition based on signs and symptoms. C. ruling out specific medical conditions based on the absence of certain signs and symptoms. D. the EMT’s prediction of the type of illness a patient has based on how the call is dispatched.

In contrast to the assessment of a trauma patient, assessment of a medical patient: A. is focused on the nature of illness, the patient’s chief complaint, and his or her symptoms. B. almost exclusively focuses on physical signs that indicate the patient is experiencing a problem. C. is not as complex for the EMT because most patients typically present with classic symptoms. D. requires a thorough head-to-toe exam that involves a detailed assessment of all body systems.

A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: A. ask law enforcement officials if they are familiar with the patient. B. wait for family members to arrive before asking any questions. C. defer SAMPLE history questions until you arrive at the hospital. D. determine if the patient has a medical alert bracelet or wallet card.

Before giving activated charcoal, you should: Select one: A. mix the suspension by stirring the bottle. B. have the patient drink a glass of milk. C. mix it with an equal amount of water. D. obtain approval from medical control.

D. obtain approval from medical control.

The BEST way to prevent infection from whooping cough is to: A. routinely place a surgical mask on all respiratory patients. B. wear a HEPA mask when treating any respiratory patient. C. ask all patients if they have recently traveled abroad. D. get vaccinated against diphtheria, tetanus, and pertussis.

A 50-year-old male presents with altered mental status. His wife tells you that he had a “small stroke” 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should: A. repeat the primary assessment. B. prepare for immediate transport. C. inquire about his family history. D. perform a head-to-toe assessment.

EMTs are dispatched for a teenage male who is “not acting right.” When they arrive, they are informed that the patient was huffing. Several cans of Freon are found near the patient. Which of the following is a unique consideration for this patient? Select one: A. The pulse oximeter will yield a falsely elevated reading. B. A sudden adrenaline release can cause a fatal dysrhythmia. C. Encouraging walking will help eliminate Freon from the body. D. Oxygen will not increase the patient’s oxygen saturation.

B. A sudden adrenaline release can cause a fatal dysrhythmia.

In general, injected poisons are impossible to dilute or remove because they: Select one: A. are usually absorbed quickly into the body. B. absorb slowly into the body, despite their potency. C. are usually fatal within 30 minutes of exposure. D. react with the blood, which increases their toxicity.

A. are usually absorbed quickly into the body.

During your assessment of a 50-year-old male who was found unresponsive in an alley, you note that he has slow, shallow respirations; bradycardia; facial cyanosis; and pinpoint pupils. As your partner begins assisting the patient’s ventilations, he directs your attention to the patient’s arms, which have multiple needle tracks on them. Which of the following would most likely explain the patient’s presentation? Select one: A. Delirium tremens B. Heroin overdose C. Alcohol intoxication D. Closed-head injury

B. Heroin overdose

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be most alert for: Select one: A. a sudden outburst of violence. B. seizures and cardiac dysrhythmias. C. an increase in her blood pressure. D. acute respiratory depression.

B. seizures and cardiac dysrhythmias.

Naloxone (Narcan) would reverse the effects of: Select one: A. temazepam (Restoril). B. phenobarbital (Luminal). C. hydromorphone (Dilaudid). D. diazepam (Valium).

C. hydromorphone (Dilaudid)

The primary prehospital treatment for most medical emergencies: A. focuses on definitive care because a diagnosis can usually be made. B. addresses the patient’s symptoms more than the actual disease process. C. involves transport only until treatment can be performed at the hospital. D. typically does not require the EMT to contact medical control.

A 71-year-old female slipped on a rug and fell. She is conscious but confused and complains of severe pelvic pain. Her respirations are 22 breaths/min and her heart rate is 120 beats/min. What should you do? A. Transport her on her left side B. Gently palpate her pelvis C. Transport her in a seated position D. Treat her for possible shock

A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient? A. Positive-pressure ventilations and immediate transport to the closest hospital B. Assisted ventilation with a bag-valve mask and a head-to-toe exam C. Oxygen via nonrebreathing mask and a focused secondary assessment D. Oxygen via a nasal cannula, vital signs, and prompt transport to the hospital

A crackling sound produced by air bubbles under the skin is called: A. subcutaneous emphysema. B. crepitus C. Korotkoff sounds. D. rhonchi.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. rapid and shallow. B. slow and deep. C. slow and shallow. D. deep and rapid.

A decrease in blood pressure may indicate: A. loss of vascular tone. B. increased blood volume. C. arterial constriction. D. forceful cardiac contraction.

The respiratory distress that accompanies emphysema is caused by: A. chronic stretching of the alveolar walls. B. acute fluid accumulation in the alveoli. C. repeated exposure to cigarette smoke. D. massive constriction of the bronchioles.

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? A. Pulmonary edema, history of hypertension, and anxiety B. Conscious and alert patient with an oxygen saturation of 85% C. Shortness of breath and a blood pressure of 76/56 mm Hg D. Difficulty breathing, two-word dyspnea, and tachycardia

Which of the following statements regarding the hypoxic drive is correct? A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. Chronic carbon dioxide elimination often results in activation of the hypoxic drive.

Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose? Select one: A. BP, 200/100 mm Hg; pulse, 150 beats/min B. BP, 190/90 mm Hg; pulse, 40 beats/min C. BP, 180/100 mm Hg; pulse, 50 beats/min D. BP, 60/40 mm Hg; pulse, 140 beats/min

A. BP, 200/100 mm Hg; pulse, 150 beats/min

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include: Select one: A. assisted ventilation and naloxone (Narcan). B. high-flow oxygen via a nonrebreathing mask. C. oxygen via a nasal cannula and atropine sulfate. D. assisted ventilation and flumazenil (Romazicon).

A. assisted ventilation and naloxone (Narcan).

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Immediate management for this patient should include: Select one: A. performing a rapid secondary assessment. B. assisted ventilation with a bag-mask device. C. thoroughly suctioning her oropharynx. D. requesting a paramedic to give her atropine.

C. thoroughly suctioning her oropharynx.

While auscultating an elderly woman’s breath sounds, you hear low-pitched “rattling” sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? A. Early pulmonary edema B. Widespread atelectasis C. Aspiration pneumonia D. Acute asthma attack

A palpable pulse is created by: A. the pressure of circulating blood against the walls of the veins. B. the pressure that is caused when venous blood returns to the heart. C. electrical conduction in the heart producing contraction of the atria. D. pressure waves through the arteries caused by cardiac contraction.

You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath, and depress the inhale. You should: A. allow him to breathe room air and assess his oxygen saturation. B. instruct him to hold his breath for as long as he comfortably can. C. advise him to exhale forcefully to ensure medication absorption. D. immediately reapply the oxygen mask and reassess his condition.

A patient in unstable condition should be reassessed at least every: A. 10 minutes. B. 15 minutes. C. 5 minutes. D. 20 minutes.

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect: A. spontaneous pneumothorax. B. acute pulmonary embolism. C. right-sided heart failure. D. acute pulmonary edema.

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient’s respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should: Select one: A. apply oxygen via a nonrebreathing mask. B. perform a rapid head-to-toe exam. C. contact the poison control center. D. ventilate her with a bag-mask device.

D. ventilate her with a bag-mask device.

You respond to a college campus for a young male who is acting strangely. After law enforcement has secured the scene, you enter the patient’s dorm room and find him sitting on the edge of the bed; he appears agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this patient includes: Select one: A. attempting to calm him and giving him oxygen if tolerated. B. requesting a paramedic to administer naloxone (Narcan). C. assisting his ventilations with a bag-mask device. D. asking law enforcement to place handcuffs on the patient.

A. attempting to calm him and giving him oxygen if tolerated.

You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the night before. When she awoke, she was in the bed of the motel room. You should suspect that this patient: Select one: A. has a hangover from the night before. B. was given flunitrazepam (Rohypnol). C. is addicted to a benzodiazepine drug. D. is a frequent and heavy heroin user.

B. was given flunitrazepam (Rohypnol).

A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he: A. is experiencing difficulty breathing. B. has a decreased level of consciousness. C. has abdominal muscle spasms. D. is experiencing severe back pain.

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: A. insert a nasopharyngeal airway and begin assisted ventilation. B. apply oxygen via a nonrebreathing mask and transport at once. C. insert an oropharyngeal airway and perform oral suctioning. D. place her in the recovery position and monitor for vomiting.

A patient who moves and cries out only when you pinch his or her trapezius muscle is said to be: A. completely unresponsive. B. conscious and alert. C. responsive to painful stimuli. D. responsive to verbal stimuli.

You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: A. obtain a complete list of all of her medications. B. apply a pulse oximeter and assess her vital signs. C. administer oxygen via a nonrebreathing mask. D. assist her ventilations with a bag-mask device.

A patient with high blood pressure would be expected to have skin that is: A. flushed and red. B. mottled and cool. C. pale and moist. D. cyanotic and dry.

A pleural effusion is MOST accurately defined as: A. diffuse collapsing of the alveoli. B. a bacterial infection of the lung tissue. C. fluid accumulation outside the lung. D. a unilaterally collapsed lung.

Albuterol is a generic name for: A. Singulair. B. Ventolin. C. Alupent. D. Atrovent.

A patient with spontaneous respirations is breathing: A. with shallow depth. B. without difficulty. C. at a normal rate. D. without assistance.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: A. respiratory insufficiency. B. adequate air exchange. C. respiratory difficulty. D. an obstructed airway.

A pulse with a consistent pattern is considered to be: A. regular. B. weak. C. strong. D. irregular.

Asthma is caused by a response of the: A. endocrine system. B. respiratory system. C. immune system. D. cardiovascular system.

Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the following side effects would you expect the patient to experience? Select one: A. Pupillary constriction B. Excessive lacrimation C. Dry mucous membranes D. A fall in blood pressure

C. Dry mucous membranes

Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow respirations. You should be most concerned that this patient: Select one: A. is severely hypoglycemic. B. might vomit and aspirate. C. might experience a seizure. D. might become violent.

B. might vomit and aspirate.

A hypnotic drug is one that: Select one: A. increases the senses. B. induces sleep. C. prevents amnesia. D. increases the pulse.

B. induces sleep.

Harsh, high-pitched inspiratory sounds are characteristic of: A. rales. B. wheezing. C. stridor. D. rhonchi.

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and hyperthermia should be suspected of ingesting a significant quantity of: Select one: A. ibuprofen. B. acetaminophen. C. aspirin. D. cocaine.

C. aspirin.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: Select one: A. dependence. B. addiction. C. tolerance. D. withdrawal.

C. tolerance.

Activated charcoal may be indicated for a patient who ingested: Select one: A. aspirin. B. iron. C. methanol. D. ethanol.

A. aspirin.

In order for efficient pulmonary gas exchange to occur: A. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar–capillary membrane.

After performing a head tilt–chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: A. provide positive-pressure ventilatory assistance. B. assess respiratory rate, depth, and regularity. C. place him or her in the recovery position. D. suction as needed and insert an airway adjunct.

In what area of the lungs does respiration occur? A. Trachea B. Alveoli C. Capillaries D. Bronchi

An adult patient who is NOT experiencing difficulty breathing will: A. assume a position that will facilitate effective and easy breathing. B. have a respiratory rate that is between 20 and 24 breaths/min. C. be able to speak in complete sentences without unusual pauses. D. exhibit an indentation above the clavicles and in between the ribs.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. pay special attention to the exhalation phase because this is when you will likely hear rales or rhonchi. B. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. C. start at the lower lung fields and determine at which level you start hearing clear breath sounds. D. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs.

An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: A. gathering medical history data. B. obtaining baseline vital signs. C. airway, breathing, and circulation. D. providing immediate transport.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A. abnormal breath sounds. B. an absence of breath sounds. C. diminished breath sounds. D. normal breath sounds.

As time progresses following a significant injury: A. the body’s ability to compensate for shock decreases. B. the patient’s injuries will most likely be irreparable. C. the patient’s blood pressure elevates significantly. D. most patients will die secondary to internal bleeding.

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A. 3 B. 2 C. 4 D. 6

After administering activated charcoal to a patient, it is most important to: Select one: A. monitor the patient’s blood pressure. B. be alert for vomiting. C. document the intervention. D. call medical control.

B. be alert for vomiting.

A 22-year-old male with a history of clinical depression called 9-1-1 and stated that he has attempted to kill himself. Your unit and law enforcement officers arrive at the scene simultaneously. You find the patient lying supine on the living room floor. He is unresponsive and cyanotic. An empty bottle of hydromorphone (Dilaudid) is found on an adjacent table. You should: Select one: A. provide care after determining what Dilaudid is used for. B. ask the police to handcuff the patient for safety purposes. C. wait for the police to examine him before providing care. D. open the patient’s airway and assess his respirations.

D. open the patient’s airway and assess his respirations.

During the primary assessment, circulation is evaluated by assessing: A. skin quality, blood pressure, and capillary refill. B. external bleeding, skin condition, and capillary refill. C. pulse quality, external bleeding, and skin condition. D. blood pressure, pulse rate, and external bleeding.

A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: Select one: A. approach the patient and calm him by placing your hand on his shoulder. B. try to gain the patient’s trust by telling him that you see the vampires too. C. restrain the patient with appropriate force in order to treat his injuries. D. request that the police officers arrest him and take him to the hospital.

C. restrain the patient with appropriate force in order to treat his injuries.

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: Select one: A. calmly identify yourself to the patient. B. approach the patient with caution. C. quickly tend to the bleeding wound. D. tell the patient that you want to help.

A. calmly identify yourself to the patient.

A 66-year-old male presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious and has a patent airway and adequate breathing. You should: Select one: A. ask the daughter how her father normally behaves. B. conclude that the patient has Alzheimer’s disease. C. advise the patient that his behavior is unacceptable. D. carefully restrain the patient and transport at once.

A. ask the daughter how her father normally behaves.

A 78-year-old female presents with an acute change in her behavior. The patient’s son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer’s disease 6 months ago. The patient’s speech is slurred, and she is not alert to her surroundings. You should: Select one: A. transport the patient to a psychiatric facility. B. inquire about the possibility of head trauma. C. conclude that the patient’s blood sugar is high. D. allow the patient to refuse transport if she wishes.

B. inquire about the possibility of head trauma.

External bleeding from an extremity can usually be controlled initially by: A. elevating the extremity. B. applying chemical ice packs. C. applying a tourniquet. D. applying direct pressure.

For an adult, the normal resting pulse should be between: A. 60 and 100 beats/min. B. 50 and 60 beats/min. C. 100 and 110 beats/min. D. 40 and 50 beats/min.

If a patient develops difficulty breathing after your primary assessment, you should immediately: A. reevaluate his or her airway status. B. begin assisting his or her breathing. C. auscultate his or her breath sounds. D. determine his or her respiratory rate.

If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should: A. assess for adequate breathing. B. palpate at another pulse site. C. apply an AED at once. D. immediately begin CPR.

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. forehead and face. B. lips or oral mucosa. C. dorsum of the hand. D. back of the neck.

In which of the following situations is a pertinent negative identified? A. A 50-year-old woman states that nothing makes her chest pain better or worse. B. A 56-year-old woman states that her chest hurts when she takes a deep breath. C. A 53-year-old man with dizziness also tells you that he has vomited three times. D. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A. in a supine position. B. in a prone position. C. in a recumbent position. D. sitting up at a 45° angle.

Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants. A. 20, 30 B. 18, 28 C. 40, 60 D. 30, 40

Normal skin color, temperature, and condition should be: A. pale, cool, and moist. B. pink, warm, and moist. C. flushed, cool, and dry. D. pink, warm, and dry.

Pain that moves from its point of origin to another body location is said to be: A. referred. B. provoking. C. palliating. D. radiating.

Palliating factors regarding a patient’s pain involve those that: A. worsen the pain. B. alleviate the pain. C. change the pain. D. initiate the pain.

Poor peripheral circulation will cause the skin to appear: A. cyanotic. B. flushed. C. pink. D. ashen.

Reassessment is performed to determine all of the following, EXCEPT: A. whether or not the patient is deteriorating. B. the reason why the patient called EMS. C. the nature of any newly identified problems. D. the patient’s response to your treatment.

Supplemental oxygen without assisted ventilation would MOST likely be administered to patients: A. with rapid respirations and a reduced tidal volume. B. who have accessory muscle use and slow breathing. C. who are semiconscious with shallow respirations. D. with difficulty breathing and adequate tidal volume.

The “Golden Hour” begins when an injury occurs and ends when: A. the patient is admitted to the ICU. B. you depart the scene for the hospital. C. you arrive at the emergency department. D. the patient receives definitive care.

The chief complaint is MOST accurately defined as the: A. most life-threatening condition that you discover. B. gross physical signs that you detect on assessment. C. most serious thing the patient is concerned about. D. condition that exacerbates an underlying problem.

A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should: A. select a smaller oropharyngeal airway and attempt to insert it. B. continue to insert the airway as you suction her oropharynx. C. insert the airway no further but leave it in place as a bite block. D. remove the airway and be prepared to suction her oropharynx.

A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: A. assist her ventilations with a bag-mask device. B. administer oxygen via a nonrebreathing mask. C. insert a nasal airway in case her mental status decreases. D. perform a secondary assessment and then begin treatment.

A man was found unresponsive in his bed at home. There is no evidence of injury, and the patient’s medical history is not known. The patient’s face is cherry red, yet the pulse oximeter reads 98%. Which of the following would MOST likely explain this? A. Carbon monoxide poisoning B. Increased body temperature C. Severe pulmonary edema D. Cold extremities

A nasopharyngeal airway is inserted: A. into the larger nostril with the tip pointing away from the septum. B. with the bevel facing the septum if inserted into the right nare. C. into the smaller nostril with the tip following the roof of the nose. D. with the bevel pointing downward if inserted into the left nare.

All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT: A. ventilating the patient at the appropriate rate. B. increasing the amount of delivered tidal volume. C. delivering each breath over 1 second. D. ensuring the appropriate airway position.

An adult at rest should have a respiratory rate that ranges between: A. 12 and 20 breaths/min. B. 10 and 18 breaths/min. C. 8 and 15 breaths/min. D. 22 and 24 breaths/min.

An unconscious patient found in a prone position must be placed in a supine position in case he or she: A. has increased tidal volume. B. requires CPR. C. begins to vomit. D. regains consciousness.

As the single EMT managing an apneic patient’s airway, the preferred initial method of providing ventilations is the: A. mouth-to-mouth technique. B. manually triggered ventilation device. C. one-person bag-valve mask. D. mouth-to-mask technique with a one-way valve.

Based on current guidelines, in which of the following situations should supplemental oxygen be administered? A. Any diabetic patient whose oxygen saturation is less than 98% B. Signs of myocardial infarction and an oxygen saturation of 97% C. Exposure to carbon monoxide and an oxygen saturation of 94% D. Any elderly patient whose oxygen saturation is less than 95%

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: A. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid. B. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid. C. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid. D. increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.

CPAP is indicated for patients who: A. have signs of pneumonia but are breathing adequately. B. are hypotensive and have a marked reduction in tidal volume. C. have pulmonary edema and can follow verbal commands. D. are unresponsive and have signs of inadequate ventilation.

During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates: A. secretions in the airway. B. swelling of the upper airway. C. fluid in the alveoli. D. a lower airway obstruction.

Each cell of the body combines nutrients and oxygen and produces energy and waste products through a process called: A. metabolism. B. oxygenation. C. respiration. D. ventilation.

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? A. It pushes thick, infected pulmonary secretions into isolated areas of the lung. B. It prevents alveolar collapse by pushing air into the lungs during inhalation. C. It decreases intrathoracic pressure, which allows more room for lung expansion. D. It forces the alveoli open and increases the concentration of oxygen in the alveoli.

Hypoxia is MOST accurately defined as: A. inadequate oxygen to the tissues and cells. B. an increase in carbon dioxide in the blood. C. high oxygen levels in the tissues and cells. D. a decrease in arterial oxygen levels.

In contrast to inhalation, exhalation: A. requires muscular effort to effectively expel air from the lungs. B. occurs when the diaphragm lowers and expels air from the lungs. C. is an active process caused by decreased intrathoracic pressure. D. is a passive process caused by increased intrathoracic pressure.

In which of the following patients would the head tilt–chin lift maneuver be the MOST appropriate method of opening the airway? A. A 37-year-old female who is found unconscious in her bed B. A 45-year-old male who is semiconscious after falling 20 feet C. A 50-year-old male who is unconscious following head trauma D. A 24-year-old male who is found unconscious at the base of a tree

Inhalation occurs when the: A. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure. B. diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure. C. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure. D. diaphragm and intercostal muscles relax and causean increase in intrathoracic pressure.

The __________ cartilage is a firm ring that forms the inferior part of the larynx. A. thyroid B. laryngeal C. cricoid D. pyriform

The actual exchange of oxygen and carbon dioxide occurs in the: A. bronchioles. B. alveolar sacs. C. apex of the lung. D. pulmonary capillaries.

The jaw-thrust maneuver is used to open the airway of patients with suspected: A. upper airway swelling. B. copious oral secretions. C. cervical spine injuries. D. mandibular fractures.

The physical act of moving air into and out of the lungs is called: A. oxygenation. B. respiration. C. diffusion. D. ventilation.

The primary waste product of aerobic metabolism is: A. lactic acid. B. carbon dioxide. C. adenosine triphosphate. D. pyruvic acid.

The structure located superior to the larynx is called the: A. epiglottis. B. cricoid ring. C. carina. D. thyroid cartilage.

A patient with a history of schizophrenia called EMS because he was experiencing abdominal pain. When law enforcement arrived, the patient became violent, necessitating the placement of handcuffs. When you assess the patient, he tells you that killing someone will make his abdominal pain go away. His vital signs are stable. How should you manage this situation? Select one: A. Refuse to transport the patient because of his homicidal threat. B. Request that a police officer transport him to the hospital. C. Request a police officer to accompany you in the ambulance. D. Transport the patient in a prone position on the stretcher.

C. Request a police officer to accompany you in the ambulance.

Law enforcement personnel request your assistance for a 30-year-old man who was pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should: Select one: A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained. B. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. C. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren. D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and transport without delay.

B. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation? Select one: A. Have law enforcement place her in protective custody. B. Encourage the patient to remain quiet during transport. C. Ask the patient if she has developed a suicidal plan. D. Leave the scene and have a neighbor check in on her.

C. Ask the patient if she has developed a suicidal plan.

You are assessing a conscious 55-year-old male with a sudden change in behavior. Which of the following clinical findings would be MOST suggestive of dysfunction of this patient’s central nervous system? Select one: A. Rapid eye movement B. Excessive tearing or crying C. An irregular pulse D. Consistent eye contact

A. Rapid eye movement

You respond to a call for an unknown emergency. When you arrive at the scene, the patient’s husband meets you at the door and states that his wife has been depressed and has locked herself in an upstairs bedroom. He further tells you that he keeps his handgun in the bedroom. You should: Select one: A. ask the husband to attempt to reason with his wife. B. go upstairs with caution and attempt to talk to the patient. C. get in your ambulance and leave the scene immediately. D. remain in a safe place and request law enforcement.

D. remain in a safe place and request law enforcement.

____________ is what you can see of a person’s response to the environment. Select one: A. Psychosis B. Neurosis C. Affect D. Behavior

D. Behavior

A physiologic disorder that impairs bodily function when the body seems to be structurally normal is called a: Select one: A. drug and alcohol abuse B. functional disorder C. traumatic brain injury D. seizure

B. functional disorder

A technique used to gain insight into a patient’s thinking, which involves repeating in question form what the patient has said, is called: Select one: A. passive listening. B. reflective listening. C. intuitive listening. D. active listening.

B. reflective listening.

After ensuring his or her own safety, the EMT’s next priority when caring for a patient with a behavioral emergency is to: Select one: A. transport the patient directly to a specialized psychiatric facility. B. assess the patient’s response to his or her environment. C. diagnose the patient’s problem and provide definitive treatment. D. determine the underlying cause of the problem and offer advice.

B. assess the patient’s response to his or her environment.

Common causes of acute psychotic behavior include all of the following, EXCEPT: Select one: A. mind-altering substance use. B. Alzheimer’s disease. C. schizophrenia. D. intense stress.

B. Alzheimer’s disease.

General guidelines for managing a patient with a behavioral emergency include: Select one: A. being prepared to spend extra time with the patient. B. allowing the patient to be alone if he or she wishes. C. placing the patient between yourself and an exit. D. firmly identifying yourself as an EMS provider.

A. being prepared to spend extra time with the patient.

Immediately after physically restraining a violent patient, the EMT should: Select one: A. inform medical control of the situation. B. reassess the patient’s airway and breathing. C. advise the patient why restraint was needed. D. document the time the restraints were applied.

B. reassess the patient’s airway and breathing.

In which position should you restrain a physically uncooperative patient? Select one: A. Supine B. With arms and legs bound together C. With hands tied behind the back D. Prone

A. Supine

Organic brain syndrome is defined as: Select one: A. a change in behavior or mental status secondary to decreased cerebral blood flow. B. bizarre behavior secondary to a chemical imbalance or disturbance in the brain. C. a dysfunction of the brain caused by abnormal physical or physiological function. D. a disorder that cannot be traced to the abnormal structure or function of an organ.

C. a dysfunction of the brain caused by abnormal physical or physiological function.

People at risk for suicide include all of the following, EXCEPT: Select one: A. married males older than 30 years. B. children with parents addicted to alcohol. C. substance abusers. D. those with a recent diagnosis of a serious illness.

A. married males older than 30 years.

Posttraumatic stress disorder can happen after: Select one: A. extended periods of hyperthermia or hypothermia. B. alcohol withdrawal. C. exposure to or injury from a traumatic occurrence. D. a bout with depression.

C. exposure to or injury from a traumatic occurrence.

Signs of excited delirium include: Select one: A. subdued behavior, crying, and suicidal thoughts. B. diaphoresis, tachycardia, and hallucinations. C. slurred speech, bradycardia, and a high fever. D. pallor, hypotension, and constricted pupils.

B. diaphoresis, tachycardia, and hallucinations.

The first step in assessing a patient with a behavioral emergency is to: Select one: A. restrain the patient. B. take vital signs. C. obtain proper consent. D. ensure your safety.

D. ensure your safety.

The single most significant factor that contributes to suicide is: Select one: A. advanced age. B. depression. C. drug abuse. D. a chronic illness.

B. depression.

The term “behavioral crisis” is MOST accurately defined as: Select one: A. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications. B. a situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior. C. a medical illness with psychological symptoms that may lead to limited motor functioning. D. a sudden, violent outburst of an otherwise mentally stable person toward a family member.

B. a situation in which a patient of any age exhibits agitated, violent, or uncooperative behavior.

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: Select one: A. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. B. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly.

C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

Which of the following drugs is commonly referred to as “roofies”? Select one: A. GHB B. Ketamine C. MDMA D. Rohypnol

D. Rohypnol

Which of the following statements regarding gonorrhea is correct? Select one: A. Symptoms of gonorrhea usually appear within 3 months after being infected. B. Painful urination is a common symptom of gonorrhea in men and women. C. Most men who are infected with gonorrhea do not experience symptoms. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

B. Painful urination is a common symptom of gonorrhea in men and women.

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease? Select one: A. A shuffling gait when walking B. Bright red blood in the urine C. A history of ectopic pregnancy D. Vaginal passage of blood clots

A. A shuffling gait when walking

As a woman approaches menopause: Select one: A. her risk of developing pelvic inflammatory disease lowers significantly. B. she usually experiences abdominal cramping without vaginal bleeding. C. she cannot become pregnant because of fluctuating hormone levels. D. her menstrual periods may become irregular and vary in severity.

D. her menstrual periods may become irregular and vary in severity.

Each ovary produces an ovum in alternating months and releases it into the: Select one: A. uterus. B. vagina. C. fallopian tube. D. cervical os.

C. fallopian tube.

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, “I can’t remember anything, but I know I was raped.” The EMTs should suspect that: Select one: A. the traumatic experience has created a mental block. B. the patient knew her attacker, but is afraid to say. C. an underlying head injury is causing her amnesia. D. the patient was given a drug prior to the incident.

D. the patient was given a drug prior to the incident.

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: Select one: A. carefully removing any foreign bodies from the vagina. B. treating external lacerations with sterile compresses. C. refraining from placing any dressings into the vagina. D. supplemental oxygen and keeping the patient supine.

A. carefully removing any foreign bodies from the vagina.

In anticipation of receiving a fertilized ovum, the lining of the uterine wall: Select one: A. diverts blood flow to the vagina. B. sheds and is expelled externally. C. becomes engorged with blood. D. thins and begins to separate.

C. becomes engorged with blood.

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: Select one: A. is typically not as severe. B. often presents with acute pain. C. can be controlled in the field. D. may be relatively painless.

D. may be relatively painless.

It is common for young females who experience their first menstrual period to: Select one: A. experience abdominal cramping, which may be misinterpreted. B. become so emotionally distraught that they contemplate suicide. C. lose up to 500 mL of blood within the first 24 hours. D. have a false positive home pregnancy test result.

A. experience abdominal cramping, which may be misinterpreted.

Pelvic inflammatory disease (PID) typically does NOT affect the: Select one: A. ovaries. B. urinary bladder. C. uterus. D. fallopian tubes.

B. urinary bladder.

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include: Select one: A. uterine rupture with severe bleeding. B. bacterial vaginosis and chlamydia. C. ovarian abscess and ectopic pregnancy. D. ovarian cysts and gonorrhea.

C. ovarian abscess and ectopic pregnancy.

The onset of menstruation usually occurs in females who are: Select one: A. between 8 and 10 years of age. B. between 25 and 28 years of age. C. between 11 and 16 years of age. D. between 18 and 23 years of age.

C. between 11 and 16 years of age.

The physical examination of a sexual assault victim should be: Select one: A. limited to a brief survey for life-threatening injuries. B. performed in the presence of at least two police officers. C. as detailed as possible so all injuries can be documented. D. deferred until the patient can be evaluated by a physician.

A. limited to a brief survey for life-threatening injuries.

When a female has reached menarche: Select one: A. she usually requires hormone therapy. B. she is capable of becoming pregnant. C. she can no longer produce an ovum. D. menstrual periods become less frequent.

B. she is capable of becoming pregnant.

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: Select one: A. has formed a general impression of the patient. B. has gathered patient history information. C. ascertains if the patient was ever pregnant. D. has obtained a complete set of vital signs.

B. has gathered patient history information.

When caring for a female patient who has been sexually assaulted, you should: Select one: A. ask the patient for a concise, detailed report of what happened to her. B. allow law enforcement to take her statement before you begin treatment. C. place any bloodstained clothing or other articles in separate paper bags. D. advise her that she will not be allowed to shower or change her clothes.

C. place any bloodstained clothing or other articles in separate paper bags.

When caring for a woman who is experiencing a gynecologic emergency, the EMT’s main focus should be to: Select one: A. keep assessment and treatment to a minimum. B. ask questions related to her gynecologic history. C. determine the underlying cause of her problem. D. maintain her ABCs and transport without delay.

D. maintain her ABCs and transport without delay.

When documenting a call in which a female was sexually assaulted, you should: Select one: A. record your opinion only if you have reasonable proof to justify the statement. B. only use quotation marks when recording any statements made by witnesses. C. keep the report concise and record only what the patient stated in her own words. D. translate the patient’s words or statements using proper medical terminology.

C. keep the report concise and record only what the patient stated in her own words.