Emt Prep Flashcards
1
Q
You have been called to the scene of an automobile accident. Your patient complains of pain in their upper right quadrant of the abdomen. What organs are you concerned about? Liver Appendix Sigmoid colon Spleen
A
Liver
The quadrants of the abdomen are defined by the umbilicus and the midline of the abdomen. Top right quadrant includes the organs of the liver, gallbladder and some of the colon. The top left quadrant encompasses the spleen and stomach. The lower right quadrant includes the ascending colon, cecum, appendix and small intestine. The descending colon, sigmoid colon and small intestinal organs are associated with the lower left quadrant. It is important to remember that the quadrants are defined by the patient’s left and right.
2
Q
The spinal cord is composed of: Cerebrospinal fluid Muscle Vertebrae Neurons
A
Neurons
The spinal cord is made up of neurons. It is protected by the vertebral column which is composed of vertebrae.
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3
Q
You determine that your 62-year-old male patient is hypoglycemic. His vital are: BP 110/63, P 92, R 20, CBG 41 mg/dL. He is lying supine in his bed, unconscious, but will moan when you touch him. You should do what next?
Administer 25 g oral glucose in the pt’s mouth between the cheeks and gums
Administer 25 g oral glucose and transport immediately
Transport immediately
Administer insulin
A
Transport immediately
A contraindication to oral glucose is unconsciousness and inability to swallow, making glucose inappropriate for this patient. EMT’s never give insulin.
4
Q
The Krebs cycle is responsible for yielding a high amount of energy for the body to use. Which of the following answers requires oxygen and is most efficient? Citric acid cycle Shock Anaerobic metabolism Aerobic metabolism
A
Aerobic metabolism
5
Q
Hypothermia could best be described as which of the following? Too hot Dehydrated Too cold Short of breath
A
Too cold
Hypothermia is a condition where the core temperature of the body is lowered. There are 5 stages in varying degrees of core temperature.
6
Q
You are dispatched emergent to a baseball game to find your patient sitting on the bleachers after being struck in the head by a foul ball. His chief complaint is ringing in the ears, which is also known as? Tinnitus Rhinitis Pheumothorax Tympany
A
Tinnitus
7
Q
When a person is involved in a frontal impact, the patient will travel in one of three pathways. Which is not one of the pathways a patient will travel? Up-and-over pathway Down-and-under pathway Ejection Lateral
A
Lateral
8
Q
Mrs. Swenson is a 35-year-old female who has been impaled through the cheek by a large fishing lure. She is unconscious and has a small amount of bleeding coming from her cheek. The fishing lure is inside her mouth. When caring for this patient you should?
Stabilize the fishing lure and bandage around it
Hold the fishing lure in the patient’s mouth to prevent choking, but leave it impaled
Remove the fishing lure
Remove the fishing lure and place gauze on the inside of the cheek to stop bleeding
A
Remove the fishing lure
An impaled object should be removed in only two cases. First, when it is impaled through the chest and prevents CPR. Second, when it could cause an airway obstruction. In this case the fishing lure has potential to cause an airway obstruction in your unconscious patient and should be removed. Placing gauze on the inside of the cheek also poses a possible airway obstruction.
9
Q
You are called to an airport where a 45-year-old female has just returned from the Caribbean. She reports abnormal irritability, chest pains, numbness in her legs, and deep pains in her muscles and joints. These symptoms most strongly suggest? Internal bleeding Intoxication or poisoning An air embolism Decompression sickness
A
Decompression sickness
These are the classic signs of decompression sickness. Deep pain in the muscle and joints are also known as “the bends”. It would be appropriate to question this patient about scuba diving on her vacation.
10
Q
Which of the following substances is a nerve agent? Ricin Sulfur mustard Chlorine gas Sarin
A
Sarin
Sarin is a weaponized nerve agent. Some fertilizers, such as organophosphates, causes the same symptoms as a nerve agent exposure.
11
Q
It is extremely important that EMTs know the limitation of their tools and equipment. The preferred mode of transporting a patient over a large amount of rough terrain, such as a hiking trail, to an ambulance is? A portable stretcher A basket stretcher A scoop (orthopedic) stretcher A rigid backboard
A
A basket stretcher
12
Q
There is a multiple car accident on the freeway at 9:30 A.M. You arrive on the scene after the fire department and law enforcement has secured the scene. You notice multiple patients that are lying on the ground with massive wounds and blood pooling. A few patients are sitting on the barrier, talking and appear to have minimal injuries. Finally, there are a few patients still in their vehicles, and you notice firefighters working on extricating them. You are the only emergency medical staff available at this moment and are assigned to triage the scene. You decide to give the patients sitting on the barrier a triage priority number of? 1 2 3 4
A
3
There are 4 major priority rankings for triage: Priority 1, for patients that are in critical condition and need immediate care and transport. These patients typically are unstable and cannot walk. Priority 2 patients may not be able to walk, but are otherwise stable and can be delayed in care and transport. Priority 3 patients have minor injuries and are able to walk. You can usually sort these patients out by asking anyone who can walk to move to a separate location. Priority 4 (or 0 in some cases) patients are dead or in conditions that would not allow transport and recovery. In this situation, your patients that were able to move and sit on the barrier would be considered priority 3 patients.
13
Q
The police departments asks for a medic unit to respond to a private residence for an assault victim. You find a 38-year-old male who is combative and confused with a large gash on his head. After multiple attempts to get the patient to allow you to help him, he still refuses to allow treatment. Your best course of action would be?
Restrain the patient and treat him
Continue asking him until he allows you to treat him
Have the police sign the AMA form for the patient
Contact Medical Control for advice
A
Restrain the patient and treat him
This patient is believed to have a head injury, which can cause the patient to be confused and combative. He needs to be transported and evaluated by a physician, and is unable to sign a refusal because he is not oriented appropriately. Our goal is never to restrain someone against their wishes, but implied consent dictates that if the patient were acting normally, he would want to be treated.
14
Q
You are assessing a male adult patient you suspect was exposed to nerve gas. When assessing this patient, which pneumonic will help you determine if the symptoms match your suspicion of injury? AEIOU-TIPS OPQRST DUMBELS BURP
A
DUMBELS
DUMBELS: defecation, urination, miosis, bradycardia, emesis, lacrimation, salivation. These symptoms are all consistent with nerve agent poisoning, which inhibits acetylcholinesterase from the breakdown of acetycholine. This leads to over-stimulation of the parasympathetic nervous system.
15
Q
A radio's frequency refers to the number of times per \_\_\_\_\_\_\_\_\_\_\_\_\_\_ a radio wave oscillates? Millisecond Second Minute Ampere
A
Second
16
Q
You are on the scene of a 15-year-old female who is presenting with a panic attack. The patient appears very upset, is crying and breathing at a rate of 38/minute, and complaining of numbness and tingling in her extremities. The patient's boyfriend tells you the patient is scheduled to have an abortion at a clinic today. Which type of abortion is this pt having? Incomplete abortion Complete abortion Threatened abortion Therapeutic abortion
A
Therapeutic abortion
Complete abortion is the passage of all fetal tissue before 20 weeks of gestation. An incomplete abortion is failing to pass all fetal tissue. Threatened abortion refers to frank bleeding or discharge during the first half of pregnancy without dilation. Planned surgical removal of the fetus from the uterus is a therapeutic abortion.
17
Q
After arriving to the residence of a woman in active labor, you determine that it is best for both the mother and the baby that delivery takes place immediately. As a health-care provider, what is your biggest concern for the mother? Eclampsia Heart failure Occlusive Stroke Blood Loss
A
Blood Loss
18
Q
You have responded to a college campus for the report of a person who is unconscious and unresponsive. Your patient is a 19-year-old female student who is unconscious and unresponsive. The patient has snoring respirations with a respiratory rate of four breaths/minute and is becoming cyanotic around the lips. Her friends tell you that she just tried heroine for the first time. Your partner opens the patient's airway with a head tilt/chin lift and begins ventilating the patient with high-flow oxygen at a rate of 12 breaths/minute. Based on the information given to you by the patient's friend, you suspect a possible heroin overdose. You get a pen light out of your kit and assess the patient's pupils. Which cranial nerve is responsible for pupil size, shape, and reactivity? Olfactory (I) Optic (II) Oculomotor (III) Trochlear (IV)
A
Oculomotor (III)
Cranial nerves II, III, and IV are all associated with the eyes. The Optic nerve (II) is responsible for our ability to see. The Oculomotor nerve (III) is responsible for pupil size, shape, and reactivity. The Trochlear nerve is responsible for gaze.
19
Q
The esophagus is what to the trachea? Posterior Medial Superficial Lateral
A
Posterior
The esophagus lies behind the trachea. The word posterior indicates that the esophagus lies closer to the back of the person than the trachea.
20
Q
follows a specific pathway through the heart. After traveling through the right atrium, blood goes through WHICH valve into the right ventricle? Aortic Valve Pulmonary Valve Bicuspid Valve Tricuspid Valve
A
Tricuspid Valve
The pathway of blood through the heart is superior vena cava, right atrium, tricuspid valve, right ventricle, lungs for oxygenation, pulmonary valve, left atrium, bicuspid valve, left ventricle, aortic valve, aorta.
21
Q
Delayed capillary refill times are a result of decreases in perfusion to the skin. Which of the following is not a cause of delayed capillary refill time?
Increase in contractility of the heart muscle
Decrease in body temperature to 94 degrees Fahrenheit
Decrease in fluid uptake, leading to dehydration
Moderate blood loss resulting in shock
A
Increase in contractility of the heart muscle
An increase in contractility of the heart muscle would increase stroke volume and cardiac output, which would cause increased tissue perfusion.
22
Q
A 60-year-old female presents in respiratory distress. She is AOx4, breathing at 22 breaths per minute. You note adequate and bilateral chest expansion with clear breath sounds. What is the most appropriate method of airway management? Oxygen via NRB NPA with assisted ventilations NPA with supplemental oxygen A nasal cannula at 2-6 L per minute
A
A nasal cannula at 2-6 L per minute
23
Q
A reduced tidal volume would most likely occur from? Nostril flaring Accessory muscle use Unequal chest expansion Increased minute volume
A
Unequal chest expansion
24
Q
Your patient is a 21-year-old male involved in a skiing accident. Bystanders tell you he lost control while skiing and crashed into a ski lift pole. After a thorough physical examination, you determine he is breathing adequately. All of the following are signs of adequate breathing EXCEPT?
Normal rate and depth
A regular pattern of inspiration and expiration
Audible breath sounds on both sides of the chest
Asymmetrical rise and fall on both sides of the chest
A
Asymmetrical rise and fall on both sides of the chest
Asymmetrical means the rise and fall of the patient’s chest is uneven on both sides. An equal rise and fall on both sides of the chest is a sign of adequate breathing.
25
In an unresponsive patient who has not sustained trauma, how are respirations of 16 breaths per minute with good chest expansion most appropriately managed?
Suctioning and ventilations with a BVM
The jaw-thrust maneuver and frequent suctioning
An airway adjunct and oxygen via NRB
An airway adjunct and ventilations with a BVM
An airway adjunct and oxygen via NRB
26
```
Which breathing pattern is characterized as having an irregular pattern, rate, and depth with intermittent patterns of apnea?
Biot
Cheyne-Stokes
Agonal
Ataxic
```
Biot
Biot respirations may indicate severe brain injury or brain stem herniation.
27
Your partner says the patient is exhibiting paradoxical chest wall movement. This is best defined as?
The opposite of the chest wall during inspiration and expiration
Hives that are causing respiratory compromise
Parallel movement of the chest on inspiration
Perpendicular chest wall movement during expiration
The opposite of the chest wall during inspiration and expiration
28
```
Which strap should be applied second when placing a Sager traction splint?
The distal strap
The ischial strap
The knee strap
The waist strap
```
The distal strap
The distal strap (ankle strap) should always be applied after the ischial strap to check for proper positioning of the device. You're going to see this time and time again, but make sure you check CMS before and after you apply the traction splint!
29
```
Blunt trauma injuries will most frequently involve the liver and which other abdominal organ?
Spleen
Stomach
Small intestine
Gall bladder
```
Spleen
This is due simply to the location and size of the spleen.
30
```
Your patient was involved in a MVC. Your patient's vitals are as follows: BP 196/124, Pulse 52, irregular respiratory pattern. Based on the vital signs, what do you suspect?
Hypovolemic shock
Head Injury
Anxiety
Cardiogenic Shock
```
Head Injury
These vital signs resemble Cushing's triad which is indicative of a head injury. Cushing's triad includes hypertension, bradycardia and irregular respirations. You would see a low BP and increased HR in a patient with hypovolemic shock.
31
How close can emergency vehicles be parked to the landing zone?
They must be at least 15 feet away from the landing zone
They must be at least 30 feet away from the landing zone
They must be at least 50 feet away from the landing zone
They can be used to clearly mark the boundaries of the landing zone
They must be at least 30 feet away from the landing zone
When possible, emergency vehicles should be parked at least 30 feet away from the landing zone.
32
```
Which of the following would not limit your exposure to radiation?
Type of radiation
Time
Distance
Shielding
```
Type of radiation
The type of radiation does not limit your exposure. Time, Distance and Shielding do.
33
```
Who is responsible for the oversight of all operations at an MCI?
Safety Officer
Incident Commander
Triage Officer
Company Officer
```
Incident Commander
It is the job of the Incident Commander to oversee all the operations at an MCI.
34
```
Which of the following changes would you most likely NOT see with a pregnant adult female?
Hypotension
Increased heart rate
Odd cravings
Decrease in heart rate
```
Decrease in heart rate
Depending on where the female is in her pregnancy you will at some point see all of the following changes except a decrease in heart rate. This question is referring to changes that are maintained, not acute short time frame changes.
35
Break down Cystitis
Cyst- is the prefix meaning
Itis- provides the suffix of
Cholecysto-
Cyst- is the prefix meaning bladder.
Itis- provides the suffix of inflammation.
Cholecysto- would be gall bladder.
36
```
Your patient is a 9-year-old female who is unusually quiet according to her mother. She looks distant and is responding to verbal commands. When you take her vitals, you notice a slowed pulse. You suspect she is experiencing?
Hypotension
Hypoglycemia
Stroke
Hypoxia
```
Hypoxia
In children, hypoxia often presents as altered mental status and bradycardia. Hypoxia occurs when there is a deprivation of oxygen to the body.
37
Status epilepticus occurs when which of the following is present?
The patient experiences seizure activity that lasts longer than five minutes
The patient experiences two or more seizures in a row without regaining consciousness in between seizures
The patient screams while in seizure due to pain
The patient remains in seizure despite administration of midazolam
The patient experiences two or more seizures in a row without regaining consciousness in between seizures
Status epileptics can be a life-threatening emergency since a seizing patient has impairment of the ability to control their airway.
38
```
A 25-year-old female appears to have urticaria and other histamine responses. She also appears to be having a hard time breathing, and has a decreasing blood pressure. Of the following options, which is she most likely experiencing?
Neurogenic Shock
Hypovolemic Shock
Anaphylactic Shock
Cardiogenic Shock
```
Anaphylactic Shock
All but one of these signs would point to an allergic reaction. However, since the BP has dropped you now have cardiac compromise which is the first sign the patient is in anaphylactic shock.
39
Which of the following statements about hydrofluoric acid is correct?
It is a very mild toxin with a low mortality rate
It leeches calcium from the body, causing life-threating alterations to cellular function
It only causes burns to the affected body surface
Irrigation of the affected area should be avoided
It leeches calcium from the body, causing life-threating alterations to cellular function
Hydrofluoric acid is an extremely strong toxin that is associated with high mortality rates. It leeches calcium from the body, causing life-threating alterations to cellular function. Hydrofluoric acid initially burns the skin but continues causing damage to the body as it begins to leech calcium. Hydrofluoric acid exposures should be irrigated with copious amounts of water and transported immediately.
40
In the human heart, the right ventricle pumps what?
Deoxygenated blood to systemic circulation
Oxygenated blood to systemic circulation
Deoxygenated blood to pulmonary circulation
Oxygenated blood to pulmonary circulation
Deoxygenated blood to pulmonary circulation
The right atrium receives deoxygenated blood from systemic circulation. The deoxygenated blood then enters the right ventricle via the tricuspid valve. The right ventricle pumps the deoxygenated blood into pulmonary circulation where gas exchange occurs and the blood becomes re-oxygenated.
41
The left ventricle is responsible for which of the following actions?
Receiving blood from the veins of the body
Receiving blood from the lungs
Pumping blood to the body
Pumping blood to the lungs
Pumping blood to the body
You need to know the progression of blood through the body. Remember that blood coming from the left ventricle is oxygenated, but the blood coming from the right is not.
42
```
You are dispatched emergent to a call for difficulty breathing. Your patient is a 22-year-old female that has no medical history and no allergies. Her only medication is birth control. Breath sounds are normal and she is showing signs of JVD. Vitals are within normal limits, leading you to suspect?
Pulmonary embolism
Tension pneumothorax
Pericardial Tamponade
Ectopic pregnancy
```
Pulmonary embolism
Young women on birth control are susceptible to blood clots, which can lead to a pulmonary embolism.
43
```
Abnormal respiratory sounds often indicate that a patient is in respiratory distress. When these abnormal respiratory sounds are found with a certain physical finding, you should be able to develop an idea of what kind of respiratory problem your patient is having. What is this physical finding?
Nasal flaring
Retractions
Flail chest
Tripod positioning
```
Retractions
When retractions are present along with abnormal respiratory sounds, you should be able to differentiate between respiratory problems. Each abnormal respiratory sound (with retractions present) is indicative of a specific type of respiratory problem. For example, retractions present with stridor may imply that your patient is experiencing an upper airway obstruction.
44
After an adult cardiac arrest patient has been intubated by your paramedic partner, you are tasked with providing ventilations as another member of your crew performs chest compressions. When ventilating the patient, you should?
Deliver 2 breaths during a brief pause of chest compressions
Deliver each breath over roughly 1 second at a rate of 8 to 10 breaths per minute
Hyperventilate the patient to maximize CO2 elimination
Deliver each breath over 3 seconds at a rate of 12 to 15 breaths per minute
Deliver each breath over roughly 1 second at a rate of 8 to 10 breaths per minute
45
You are using a BVM to assist ventilations in an altered patient with a gag reflex. You begin to notice reduced bag compliance and a decreasing SpO2. What should you do first?
Use both hands to squeeze all the air out of the BVM for each breath
Insert an oropharyngeal airway
Insert a nasopharyngeal airway
Reposition the airway with a head tilt-chin lift
Reposition the airway with a head tilt-chin lift
Ventilation and oxygenation cannot be achieved without an open, patent airway. Repositioning of the airway is crucial and a quick and easy fix if it is the problem. After ensuring that the airway is open and patent, you may then elect to insert a NPA. An OPA is contraindicated in a patient with a gag reflex. Squeezing all of the air out of the BVM for each breath could cause barotrauma to the patient.
46
```
According to the American College of Surgeons, a class 3 hemorrhage is associated with a circulating blood loss of what percentage range?
10-20%
20-30%
25-35%
30-40%
```
30-40%
47
```
A 34-year-old patient states that she fell and broke her shoulder. She could be referring to which of the following bones?
Clavicle, femur, tibia
Humerus, clavicle, fibula
Humerus, scapula, clavicle
Clavicle, tibia
```
Humerus, scapula, clavicle
Remember your anatomy. Humerus = upper arm. Clavicle = collarbone. Scapula = shoulder blade.
48
```
Which division is responsible for ensuring the delivery of patients to the transportation sector during an MCI?
Triage
Treatment
Transport
Extrication
```
Treatment
During an MCI, the treatment division provides treatment and is also responsible for ensuring that patients are moved to the transport area. The transport division is responsible for organizing patient transport from the transport sector to their end destination, usually a hospital.
49
```
You respond to a multi-vehicle accident. On arrival you notice starring to one of the vehicle's windshield. No airbags were deployed leading you to suspect the starring was caused by?
A foreign object
The patient's head
Another vehicle
Extrication efforts
```
The patient's head
Whenever starring is noted on a vehicle's windshield, head injury should be assumed until it can be ruled out. Airbag deployment can mimic the classic starring pattern caused by a patient's head hitting the windshield.
50
What two hormones does the placenta secrete?
Testosterone and estrogen
Estrogen and progesterone
Follicle-stimulating hormone and luteinzing hormone
Oxytocin and prolcatin
Estrogen and progesterone
As one of its many functions, the placenta acts as an endocrine gland and produces several hormones including estrogen and progesterone.
51
```
A premature separation of the placenta from the uterine wall is known as what?
Placenta previa
Abruptio placentae
PID
Gonorrhea
```
Abruptio placentae
52
```
Patient apnea due to paralyzation of all respiratory muscles is a result of spinal cord injury above which vertebrae?
C1
C2
C3
C4
```
C3
Injury to the spinal cord that occurs above C3 will result in the paralysis of all respiratory muscles and cause patient apnea. You will need to provide positive pressure ventilation via BVM attached to high-flow oxygen to these patients.
53
```
You arrive on the scene of an automobile-pedestrian accident. There is a patient down in the middle of the road. After completing your initial assessment, you obtain a set of vitals. Your patient's blood pressure is 105/65, pulse is 130, respiratory rate is 14, and he is responding to verbal commands. Your instinct tells you that your patient may be experiencing?
Stroke
Shock
Blood shock
Intracranial pressure
```
Shock
This patient has a low blood pressure and a high pulse with a normal respiratory rate and slightly altered mental status. The key components are the blood pressure and pulse which indicate shock.
54
```
You are called to the residence of a 91-year-old female who fell from her chair. She is complaining of 5 out of 10 left hip pain on movement. She states she had a fracture of the femoral neck on the right side and that this injury feels very similar. On visual examination, if a hip fracture were present, you would expect to see:
Shortening and external rotation
Shortening and internal rotation
Lengthening and external rotation
Lengthening and internal rotation
```
Shortening and external rotation
When the femoral neck fractures and displaces the bone, it is a very painful injury with hallmark signs being shortening of the leg with external rotation. It is not uncommon for the CSMs to be intact and minimal pain reported by the patient.
55
Your patient is an obese 39-year-old woman involved in a lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this patient?
Relative to body size, the patient can tolerate a larger amount of hemorrhage before showing signs of shock.
Blood volume increases proportionally with body weight, and the patient will experience signs of shock consistent with the classic stages of hemorrhage.
Relative to body weight, a smaller amount of hemorrhage will result in shock.
This patient will tolerate blood loss well, as only non-vital tissues will become ischemic.
Relative to body weight, a smaller amount of hemorrhage will result in shock
No matter how large/small the person is, adults carry on average 4.5-5.5 liters of blood.
56
```
Which is the most common type of impact in MVCs?
Frontal
Roll over
Rear end
Rotational
```
Rotational
57
```
Which of the following is not a type of airway obstruction?
Partial with good air exchange
Partial with poor air exchange
Complete
Incomplete
```
Incomplete
All of the above are accepted terms except incomplete for the types of airway obstructions.
58
Your patient is a 41-year-old female who has just been pulled from a burning building. Her respirations are 25-per-minute and very shallow. The best management for this patient is?
100% supplemental oxygen via a nasal cannula
100% supplemental oxygen via a non-breathing mask
100% supplemental oxygen with assisted positive pressure ventilation
Blow by 100% supplemental oxygen allowing the patient to hold the mask
100% supplemental oxygen with assisted positive pressure ventilation
Shallow breaths of 25-per-minute are inadequate to sufficiently ventilate the patient. The patient's breathing should be assisted with ventilation and supplemental oxygen. Passive ventilation is inadequate due to the patient's decreased tidal volume.
59
The systolic pressure measured by a blood pressure cuff is a measure of?
The pressure of the blood against the walls of the arteries when the heart is contracting
The pressure of the blood against the wall of the veins when the heart is contracting
The pressure of the blood against the walls of the arteries when the heart is relaxed
The pressure of the blood against the wall of the veins when the heart is relaxed
The pressure of the blood against the walls of the arteries when the heart is contracting
Blood pressure marks the force of the blood against the walls of the arteries. The systolic blood pressure is measured as the pressure of blood against the arteries during contraction.
60
```
In pulmonary circulation, ___________ carry oxygenated blood from the lungs to the heart and ____________ carry deoxygenated blood from the heart to the lungs.
Capillaries; arterioles
Venioles; capillaries
Arteries; veins
Veins; arteries
```
Veins; arteries
Pulmonary circulation is the opposite of systemic circulation. In pulmonary circulation, veins carry oxygenated blood from the lungs to the heart and arteries carry deoxygenated blood from the heart to the lungs.
61
Automaticity of cardiac cells refers to?
The cells ability to spontaneously depolarize
The cells being able to depolarize at a constant rate
The cells being able to automatically communicate with one another
The cells ability increase the heart rate to increase cardiac output
The cells ability to spontaneously depolarize
Unlike other cells in the body, cardiac cells have the ability to generate electrical impulses spontaneously. Automaticity has nothing to do with rate or communication.
62
```
The ischial strap is applied at what point during placement of a Sager traction splint?
First
Second
Third
Fourth
```
First
The ischial strap is placed first to provide the proper placement of the device.
63
```
A hyperthermic patient is most at risk when his/her skin is?
Pale and clammy
Pale, cool, and clammy
Pink, normal, and dry
Pink, hot and dry
```
Pink, hot and dry
Hot skin, that is dry, strongly suggests that the body has lost its ability to regulate internal temperature through sweating, and is thus moving towards heat stroke, a true hyperthermic emergency.
64
Which of the following pieces of information would NOT be considered confidential?
The patient's medical history gathered from the interview
Your findings during the physical exam
The emergency medical care that you rendered
The street you responded to
The street you responded to
All of the above answers would be considered confidential pieces of information except the street you responded to. Unless important for the care of the patient, this information is not to be shared.
65
```
A law that is created or upheld by the U.S. Supreme Court is known as?
Administrative law
Common law
Legislative law
Constitutional law
```
Common law
Common law is created by judges or as a result of cases heard in court. Common law changes over time as society's norms and customs change.
66
```
Which of the following is not a classification of chemical agents?
Incendiary agent
Vesicants
Biotoxins
Incapacitating agents
```
Incendiary agent
Incendiary devices are a type of explosive agent that cause heat and burn injuries.
67
The following criteria are used to assess a patient when using the START triage method?
AIRWAY, BREATHING, CIRCULATION
EYE MOVEMENT, MOTOR RESPONSE, VERBAL
RESPIRATIONS, CAPILLARY REFILL, FOLLOWING SIMPLE COMMANDS
ALLERGIES, MEDICATIONS, MEDICAL HISTORY
AIRWAY, BREATHING, CIRCULATION
START triage is used to make a rapid (30-60 sec) assessment during multiple patient scenes when resources are limited. It measures the respirations, cap refill, and the ability of the patient to follow simple commands. The mnemonic 30-2-"CAN DO" is used as a reminder of the criteria you're using to assess the patient. Eye movement, motor response, and verbal are the criteria used for a GCS score, so you can immediately throw that option out.
68
```
Another term for a bruise is?
Abrasion
Concussion
Contusion
Urticaria
```
Contusion
The medical term for a bruise is called a contusion. Its easy and basic, but important for answering questions. If you struggle with terminology, open that book back up for a little review.
69
```
are treating a patient who was rescued from a house fire and sustained multiple burns. Following assessment, you note burns to the anterior torso, back, right leg, and left forearm. By rule of nines, what percentage of the patient's body surface area is burned?
48.5%
54%
58.5%
63%
```
58.5%
Anterior torso: 18%, right leg: 18%, back: 18%, left forearm: 4.5%. Expect to see questions concering the rule of nines for both adults and pediatrics!
70
You are called to the scene of a fight where injuries are suspected. The police have controlled the scene, and you approach the injured patient. The crowd begins to become unruly and is directing their anger at you and your partner. What is the best course of action?
Retreat
Bargain with the crowd
Wait in the truck for order to be restored
Stay and fight
Retreat
Whenever you feel your personal safety is in jeopardy, retreat to the closest safe place. Try to cover yourself as you retreat with any equipment and keep your back safe.
71
All of the following patients would cause you to reevaluate your scene safety except:
A 41-year-old female screaming and running at you after you notify her of her husband's death
An intoxicated 22-year-old male patient with balled up fists
A 6' 6" 29-year-old male patient on meth who is stepping into your "personal space"
A 15-year-old female who is hysterical and has horizontal "cut" marks on her wrists after her boyfriend broke up with her
A 15-year-old female who is hysterical and has horizontal "cut" marks on her wrists after her boyfriend broke up with her
Although the "cut" marks may have been caused by a sharp object, the 15-year-old female patient poses the least danger to your safety. All of the other patients are already assaulting you or are seconds away from it.
72
```
The expectation of EMS personnel to treat all patients equally with respect and to not show any bias or judgment is called?
Justice
Ethics
Morals
HIPPA
```
Justice
Justice is the expectation for EMS personnel to treat each patient fairly and not show any bias in patient care based upon demographics, race, sex, religion, gender, culture, socioeconomic states, etc.
73
```
Your 42 year-old female patient is complaining of left arm numbness and back pain that began 10 minutes ago. She is embarrassed that she called 911, but states that "something just doesn't feel right." She has no medical history, takes no medications, and is allergic to penicillin. She is alert and oriented to person, place, time, and event. Based on this limited information, which of the following vital signs would be least helpful in determining your differential diagnosis?
CBG
ELECTROCARDIOGRAM
STROKE SCREEN
PULSE OXIMETRY
```
CBG
While some agencies make it their practice to obtain a CBG on every patient, it is not indicated in this patient based on this information. A CBG may be a secondary vital but the other options are much more time-sensitive if they reveal life-threatening findings. Start with life-threatening possibilities when determining differential diagnosis.
74
```
What is the name of the protective membrane, sac-like structure that surrounds the fetus in the uterus?
Embryonic sack
Amniotic sac
Visceral pleura
Parietal perineum
```
Amniotic sac
The amniotic sac is a protective sac that is filled with fluid, mostly urine from the fetus.
75
```
The term OB/GYN is short for which of the following?
Obstetrics and gynecology
Obstetricians and gynecologists
Obstemeter and gynecometer
Obsidian and gynasty
```
Obstetrics and gynecology
76
```
Twins occur in 1 out of how many births?
60-70
200-300
80-90
700-800
```
80-90
This number will change each year. In fact, in 2011 it was estimated that as many as 1 in every 30 births were twins. However, don't let the small statistics scare you. Know the general numbers that your book talks about.
77
Stage one of labor begins with the onset of labor and ends when?
The start of contractions
The end of contractions
Complete dilatation of the cervix
The entrance of the fetus into the birth canal
Complete dilatation of the cervix
78
```
The medical term that refers to the time period before delivery is:
Prepartum
Postpartum
Antepartum
Priorpartum
```
Antepartum
| Ante- = before -partum = birth or labor
79
```
Excessive pain during menstruation is known as what?
Menopause
Dysmenorrhea
Diplopia
Menorrhagia
```
Dysmenorrhea
80
```
Which of the following is not one of the three phases of the uterine menstrual cycle?
Proliferative
Secretory
Menstruation
Ovular
```
Ovular
The three phases of an uterine menstrual cycle are: proliferative, secretory, and menstruation.
81
You're driving the ambulance code 1 and you come up to an intersection with three other cars. Who has the right of way in this situation?
Whoever proceeds into the intersection first
The car on the right
The car on the left
It is different at every intersection
The car on the right
Code 1, or non-emergent, driving conditions must follow the same rules as other traffic. The car on the right has the right of way at an intersection.
82
You are called to a traffic accident. As you approach, you are informed that a small fire has ignited in the engine compartment of one of the vehicles. There is no spilled fuel or other apparent hazards. You should park the ambulance?
Next to the scene of the accident
25 feet away from the scene of the accident
50 feet away from the scene of the accident
100 feet away from the scene of the accident
100 feet away from the scene of the accident
83
```
Which is not an example of an incendiary device?
Napalm
Gasoline
Magnesium
Dynamite
```
Dynamite
Incendiary devices are those that have decreased explosive power but increased heat production and potential to produce burns. Dynamite is an explosive device.
84
```
Spinal boards were originally introduced to EMS in :
1968
1978
1988
1998
```
1968
Spinal boards were introduced to EMS in 1968 originally for extrication of patients from diving accidents. Protocols were updated to include widespread use of spinal boards by the DOT in 1984.
85
```
After establishing personal safety during a technical rescue incident, what should your next safety priority be?
Rescue team safety
Patient safety
Bystander safety
Transport team safety
```
Rescue team safety
With your own personal safety established, your next safety priority is that of the providers performing the actual rescue.
86
You are dispatched to a cardiac arrest and are met at the door by the patient's son, who is frantically telling you his mother has a DNR. You enter the home to find the victim's daughter performing CPR. She says that her mother had the DNR cancelled. What is your next course of action?
Verify pulselessness and initiate CPR
Ask the son and daughter to find the DNR to ensure its validity
Contact medical control
Load the patient and transport
Verify pulselessness and initiate CPR
You must begin a full resuscitation if the DNR isn't readily available. Have a family member look for the DNR, but you should not delay resuscitative efforts while the DNR is being located.
87
All is true of an airbag in a vehicle except?
The release of airbags signifies a considerable transfer of energy in an automobile collison
If the key has been turned off and the battery has been disconnected, there is little chance the airbag can deploy.
There are many types of airbags, including frontal impact, side impact, and head protection bags.
Once an airbag is deployed, it will not deploy again.
If the key has been turned off and the battery has been disconnected, there is little chance the airbag can deploy.
The unintentional deployment of airbags seriously injuries many EMTs and firefighters each year. Airbags are capable of holding a charge and can deploy even when there is no external power source. Be sure to maintain a safe distance from undeployed airbags during a vehicle rescue.
88
While approaching a vehicle involved in a motor vehicle crash, you should perform a windshield survey. A windshield survey includes all of the following except?
Observing for "spidering" of the windshield
Checking to see if the occupants are moving
Trying to determine if the occupants appear conscious
Determining if the occupants are attempting to self-extricate
Observing for "spidering" of the windshield
A windshield survey is a quick survey that will help you to form a general impression of the condition of the occupants in the vehicle and the resources you will need to help them.
89
This book is designed to be used as a comprehensive reference in helping you identify a certain hazardous material by its name or ID number:
North American Emergency Response Guidebook
DOT Emergency Response Guidebook
Material Safety Data Sheet (MSDS)
CHEMTREC
DOT Emergency Response Guidebook
The DOT Emergency Response Guidebook (ERG) should be carried on every emergency apparatus. It allows for easy recognition of hazardous materials and gives minimum safe distances in an emergency.
90
```
The signs that are placed on the outside of containers holding hazardous materials is called?
Container label
MSDS
Identification triangle
Placard
```
Placard
Placards are located on the outside of hazardous materials containers and are meant to help you correctly identify the hazardous material present.
91
While you are at work, a fellow employee comes to tell you that a worker in the manufacturing bay has been electrocuted. You arrive at the scene and see a man lying on the ground next to a machine that is still running. What should you do next?
Attempt to turn off the machine yourself
Assess the victim immediately
Ensure power to the machine has been properly turned off
Move the patient away from the machine
Ensure power to the machine has been properly turned off
Scene safety, including your personal safety, is the number one priority. If a machine has electrocuted the patient, you should be wary that it may do it again. Attempting to turn the machine off, assessing the victim, and moving the patient away are all actions that can expose you to the machine and possibly result in your electrocution as well. Ensuring power to the machine has been properly turned off is the safest action.
92
```
Red blood cells main function is to do which of the following?
Form clots
Fight off infection
Deliver oxygen to the tissues
Raise blood pressure
```
Deliver oxygen to the tissues
The RBC's main job is to deliver oxygen to the tissues.
93
```
Which of the following symptoms is not commonly associated with tuberculosis?
Polyuria
Hemoptysis
Pyrexia
Unexplained weight loss
```
Polyuria
Unexplained weight loss, fever, and coughing up blood are all associated with tuberculosis.
94
```
Upon arriving at a local grocery store, you approach an elderly man sitting upright and surrounded by a group of people. He appears to be suffering from dyspnea and is only responsive when directly addressed. When questioning him, he makes eye contact with you but does not verbally respond. You decide to ask him to hold both arms up while closing his eyes until you instruct otherwise. When he does this, you see that his right arm wobbles off to the side considerably more than the left. What is the most likely cause of this man's condition?
AMI
CVA
SVT
DKA
```
CVA
While Supraventricular Tachycardia, DKA, and an AMI can cause dyspnea and alter the patient's mental status, it will not likely cause an arm drift. In fact, most patients suffering from this will have a hard time holding both arms out, since a common symptom of an AMI is intense shooting pain down the left arm.
95
When inserting an oropharyngeal airway in an adult patient, you should be sure it is inserted so that?
The patient's tongue is depressed and the airway is initially inserted upside down
The patient's tongue is depressed and the airway is initially inserted sideways
The airway is initially inserted upside down and then rotated 180 degrees
The airway is initially inserted sideways and then rotated 180 degrees
The airway is initially inserted upside down and then rotated 180 degrees
The best method for inserting an oropharyngeal airway is to depress the patient's tongue and insert the airway upside down (pointing up towards the hard palate). When the OPA reaches the soft palate, rotate the airway 180 degrees until it rests against the lips and teeth.
96
You are called to an unknown 'patient down" at a private residence. As you get inside and into the back bedroom, you can see that there is a woman face down and motionless. She does not appear to be conscious and there is a pool of saliva next to her head. The two of you maintain spinal precautions as you get her onto your back. The husband states that she has a history of heart problems, takes a lot of medications, and has no allergies. What would you do next?
Have your partner begin CPR
Verify the absence of a carotid pulse and begin CPR
Verify a palpable pulse, attach the AED, and prepare to analyze
Open the airway with a jaw-thrust maneuver and deliver two rescue breaths
Verify the absence of a carotid pulse and begin CPR
Remember C-A- B... Verify a carotid pulse, or the absence of one, and begin CPR immediately if the patient is pulseless. Having your partner begin CPR could almost be a correct answer, but you must check a pulse first, making the other answer the best answer.
97
```
You respond to a call of a 27-year-old male complaining of chest pain. You conduct a thorough physical exam and SAMPLE history. You learn that he is a smoker, his father has had several myocardial infarctions since he turned 40, and he has low blood pressure. Which of the following is not a risk factor for cardiovascular disease?
Smoking
Family history of heart disease
Low blood pressure
He is a male
```
Low blood pressure
Risk factors of cardiovascular disease include smoking, family history of heart disease, being male, and hypertension. Low blood pressure is hypotension.
98
```
When administering Nitroglycerine to your 79-year-old female chest pain patient, it is important to ask her about recent history of taking erectile dysfunction medications. Women are prescribed these medications as well as men for ailments other than ED. These drugs were initially developed for the treatment of what condition?
Parkinson’s
Diabetes
Angina Pectoris
Neuropathy
```
Angina Pectoris
The generic (sildenafil) was originally developed for the treatment of angina pectoris and hypertension because it is a vasodilator. This has a clinical significance for paramedics because women can be prescribed this medication as well as men. Paramedics must ask all patients if they have taken any erectile dysfunction medications before administering nitrates.
99
In reference to a seizure, an aura is?
An unilateral motor deficiency after a seizure
A sensory hallucination that often occurs just prior to a seizure
A pattern of tonic-clonic movement during a seizure
A state of confusion and lethargy after a seizure
A sensory hallucination that often occurs just prior to a seizure
An aura occurs when a partial seizure spreads to the rest of the brain, becoming a generalized seizure. Patients often report odd tastes, odd scents, or seeing "halos" of light.
100
```
You respond to the chiropractor's office for a patient with general weakness. The patient presents with weakness in the feet and in the torso. Which of these diseases is the patient most likely experiencing?
ALS
Guillain-Barre
Neuropathy
Ketoacidosis
```
Guillain-Barre
The hallmark of Guillain-Barre is weakness in the feet with it migrating to trunk. It is very rare, but it is treatable and can lead to respiratory compromise if left untreated. Neuropathy is generally characterized by painful extremities.
101
```
You are dispatched to a report of a child struck by a motor vehicle. Upon arrival, you find a 5-year-old male who was riding his bike when he was struck. Bystanders report that he wasn't wearing a helmet and witnessed his head striking the pavement. He is unconscious, unresponsive, and you notice that the patient has an irregular breathing pattern. Which of the following breathing patterns is the patient likely exhibiting?
Kussmaul
Apnea
Cheyne-Stokes
Eupnea
```
Cheyne-Stokes
Cheyne-Stokes respirations are indicative of a head injury. The presence of apnea would mean the patient is not breathing. The presence of Eupnea would indicate that the patient has normal breathing. The presence of Kussmaul respirations would indicate the patient is likely in a state of metabolic acidosis, or diabetic ketoacidosis.
102
```
Which ribs are the most commonly fractured?
1-3
3-7
4-8
8-12
4-8
```
Ribs 4-8, on the lateral chest walls, are the most commonly fractured due to little tissue (including muscle and fat) covering this area.
4-8
Ribs 4-8, on the lateral chest walls, are the most commonly fractured due to little tissue (including muscle and fat) covering this area.
103
You are assessing a 14-year-old female patient who has attempted suicide by lacerating her wrists. The patient has lacerated herself with a scalpel across tension lines. Why is this more concerning than cutting with tension lines?
The laceration will spread wide open when cutting across tension lines.
The arteries are more apt to be transected against tension lines.
Cutting with tension lines creates a more injurious pattern.
Scarring is more prevalent when tension lines are cut across.
The laceration will spread wide open when cutting across tension lines.
The tension lines run horizontally across the wrists and if the patient cuts parallel with the radius and ulna bones, they will transect the tension lines. These wounds tend to open up more and lead to a greater amount of blood loss, more healing time and more scarring. In the pre-hospital setting, the blood loss is the most concerning factor.
104
```
Penetrating trauma will most likely involve the small bowel and which other abdominal organ?
Liver
Spleen
Stomach
Gall bladder
```
Liver
This question is only asking the likelihood of injury due to size. The liver is the largest of the organs listed and will most likely be injured during a penetrating trauma to the abdomen in addition to the small bowel.
105
```
Your 19-year-old male patient is complaining of a "thunder-clap" headache after a motor vehicle collision with intrusion to the driver's side. The patient is conscious but altered, and is speaking inappropriate words. While assessing your patient, he vomits violently and begins seizing. What type of head injury has this patient likely sustained?
Sub-arachnoid Hemorrhage
Epidural Hematoma
Subdural Hematoma
Intraventricular Hemorrhage
```
Sub-arachnoid Hemorrhage
The best answer is A. The "thunder-clap" headache is associated with a Sub-arachnoid hemorrhage. Epidural and Subdural hematoma have a similar presentation but do not present with this type of headache. An intravetricular hemorrhage is usually seen in pediatric patients of non-traumatic etiology.
106
Which of the following people is NOT at an increased risk of developing heat illnesses?
An 87-year-old male patient
A 32-year-old female diabetic patient
A 54-year-old male patient with a history of myocardial infarction
A 25-year-old pregnant female patient
Age, diabetes, and a history of heart disease are all risk factors that indicate a person may not be as effective at regulating their body temperature.
A 25-year-old pregnant female patient
Age, diabetes, and a history of heart disease are all risk factors that indicate a person may not be as effective at regulating their body temperature.
107
You are responding to an emergency with your lights and sirens on. You come across a school bus with flashing red lights and its stop sign extended. How should you proceed?
A. STOP AND THEN CAREFULLY DRIVE AROUND THE BUS
B. STOP BEHIND THE BUS. WAIT FOR THE LIGHTS ON THE BUS TO STOP FLASHING AND THE STOP SIGN TO RETRACT
C. SWITCH TO THE OPPOSITE SIDE OF THE ROAD TO CAREFULLY GO PAST THE BUS
D. STOP BEHIND THE BUS UNTIL WAVED ON BY THE DRIVER OR A CROSSING GUARD 3
STOP BEHIND THE BUS. WAIT FOR THE LIGHTS ON THE BUS TO STOP FLASHING AND THE STOP SIGN TO RETRACT
Federal law states that you must stop your bus and wait for the lights to stop flashing and the stop sign to retract. This is an issue of safety and those precautions exist to protect children. Once the road is clear, the bus driver will retract the sign, turn off the lights and only then can you proceed.
108
```
You are called to the scene for the 92-year-old female, suffering from an epistaxis emergency. You would anticipate the need to?
Apply pressure and transport
Request additional resources
"Load and go"
Administer medications
```
Apply pressure and transport
Epistaxis emergencies are simply nose bleeds, which usually require some sort of pressure and transport, as long as natural causes are suspected.
109
Your patient is suffering from an internal hemorrhage in his lower arm, however, you do not identify any life threats associated with the injury. What is your next intervention?
Immobilize and elevate the arm
Move the arm frequently to assist with bloodflow
Initiate rapid transport
Consider using a tourniquet
Immobilize and elevate the arm
Immobilizing and elevating the extremity helps to control bleeding with the help of gravity. The injury is not serious enough for rapid transport or a tourniquet.
110
All of the following do not require a release of information form to be filled out except?
Suspected abuse of a 12-year-old female patient
An insurance billing form
Nurse taking over patient care from you
Police officer wanting to know if a patient admitted to taking drugs
Police officer wanting to know if a patient admitted to taking drugs
Child abuse, insurance billing information, and pass down of patient care information to other healthcare providers involved in direct patient care do not require a release of information form to be filled out. Police are not entitled to patient healthcare information. They need to legally obtain it.
111
```
As you are performing triage in a multiple casualty incident, a patient gets up, and limps towards you screaming in pain from the burns on his arms. His arm is also broken and deformed. You tag him?
Black
Red
Yellow
Green
```
Green
Although the patient is critical, he can walk on his own, which qualifies him as a part of the green "walking wounded." You instruct him to walk over to the triage or treatment area.
112
```
You respond to an 18-year-old involved in an explosion at an automobile mechanic shop. He suffered burns to his entire head, neck, entire torso and both arms. What percentage of his body is burned?
50
63
80
83
```
63
Using the rule of nines, you're able to estimate the percentage of body area that was burned. Let's add it up: Head - 9, Anterior Torso - 18, Posterior Torso - 18, Left Arm - 9, Right Arm- 9. 9+18+18+9+9 = 63 percent. Remember that children have slightly different breakdowns on how much surface area is devoted to each body part.
113
```
Which communication system receives and transmits on the same frequency?
Simplex
Duplex
Triplex
Multiplex
```
Simplex
114
You arrive on the scene of a warehouse accident. You are informed that there are incidents of both trauma and respiratory poisoning. As you are assisting the respirations of a poisoned victim, a nearby pipe bursts and sprays a chemical a few feet away. You see a label and read that the chemical is benzene (a HAZMAT chemical which has toxic fumes). You should?
Remove the patient to a safe distance, continue treating the patient, and call for backup to set up a perimeter for decontamination
Immediately go to assess the source of the spray, and stop it if you can do so without endangering yourself
Retreat to the ambulance, with the patient, and continue treatment when the scene is safe
Retreat to the ambulance with the patient and consult the MSDS handbook for further instructions on this specific HAZMAT threat
Remove the patient to a safe distance, continue treating the patient, and call for backup to set up a perimeter for decontamination
You do not want to return to the ambulance because he/she cannot leave the scene without being decontaminated. You would never want to stop patient care to assess a leak. Remove the patient a safe distance, treat, and call for backup.
115
```
Death caused by a nerve agent is a result of paralysis of the respiratory muscles or?
Cardiac arrest
Hemorrhagic stroke
Status epilepticus
Excessive secretions in the airway
```
Excessive secretions in the airway
Nerve agent poisoning will cause the body to produce massive amounts of secretions. The patient will require antidote administration along with aggressive airway techniques to survive.
116
You have been dispatched to a possible stroke. Upon arrival you find an elderly female asleep in her chair with the telephone in her hand. When awakened, she leads you back to the bedroom where her husband is lying in bed unresponsive. Suddenly, you and your partner develop a headache and begin to feel ill. You should?
Check the patient's pulse, airway, and breathing
Place the patient in full spinal precautions based on unresponsiveness with an unknown cause
Exit the building without the patient and ensure that additional and appropriate resources have been dispatched
Quickly, but safely extricate the patient and his wife from the building
Exit the building without the patient and ensure that additional and appropriate resources have been dispatched
Scene safety is a priority, and in this scenario it seems that there is likely something within the building that is making you and your partner ill. If the scene is not safe, you do not belong inside.
117
```
Which of the following is not considering mandatory reporting to the police?
Elderly abuse
HIV status
Animal bites
Death
```
HIV status
A patient's HIV status is protected healthcare information and therefore should not be shared with the police unless you are presented with a formal subpoena.
118
```
A 45-year-old male patient tells you he hates hospitals and he isn't going. The patient is pale, cool and diaphoretic and speaking in incomplete sentences. He will not let you touch him or administer any care, and visualization is your only form of assessment. He is conscious and alert and refuses care. All conditions are met for him to legally refuse care. This is known as:
Autonomy
Implied consent
Express consent
Consent decree
```
Autonomy
Autonomy is the right of self-governance. A person who is an adult or emancipated minor, is alert and oriented, and is not being threatened, will be able to decline any medical intervention. This person meets all criteria and is able to refuse any and all care.
