Exam 1 Flashcards
1
Q
According to the National EMS Scope of Practice Model, an EMT should be able to:
Select one:
A. insert a peripheral IV line and infuse fluids.
B. administer epinephrine via the subcutaneous route.
C. interpret a basic (ECG) rhythm and treat accordingly.
D. assist a patient with certain prescribed medications.
A
D. assist a patient with certain prescribed medications.
2
Q
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:
Select one:
A. insert a peripheral intravenous catheter.
B. use an automatic transport ventilator.
C. apply and interpret data from a pulse oximeter.
D. give aspirin to a patient with chest pain.
A
A. insert a peripheral intravenous catheter.
3
Q
An appropriate demonstration of professionalism when your patient is frightened, demanding, or unpleasant is to:
Select one:
A. reassure the patient that everything will be all right, even if it will not be.
B. demand that the patient to be quiet and cooperative during transport.
C. continue to be nonjudgmental, compassionate, and respectful.
D. ignore the patient’s feelings and focus on his or her medical complaint.
A
C. continue to be nonjudgmental, compassionate, and respectful.
4
Q
Cardiac monitoring, pharmacologic interventions, and other advanced treatment skills are functions of the: Select one: A. AEMT. B. paramedic. C. EMR. D. EMT.
A
B. paramedic.
5
Q
EMS as we know it today had its origins in 1966 with the publication of:
Select one:
A. Emergency Care and Transportation of the Sick and Injured.
B. the Emergency Medical Services Act.
C. Accidental Death and Disability: The Neglected Disease of Modern Society.
D. the Department of Transportation’s White Paper: Death and Dying.
A
C. Accidental Death and Disability: The Neglected Disease of Modern Society.
6
Q
If an EMT candidate has been convicted of a felony or misdemeanor, he or she should:
Select one:
A. wait at least 24 months before taking another state-approved EMT class.
B. send an official request to the National Registry of EMTs (NREMT) to seek approval to take the EMT exam.
C. contact the state EMS office and provide its staff with the required documentation.
D. recognize that any such conviction will disqualify him or her from EMT licensure.
A
C. contact the state EMS office and provide its staff with the required documentation.
7
Q
The continuous quality improvement (CQI) process is designed to:
Select one:
A. administer punitive actions to EMTs who do not follow local protocols.
B. identify areas of improvement and provide remedial training if needed.
C. ensure that all EMTs maintain licensure through the state EMS office.
D. focus specifically on the quality of emergency care provided to the patient.
A
B. identify areas of improvement and provide remedial training if needed.
8
Q
The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the: Select one: A. shift supervisor. B. medical director. C. EMS administrator. D. field training officer.
A
B. medical director.
9
Q
Which of the following scenarios involves the administration of ALS?
Select one:
A. A 64-year-old patient who is given aspirin for suspected cardiac chest pain
B. A 48-year-old patient whose airway is secured with a supraglottic device
C. A 53-year-old patient who is assisted with his prescribed nitroglycerin
D. A 61-year-old patient who is receiving humidified supplemental oxygen
A
B. A 48-year-old patient whose airway is secured with a supraglottic device
10
Q
Which type of medical direction do standing orders and protocols describe? Select one: A. Online B. Off-line C. Direct D. Radio
A
B. Off-line
11
Q
A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child’s parents arrive at the scene, they demand to see him. You should:
Select one:
A. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside.
B. let them know that because of the circumstances of their child’s death, they will not be permitted to see him at this time.
C. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer.
D. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.
A
D. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.
12
Q
A critical incident stress debriefing should be conducted no more than \_\_\_\_\_\_\_\_ hours following the incident. Select one: A. 24 B. 72 C. 6 D. 12
A
B. 72
13
Q
According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:
Select one:
A. offer a workplace environment that reduces the risk of exposure.
B. screen all prospective employees for blood-borne pathogens.
C. provide gloves and other personal protective equipment to full-time paid employees only.
D. guarantee a 100% risk-free environment prior to employment.
A
A. offer a workplace environment that reduces the risk of exposure.
14
Q
As an EMT, it is important to remember that the signs and symptoms of cumulative stress:
Select one:
A. usually manifest suddenly and without warning.
B. may not be obvious or present all the time.
C. are most effectively treated with medications.
D. cannot be identified and can cause health problems.
A
B. may not be obvious or present all the time.
15
Q
Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT: Select one: A. history of chronic disease. B. fear of medical personnel. C. distrust of EMTs. D. mental disorders.
A
C. distrust of EMTs.
16
Q
Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT:
Select one:
A. when patients are actively being assessed or treated.
B. before personnel are preparing to reenter the scene.
C. when personnel are assessed during periods of rest.
D. before leaving the scene after the incident is resolved.
A
A. when patients are actively being assessed or treated.
17
Q
Hazards that are associated with a structural fire include all of the following, EXCEPT: Select one: A. carbon dioxide deficiency. B. smoke and toxic gases. C. risk of building collapse. D. high ambient temperatures.
A
A. carbon dioxide deficiency.
18
Q
If you use a waterless handwashing substitute in the field, it is important to:
Select one:
A. wait at least 5 minutes before touching another patient.
B. wash your hands with soap and water at the hospital.
C. avoid donning another pair of gloves for at least 10 minutes.
D. immediately dry your hands with a paper towel.
A
B. wash your hands with soap and water at the hospital.
19
Q
Patients who become dependent upon EMS personnel or other health care providers often feel: Select one: A. hopeful. B. superior. C. relieved. D. shamed.
A
D. shamed.
20
Q
Prescription glasses do not provide adequate eye protection because they: Select one: A. have large, rounded lenses. B. offer little or no side protection. C. do not have shatterproof lenses. D. are not secured with a strap.
A
B. offer little or no side protection.
21
Q
A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:
Select one:
A. request that the police place the patient under protective custody.
B. document the patient’s request but continue to transport him.
C. assess whether the patient’s mental condition is impaired.
D. have the patient sign a refusal form and return him to his office.
A
C. assess whether the patient’s mental condition is impaired.
22
Q
In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:
Select one:
A. is mentally competent and able to refuse.
B. possesses a valid driver’s license.
C. has a poor relationship with his or her parents.
D. is self-supporting and lives by him- or herself.
A
D. is self-supporting and lives by him- or herself.
23
Q
In the eyes of the courts, an incomplete or untidy patient care form indicates:
Select one:
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.
A
B. inadequate patient care was administered.
24
Q
Shortly after you load your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
Select one:
A. Because of your suspicions, the best approach is to transport him to the hospital.
B. A mentally competent adult can withdraw his or her consent to treat at any time.
C. Any patient who refuses EMS treatment must legally sign a patient refusal form.
D. Once the patient is in the ambulance, he cannot legally refuse EMS treatment.
A
B. A mentally competent adult can withdraw his or her consent to treat at any time.
25
```
When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of:
Select one:
A. battery.
B. negligence.
C. assault.
D. abandonment.
```
B. negligence.
26
Which of the following MOST accurately defines negligence?
Select one:
A. Deviation from the standard of care that may result in further injury
B. Transferring patient care to a provider with a lower level of training
C. Transport of a mentally incompetent patient against his or her will
D. Providing care that is consistent with care provided by other EMTs
A. Deviation from the standard of care that may result in further injury
27
Which of the following scenarios MOST accurately depicts abandonment?
Select one:
A. An AEMT transfers patient care to a paramedic.
B. A paramedic transfers patient care to an EMT.
C. An EMT gives a verbal report to an emergency room nurse.
D. A physician assumes patient care from an EMT.
B. A paramedic transfers patient care to an EMT.
28
While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should:
Select one:
A. stop and triage the patients while your partner remains in the ambulance.
B. remain at the scene until law enforcement and another ambulance arrive.
C. continue transporting your patient and notify the dispatcher of the crash.
D. ask a bystander to remain with your patient as you treat the crash victims.
C. continue transporting your patient and notify the dispatcher of the crash.
29
You are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:
Select one:
A. drag the patient into a larger area so that you can begin treatment.
B. obtain permission from law enforcement before moving anything.
C. treat the patient where he is so that you do not destroy any evidence.
D. quickly move the coffee table so you can access and treat the patient.
D. quickly move the coffee table so you can access and treat the patient.
30
```
You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which type of consent is her agreement considered?
Select one:
A. Informed
B. Expressed
C. Minor's
D. Implied
```
B. Expressed
31
```
Activities such as walking, talking, and writing are regulated by the:
Select one:
A. involuntary nervous system.
B. somatic nervous system.
C. autonomic nervous system.
D. central nervous system.
```
B. somatic nervous system.
32
```
Anterior to the knee is a specialized bone called the:
Select one:
A. tibia.
B. femur.
C. calcaneus.
D. patella.
```
D. patella.
33
```
At rest, the normal adult heart rate should not exceed:
Select one:
A. 100 beats/min.
B. 80 beats/min.
C. 70 beats/min.
D. 90 beats/min.
```
A. 100 beats/min.
34
Both areas of the pons are used to:
Select one:
A. augment respirations during emotional or physical stress.
B. ensure that the lungs do not overinflate during breathing.
C. provide forced inspiration or expiration as needed.
D. set the base rate and depth of breathing in a healthy person.
A. augment respirations during emotional or physical stress.
35
Capillary sphincter closure during internal or external bleeding is detrimental because:
Select one:
A. available blood is shunted off to another venule while still carrying oxygen.
B. high levels of oxygen remain in the cells and can cause significant damage.
C. waste products are not removed and nutrients are not delivered to the cells.
D. carbon dioxide and other waste can enter the cells, but oxygen cannot.
C. waste products are not removed and nutrients are not delivered to the cells.
36
Contraction of the right ventricle causes:
Select one:
A. ejection of blood into the systemic circulation.
B. a return of blood from the pulmonary veins.
C. blood to flow into the pulmonary circulation.
D. closure of the mitral and aortic valves.
C. blood to flow into the pulmonary circulation.
37
```
Deoxygenated blood from the abdomen, pelvis, and lower extremities is returned to the right atrium via the:
Select one:
A. superior vena cava.
B. common iliac vein.
C. coronary sinus vein.
D. inferior vena cava.
```
D. inferior vena cava.
38
```
Hemoglobin is a molecule that attaches to ___________ and carries oxygen.
Select one:
A. leukocytes
B. monocytes
C. erythrocytes
D. thrombocytes
```
C. erythrocytes
39
```
Key hormones of the sympathetic nervous system include:
Select one:
A. epinephrine and norepinephrine.
B. acetylcholine and insulin.
C. norepinephrine and acetylcholine.
D. glucagon and noradrenaline.
```
A. epinephrine and norepinephrine.
40
Negative-pressure breathing involves:
Select one:
A. increasing airway resistance during breathing.
B. a drop in pressure within the chest cavity.
C. relaxing the respiratory muscles.
D. pushing or forcing air into the lungs.
B. a drop in pressure within the chest cavity.
41
```
Signs of adequate breathing in the adult include all of the following, EXCEPT:
Select one:
A. respirations of 18 breaths/min.
B. bilaterally clear breath sounds.
C. rhythmic inhalation and exhalation.
D. a reduction in tidal volume.
```
D. a reduction in tidal volume.
42
```
Stimulation of the parasympathetic nervous system would result in:
Select one:
A. a slower heart rate.
B. vasoconstriction.
C. a strong pulse.
D. tachycardia.
```
A. a slower heart rate.
43
```
The ___________ is made up of the maxilla and zygoma, as well as the frontal bone of the cranium.
Select one:
A. occiput
B. mastoid
C. orbit
D. sphenoid
```
C. orbit
44
```
The amount of air that remains in the lungs simply to keep them open is called the:
Select one:
A. residual volume.
B. tidal volume.
C. expiratory reserve volume.
D. inspiratory reserve volume.
```
A. residual volume.
45
The atlas is the:
Select one:
A. seventh cervical vertebra, which is easily palpable.
B. point where the ribs attach to the sternum.
C. first cervical vertebra, which articulates with the skull.
D. attachment between the first and second cervical vertebrae.
C. first cervical vertebra, which articulates with the skull.
46
The axial skeleton is composed of the:
Select one:
A. bones that constitute the pelvic girdle.
B. arms, legs, and pelvis.
C. skull, face, thorax, and vertebral column.
D. lower part of the torso and the legs.
C. skull, face, thorax, and vertebral column.
47
```
The bones of the forearm are called the:
Select one:
A. radius and ulna.
B. humerus and ulna.
C. tibia and radius.
D. radius and humerus.
```
A. radius and ulna.
48
```
The bony prominence on the lateral/superior aspect of the thigh is called the:
Select one:
A. sacral symphysis.
B. iliac crest.
C. greater trochanter.
D. sacroiliac joint.
```
C. greater trochanter.
49
```
The circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called:
Select one:
A. perfusion.
B. respiration.
C. cardiac output.
D. metabolism.
```
A. perfusion.
50
```
The diaphragm and intercostal muscles contract during:
Select one:
A. respiration.
B. ventilation.
C. exhalation.
D. inhalation.
```
D. inhalation.
51
```
The distal aspect of the tibia forms the:
Select one:
A. medial malleolus.
B. lateral condyle.
C. Achilles tendon.
D. lateral malleolus.
```
A. medial malleolus.
52
```
The electrical impulse of the heart normally begins at the:
Select one:
A. atrioventricular node.
B. bundle of His.
C. Purkinje fibers.
D. sinoatrial node.
```
D. sinoatrial node.
53
```
The exocrine gland of the pancreas secretes:
Select one:
A. insulin.
B. glucose.
C. pancreatic juice.
D. bile.
```
C. pancreatic juice.
54
```
The inferior cartilaginous tip of the sternum is called the:
Select one:
A. jugular notch.
B. angle of Louis.
C. sternal notch.
D. xiphoid process.
```
D. xiphoid process.
55
```
The largest portion of the brain is the ___________, which is commonly referred to as the “gray matter.”
Select one:
A. diencephalon
B. cerebellum
C. cerebrum
D. brain stem
```
C. cerebrum
56
```
The left side of the heart receives oxygenated blood from the lungs through the:
Select one:
A. pulmonary veins.
B. inferior venae cavae.
C. pulmonary arteries.
D. superior venae cavae.
```
A. pulmonary veins.
57
```
The most distal four spinal vertebrae, which are fused together, form the:
Select one:
A. sacrum.
B. ischium.
C. coccyx.
D. ilium.
```
C. coccyx.
58
```
The muscle tissue of the heart is called the:
Select one:
A. epicardium.
B. pericardium.
C. myocardium.
D. endocardium.
```
C. myocardium.
59
```
The pelvic bones are formed by the fusion of the:
Select one:
A. pubis and acetabulum.
B. ilium, ischium, and pubis.
C. ilium, pubis, and sacrum.
D. sacrum and ischium.
```
B. ilium, ischium, and pubis.
60
The primary function of the right atrium is to:
Select one:
A. receive blood from the pulmonary veins.
B. receive blood from the vena cava.
C. pump blood to the lungs for reoxygenation.
D. pump blood to the pulmonary artery.
B. receive blood from the vena cava.
61
```
The smooth muscles that cause the artery to contract are found in the:
Select one:
A. tunica adventitia.
B. tunica intima.
C. lumen.
D. tunica media.
```
D. tunica media.
62
```
Together, the right and left lungs contain how many lobes?
Select one:
A. Six
B. Five
C. Four
D. Three
```
B. Five
63
```
Twelve pairs of ribs attach to which section of the spinal column?
Select one:
A. Thoracic
B. Sacral
C. Lumbar
D. Coccyx
```
A. Thoracic
64
```
Which layer of the skin is composed of fatty tissue and serves as an insulator for the body?
Select one:
A. Sebaceous
B. Subcutaneous
C. Dermal
D. Epidermis
```
B. Subcutaneous
65
```
Which of the following glands regulates the function of all other endocrine glands in the body?
Select one:
A. Adrenal
B. Pituitary
C. Parathyroid
D. Thyroid
```
B. Pituitary
66
```
Which of the following organs is NOT part of the digestive system?
Select one:
A. Pancreas
B. Stomach
C. Kidney
D. Gallbladder
```
C. Kidney
67
```
Which of the following signs of respiratory distress is typically unique to infants and children?
Select one:
A. Seesaw respirations
B. Irregular breathing pattern
C. Unequal breath sounds
D. Unequal chest expansion
```
A. Seesaw respirations
68
Which of the following statements regarding nervous system control of the cardiovascular system is correct?
Select one:
A. Alpha-adrenergic receptors are located exclusively in the heart and are stimulated by epinephrine.
B. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure.
C. When stimulated, the parasympathetic nervous system is responsible for increasing the heart rate.
D. The sympathetic and parasympathetic nervous systems work together to perform the same function.
B. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure.
69
Which of the following statements regarding the heart is correct?
Select one:
A. The heart is under the control of the autonomic nervous system.
B. The heart receives its blood supply from the pulmonary arteries.
C. The heart relies on an external electrical source to function correctly.
D. The heart can tolerate an interruption of oxygen for 5 minutes.
A. The heart is under the control of the autonomic nervous system.
70
```
Which part of the central nervous system is responsible for coordinating bodily movements such as writing or sewing?
Select one:
A. Hypothalamus
B. Cerebellum
C. Brain stem
D. Cerebrum
```
B. Cerebellum
71
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?
Select one:
A. Leave her on her side and use blanket rolls to immobilize her to the long backboard.
B. Move her to a supine position and immobilize her with a scoop stretcher and padding.
C. Immobilize her in a supine position on a long backboard and secure her with straps.
D. Apply a cervical collar and place her in a sitting position on the wheeled stretcher.
A. Leave her on her side and use blanket rolls to immobilize her to the long backboard.
72
An unrestrained patient is sitting in his car after an automobile crash. He is conscious and alert, has no visible trauma, and is complaining of neck and back pain. Before removing him from his car, you should:
Select one:
A. maintain manual stabilization of his head and grasp him by the clothes.
B. perform a detailed head-to-toe assessment and apply a cervical collar.
C. apply a cervical collar and immobilize him with a vest-style device.
D. slide a scoop stretcher under his buttocks and rotate him laterally.
C. apply a cervical collar and immobilize him with a vest-style device.
73
In most instances, you should move a patient on a wheeled ambulance stretcher by:
Select one:
A. pushing the foot of the stretcher while your partner guides the head.
B. slightly lifting the stretcher to prevent unnecessary patient movement.
C. pushing the head of the stretcher while your partner guides the foot.
D. retracting the undercarriage and carrying the stretcher to the ambulance.
C. pushing the head of the stretcher while your partner guides the foot.
74
In which of the following situations would a direct ground lift be the MOST appropriate method of moving a patient?
Select one:
A. A conscious patient complaining of abdominal pain
B. A pedestrian with back pain after being struck by a car
C. An unconscious patient with a possible ischemic stroke
D. A patient who complains of hip pain following a fall
A. A conscious patient complaining of abdominal pain
75
Situations in which you should use the rapid extrication technique include all of the following, EXCEPT:
Select one:
A. a patient who can be properly assessed while still in the vehicle.
B. a patient who needs immediate care that requires a supine position.
C. a patient who blocks access to another seriously injured patient.
D. a patient whose condition requires immediate transport to the hospital.
A. a patient who can be properly assessed while still in the vehicle.
76
The direct carry is used to transfer a patient:
Select one:
A. from a bed to the ambulance stretcher.
B. with multiple long bone injuries.
C. with a possible cervical spine injury.
D. who cannot be placed on a backboard.
A. from a bed to the ambulance stretcher.
77
```
The extremity lift would NOT be appropriate to use on a patient:
Select one:
A. with a deformed humerus.
B. with forearm lacerations.
C. who complains of nausea.
D. without a spinal injury.
```
A. with a deformed humerus.
78
To avoid injury when pushing a patient or other object, you should:
Select one:
A. push the patient from an overhead position if possible.
B. avoid pushing the patient with your elbows fully extended.
C. kneel if you are pushing an object that is above waist level.
D. push from the area of your body between the knees and hips.
B. avoid pushing the patient with your elbows fully extended.
79
When carrying a patient up or down stairs, you should avoid:
Select one:
A. the use of more than two EMTs.
B. using a wheeled stretcher whenever possible.
C. flexing your body at the knees.
D. the use of a long backboard or scoop stretcher.
B. using a wheeled stretcher whenever possible.
80
When performing the rapid extrication technique to remove a patient from his or her vehicle, you should:
Select one:
A. apply a vest-style extrication device prior to moving the patient.
B. grasp the patient by the clothing and drag him or her from the car.
C. apply a cervical collar and remove the patient on a long backboard.
D. apply a cervical collar and immobilize the patient on a short backboard.
C. apply a cervical collar and remove the patient on a long backboard.
81
```
A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is:
Select one:
A. 13.
B. 10.
C. 14.
D. 12.
```
A. 13.
82
```
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:
Select one:
A. acute pancreatitis.
B. gallbladder disease.
C. renal insufficiency.
D. liver dysfunction.
```
D. liver dysfunction.
83
```
A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patient?
Select one:
A. Treating her for possible shock
B. Rapid head-to-toe exam
C. Application of a cervical collar
D. Gentle palpation of the pelvis
```
D. Gentle palpation of the pelvis
84
```
A crackling sound produced by air bubbles under the skin is called:
Select one:
A. crepitus
B. rhonchi.
C. Korotkoff sounds.
D. subcutaneous emphysema.
```
D. subcutaneous emphysema.
85
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:
Select one:
A. has a decreased level of consciousness.
B. has abdominal muscle spasms.
C. is experiencing difficulty breathing.
D. is experiencing severe back pain.
C. is experiencing difficulty breathing.
86
```
A patient with high blood pressure would be expected to have skin that is:
Select one:
A. flushed and red.
B. pale and moist.
C. cyanotic and dry.
D. mottled and cool.
```
A. flushed and red.
87
```
A patient with spontaneous respirations is breathing:
Select one:
A. at a normal rate.
B. without difficulty.
C. without assistance.
D. with shallow depth.
```
C. without assistance.
88
A properly sized blood pressure cuff should cover:
Select one:
A. one half the length between the armpit and the crease at the elbow.
B. the entire upper arm between the armpit and the crease at the elbow.
C. two thirds the length from the armpit to the crease at the elbow.
D. one third the length from the armpit to the crease at the elbow.
C. two thirds the length from the armpit to the crease at the elbow.
89
After performing a head tilt–chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:
Select one:
A. place him or her in the recovery position.
B. suction as needed and insert an airway adjunct.
C. assess respiratory rate, depth, and regularity.
D. provide positive-pressure ventilatory assistance.
B. suction as needed and insert an airway adjunct.
90
An adult patient who is NOT experiencing difficulty breathing will:
Select one:
A. have a respiratory rate that is between 20 and 24 breaths/min.
B. exhibit an indentation above the clavicles and in between the ribs.
C. be able to speak in complete sentences without unusual pauses.
D. assume a position that will facilitate effective and easy breathing.
C. be able to speak in complete sentences without unusual pauses.
91
As you assess the head of a patient with a suspected spinal injury, your partner should:
Select one:
A. maintain stabilization of the head.
B. prepare the immobilization equipment.
C. assess the rest of the body for bleeding.
D. look in the ears for gross bleeding.
A. maintain stabilization of the head.
92
```
Clinical signs of labored breathing include all of the following, EXCEPT:
Select one:
A. use of accessory muscles.
B. shallow chest movement.
C. gasping attempts to breathe.
D. supraclavicular retractions.
```
B. shallow chest movement.
93
```
During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times.
Select one:
A. 2
B. 3
C. 6
D. 4
```
A. 2
94
If a patient develops difficulty breathing after your primary assessment, you should immediately:
Select one:
A. reevaluate his or her airway status.
B. determine his or her respiratory rate.
C. begin assisting his or her breathing.
D. auscultate his or her breath sounds.
A. reevaluate his or her airway status.
95
```
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery.
Select one:
A. radial
B. femoral
C. brachial
D. carotid
```
A. radial
96
In which of the following situations is a pertinent negative identified?
Select one:
A. A 53-year-old man with dizziness also tells you that he has vomited three times.
B. A 59-year-old man complains of crushing chest pain but denies shortness of breath.
C. A 50-year-old woman states that nothing makes her chest pain better or worse.
D. A 56-year-old woman states that her chest hurts when she takes a deep breath.
B. A 59-year-old man complains of crushing chest pain but denies shortness of breath.
97
```
Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants.
Select one:
A. 18, 28
B. 30, 40
C. 40, 60
D. 20, 30
```
C. 40, 60
98
```
Pain that moves from its point of origin to another body location is said to be:
Select one:
A. palliating.
B. referred.
C. radiating.
D. provoking.
```
C. radiating.
99
```
Poor peripheral circulation will cause the skin to appear:
Select one:
A. pink.
B. flushed.
C. cyanotic.
D. ashen.
```
D. ashen.
100
The “Golden Hour” begins when an injury occurs and ends when:
Select one:
A. you arrive at the emergency department.
B. the patient is admitted to the ICU.
C. you depart the scene for the hospital.
D. the patient receives definitive care.
D. the patient receives definitive care.
101
The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to:
Select one:
A. assess only the parts of the body that are injured.
B. definitively rule out significant internal injuries.
C. locate injuries not found in the primary assessment.
D. detect and treat all non–life-threatening injuries.
C. locate injuries not found in the primary assessment.
102
The systematic head-to-toe assessment should be performed on:
Select one:
A. stable patients who are able to tell you exactly what happened.
B. all patients with traumatic injuries who will require EMS transport.
C. responsive medical patients and patients without a significant MOI.
D. patients with a significant MOI and unresponsive medical patients.
D. patients with a significant MOI and unresponsive medical patients.
103
```
Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in respiratory distress. Your first action should be to:
Select one:
A. ask the patient what's wrong.
B. assess the patient's airway status.
C. obtain a set of baseline vital signs.
D. introduce yourself to the patient.
```
D. introduce yourself to the patient.
104
When a patient's respirations are shallow:
Select one:
A. tidal volume is markedly reduced.
B. carbon dioxide elimination is increased.
C. chest rise will be easily noticeable.
D. oxygenation occurs more efficiently.
A. tidal volume is markedly reduced.
105
```
When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT:
Select one:
A. open wounds or eviscerations.
B. subcutaneous emphysema.
C. gross bleeding and tenderness.
D. rigidity and obvious bleeding.
```
B. subcutaneous emphysema.
106
```
When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called:
Select one:
A. cyanosis.
B. pallor.
C. flushing.
D. mottling.
```
A. cyanosis.
107
When interviewing a patient, you can show him or her that you understand the situation by:
Select one:
A. interrupting him or her as needed for clarification.
B. using medical terminology whenever possible.
C. maintaining constant eye contact with him or her.
D. repeating statements back to him or her.
D. repeating statements back to him or her.
108
```
When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:
Select one:
A. rapid.
B. slow.
C. irregular.
D. thready.
```
A. rapid.
109
```
When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
Select one:
A. Extremities
B. Anterior chest
C. Abdomen
D. Posterior
```
D. Posterior
110
When using the pulse oximeter as part of your assessment of a patient, it is important to remember that:
Select one:
A. as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient is experiencing respiratory distress.
B. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin.
C. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds.
D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.
D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.
111
A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?
Select one:
A. Suction his oropharynx with a rigid catheter until all secretions are removed.
B. Provide continuous ventilations with a bag-valve mask to minimize hypoxia.
C. Insert a nasopharyngeal airway and provide suction and assisted ventilations.
D. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
D. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
112
A nasopharyngeal airway is inserted:
Select one:
A. into the smaller nostril with the tip following the roof of the nose.
B. into the larger nostril with the tip pointing away from the septum.
C. with the bevel facing the septum if inserted into the right nare.
D. with the bevel pointing downward if inserted into the left nare.
C. with the bevel facing the septum if inserted into the right nare.
113
```
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:
Select one:
A. 1,500 psi.
B. 1,000 psi.
C. 200 psi.
D. 500 psi.
```
D. 500 psi.
114
As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the:
Select one:
A. one-person bag-valve mask.
B. mouth-to-mouth technique.
C. manually triggered ventilation device.
D. mouth-to-mask technique with a one-way valve.
D. mouth-to-mask technique with a one-way valve.
115
Based on current guidelines, in which of the following situations should supplemental oxygen be administered?
Select one:
A. Any diabetic patient whose oxygen saturation is less than 98%
B. Any elderly patient whose oxygen saturation is less than 95%
C. Exposure to carbon monoxide and an oxygen saturation of 95%
D. Signs of myocardial infarction and an oxygen saturation of 97%
C. Exposure to carbon monoxide and an oxygen saturation of 95%
116
Complications associated with using a manually triggered ventilation device include:
Select one:
A. inadequate oxygenation and tracheal injury.
B. lung tissue injury and gastric distention.
C. reduced tidal volume delivery and hypoxia.
D. inadequate ventilation and hypercarbia.
B. lung tissue injury and gastric distention.
117
```
Gas exchange in the lungs is facilitated by:
Select one:
A. pulmonary capillary constriction.
B. adequate amounts of surfactant.
C. water or blood within the alveoli.
D. surfactant-destroying organisms.
```
B. adequate amounts of surfactant.
118
Inhalation occurs when the:
Select one:
A. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
B. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.
C. diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure.
D. diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure.
A. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
119
```
Prior to applying a nonrebreathing mask to a patient, you must ensure that the:
Select one:
A. patient has reduced tidal volume.
B. one-way valve is sealed.
C. flow rate is set at 6 L/min.
D. reservoir bag is fully inflated.
```
D. reservoir bag is fully inflated.
120
```
Structures of the lower airway include all of the following, EXCEPT:
Select one:
A. the epiglottis.
B. alveoli.
C. bronchioles.
D. the trachea.
```
A. the epiglottis.
121
```
The hypoxic drive is influenced by:
Select one:
A. low blood carbon dioxide levels.
B. low blood oxygen levels.
C. high blood oxygen levels.
D. high blood carbon dioxide levels.
```
B. low blood oxygen levels.
122
The main advantage of the Venturi mask is:
Select one:
A. the ability to adjust the percentage of inspired oxygen when caring for a critically ill or injured patient.
B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.
C. the ability to adjust the amount of oxygen administered to the patient by increasing the flow rate on the regulator.
D. that it does not contain an oxygen reservoir, so the same percentage of oxygen can consistently be administered.
B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.
123
```
The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.
Select one:
A. 70, 28
B. 90, 50
C. 104, 40
D. 88, 30
```
C. 104, 40
124
```
The primary waste product of aerobic metabolism is:
Select one:
A. lactic acid.
B. adenosine triphosphate.
C. pyruvic acid.
D. carbon dioxide.
```
D. carbon dioxide.
125
To select the proper size oropharyngeal airway, you should measure from the:
Select one:
A. corner of the mouth to the superior ear.
B. angle of the jaw to the center of the mouth.
C. center of the mouth to the posterior ear.
D. corner of the mouth to the earlobe.
D. corner of the mouth to the earlobe.
126
```
Which of the following is a late sign of hypoxia?
Select one:
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Anxiety
```
C. Cyanosis
127
```
Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?
Select one:
A. Pressure-compensated flowmeter
B. Bourdon-gauge flowmeter
C. Vertical-position flowmeter
D. Ball-and-float flowmeter
```
B. Bourdon-gauge flowmeter
128
Which of the following statements regarding positive-pressure ventilation is correct?
Select one:
A. To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation.
B. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body.
C. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.
D. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure.
C. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.
129
```
Which of the following structures is contained within the mediastinum?
Select one:
A. Bronchioles
B. Larynx
C. Lungs
D. Esophagus
```
D. Esophagus
130
While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:
Select one:
A. place him in a supine position and open his airway.
B. encourage him to cough as forcefully as he can.
C. deliver up to five back blows and reassess him.
D. stand behind him and administer abdominal thrusts.
D. stand behind him and administer abdominal thrusts.
131
```
With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen.
Select one:
A. 90
B. 100
C. 80
D. 70
```
A. 90
132
Without adequate oxygen, the body's cells:
Select one:
A. cease metabolism altogether, resulting in carbon dioxide accumulation in the blood.
B. incompletely convert glucose into energy, and lactic acid accumulates in the blood.
C. rely solely on glucose, which is completely converted into adenosine triphosphate.
D. begin to metabolize fat, resulting in the production and accumulation of ketoacids.
B. incompletely convert glucose into energy, and lactic acid accumulates in the blood.
133
You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag-valve mask. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should:
Select one:
A. begin ventilations using the mouth-to-mask technique.
B. continue attempted ventilations and transport immediately.
C. suction the patient's airway for 30 seconds and reattempt ventilations.
D. hyperextend the patient's head and reattempt ventilations.
A. begin ventilations using the mouth-to-mask technique.
134
You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that it has decreased significantly from previous readings. You should:
Select one:
A. increase the rate at which you are ventilating and reassess his blood pressure.
B. increase the volume of your ventilations and reassess his blood pressure.
C. reduce the rate or volume of the ventilations you are delivering.
D. perform a head-to-toe assessment to look for signs of bleeding.
C. reduce the rate or volume of the ventilations you are delivering.
135
You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:
Select one:
A. leave her dentures in place, but carefully monitor her for an airway obstruction.
B. remove her dentures at once and increase the rate and volume of your ventilations.
C. attempt to replace her dentures so that they fit tightly and resume ventilations.
D. remove her dentures, resume ventilations, and assess for adequate chest rise.
D. remove her dentures, resume ventilations, and assess for adequate chest rise.
136
Your protocols state that during the first few minutes of working on a cardiac arrest patient, you should provide passive ventilation. This means that you will:
Select one:
A. deliver positive-pressure ventilation at rate of only 5 or 6 breaths/min.
B. time your positive-pressure ventilations to occur during chest recoil.
C. allow recoil of the chest between compressions to draw air into the lungs.
D. ventilate with a bag-valve mask that is not attached to oxygen.
C. allow recoil of the chest between compressions to draw air into the lungs.
137
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:
Select one:
A. perform a secondary assessment and then begin treatment.
B. administer oxygen via a nonrebreathing mask.
C. insert a nasal airway in case her mental status decreases.
D. assist her ventilations with a bag-valve mask.
B. administer oxygen via a nonrebreathing mask.
138
A ventilation/perfusion (V/Q ratio) mismatch occurs when:
Select one:
A. ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body.
B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
C. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange.
D. a traumatic injury or medical condition impairs the body's ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.
B. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
139
```
An unconscious patient found in a prone position must be placed in a supine position in case he or she:
Select one:
A. regains consciousness.
B. begins to vomit.
C. requires CPR.
D. has increased tidal volume.
```
C. requires CPR.
140
```
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:
Select one:
A. 35%.
B. 52%.
C. 24%.
D. 44%.
```
D. 44%.
141
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
Select one:
A. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid.
B. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid.
C. slight increases in carbon dioxide or a decrease 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.
C. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.
142
Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should:
Select one:
A. ventilate her at the rate at which she is breathing.
B. restrain her and provide ventilatory assistance.
C. explain to her that you will assist her ventilations.
D. insert a nasopharyngeal airway and give oxygen.
C. explain to her that you will assist her ventilations.
143
In contrast to inhalation, exhalation:
Select one:
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 a passive process caused by increased intrathoracic pressure.
D. is an active process caused by decreased intrathoracic pressure.
C. is a passive process caused by increased intrathoracic pressure.
144
Intrapulmonary shunting occurs when:
Select one:
A. any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar–capillary membrane.
B. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs.
C. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
D. a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels.
C. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
145
Proper technique for suctioning the oropharynx of an adult patient includes:
Select one:
A. suctioning for up to 1 minute if the patient is well oxygenated.
B. continuously suctioning patients with copious oral secretions.
C. removing large, solid objects with a tonsil-tip suction catheter.
D. suctioning while withdrawing the catheter from the oropharynx.
D. suctioning while withdrawing the catheter from the oropharynx.
146
```
The diaphragm is innervated by the _________ nerve, which allows it to contract.
Select one:
A. phrenic
B. hypoglossal
C. vagus
D. vestibulocochlear
```
A. phrenic
147
```
The leaf-shaped structure located superior to the larynx is called the:
Select one:
A. vallecula.
B. cricoid ring.
C. epiglottis.
D. thyroid cartilage.
```
C. epiglottis.
148
The MOST significant complication associated with oropharyngeal suctioning is:
Select one:
A. oral abrasions from vigorous suctioning.
B. hypoxia due to prolonged suction attempts.
C. clogging of the catheter with thick secretions.
D. vomiting from stimulating the anterior airway.
B. hypoxia due to prolonged suction attempts.
149
```
The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).
Select one:
A. 1,000
B. 500
C. 3,000
D. 2,000
```
D. 2,000
150
```
The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
Select one:
A. pulmonary ventilation.
B. external respiration.
C. alveolar ventilation.
D. cellular metabolism.
```
B. external respiration.
