Exam 1 - Chapters 1 to 8

Question 1

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.

Answer 1

D. assist a patient with certain prescribed medications.

Question 2

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.

Answer 2

A. insert a peripheral intravenous catheter.

Question 3

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.

Answer 3

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

Question 4

Cardiac monitoring, pharmacologic interventions, and other advanced treatment skills are functions of the:
Select one:
A. AEMT.
B. paramedic.
C. EMR.
D. EMT.

Answer 4

B. paramedic.

Question 5

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.

Answer 5

C. Accidental Death and Disability: The Neglected Disease of Modern Society.

Question 6

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.

Answer 6

C. contact the state EMS office and provide its staff with the required documentation.

Question 7

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.

Answer 7

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

Question 8

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.

Answer 8

B. medical director.

Question 9

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

Answer 9

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

Question 10

Which type of medical direction do standing orders and protocols describe?
Select one:
A. Online
B. Off-line
C. Direct
D. Radio

Answer 10

B. Off-line

Question 11

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.

Answer 11

D. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.

Question 12

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

Answer 12

B. 72

Question 13

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.

Answer 13

A. offer a workplace environment that reduces the risk of exposure.

Question 14

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.

Answer 14

B. may not be obvious or present all the time.

Question 15

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.

Answer 15

C. distrust of EMTs.

Question 16

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.

Answer 16

A. when patients are actively being assessed or treated.

Question 17

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.

Answer 17

A. carbon dioxide deficiency.

Question 18

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.

Answer 18

B. wash your hands with soap and water at the hospital.

Question 19

Patients who become dependent upon EMS personnel or other health care providers often feel:
Select one:
A. hopeful.
B. superior.
C. relieved.
D. shamed.

Answer 19

D. shamed.

Question 20

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.

Answer 20

B. offer little or no side protection.

Question 21

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.

Answer 21

C. assess whether the patient’s mental condition is impaired.

Question 22

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.

Answer 22

D. is self-supporting and lives by him- or herself.

Question 23

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.

Answer 23

B. inadequate patient care was administered.

Question 24

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.

Answer 24

B. A mentally competent adult can withdraw his or her consent to treat at any time.

Question 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.

Answer 25

B. negligence.

Question 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

Answer 26

A. Deviation from the standard of care that may result in further injury

Question 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.

Answer 27

B. A paramedic transfers patient care to an EMT.

Question 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.

Answer 28

C. continue transporting your patient and notify the dispatcher of the crash.

Question 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.

Answer 29

D. quickly move the coffee table so you can access and treat the patient.

Question 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

Answer 30

B. Expressed

Question 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.

Answer 31

B. somatic nervous system.

Question 32

Anterior to the knee is a specialized bone called the:
Select one:
A. tibia.
B. femur.
C. calcaneus.
D. patella.

Answer 32

D. patella.

Question 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.

Answer 33

A. 100 beats/min.

Question 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.

Answer 34

A. augment respirations during emotional or physical stress.

Question 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.

Answer 35

C. waste products are not removed and nutrients are not delivered to the cells.

Question 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.

Answer 36

C. blood to flow into the pulmonary circulation.

Question 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.

Answer 37

D. inferior vena cava.

Question 38

Hemoglobin is a molecule that attaches to \_\_\_\_\_\_\_\_\_\_\_ and carries oxygen.
Select one:
A. leukocytes
B. monocytes
C. erythrocytes
D. thrombocytes

Answer 38

C. erythrocytes

Question 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.

Answer 39

A. epinephrine and norepinephrine.

Question 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.

Answer 40

B. a drop in pressure within the chest cavity.

Question 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.

Answer 41

D. a reduction in tidal volume.

Question 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.

Answer 42

A. a slower heart rate.

Question 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

Answer 43

C. orbit

Question 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.

Answer 44

A. residual volume.

Question 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.

Answer 45

C. first cervical vertebra, which articulates with the skull.

Question 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.

Answer 46

C. skull, face, thorax, and vertebral column.

Question 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.

Answer 47

A. radius and ulna.

Question 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.

Answer 48

C. greater trochanter.

Question 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.

Answer 49

A. perfusion.

Question 50

The diaphragm and intercostal muscles contract during:
Select one:
A. respiration.
B. ventilation.
C. exhalation.
D. inhalation.

Answer 50

D. inhalation.

Question 51

The distal aspect of the tibia forms the:
Select one:
A. medial malleolus.
B. lateral condyle.
C. Achilles tendon.
D. lateral malleolus.

Answer 51

A. medial malleolus.

Question 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.

Answer 52

D. sinoatrial node.

Question 53

The exocrine gland of the pancreas secretes:
Select one:
A. insulin.
B. glucose.
C. pancreatic juice.
D. bile.

Answer 53

C. pancreatic juice.

Question 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.

Answer 54

D. xiphoid process.

Question 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

Answer 55

C. cerebrum

Question 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.

Answer 56

A. pulmonary veins.

Question 57

The most distal four spinal vertebrae, which are fused together, form the:
Select one:
A. sacrum.
B. ischium.
C. coccyx.
D. ilium.

Answer 57

C. coccyx.

Question 58

The muscle tissue of the heart is called the:
Select one:
A. epicardium.
B. pericardium.
C. myocardium.
D. endocardium.

Answer 58

C. myocardium.

Question 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.

Answer 59

B. ilium, ischium, and pubis.

Question 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.

Answer 60

B. receive blood from the vena cava.

Question 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.

Answer 61

D. tunica media.

Question 62

Together, the right and left lungs contain how many lobes?
Select one:
A. Six
B. Five
C. Four
D. Three

Answer 62

B. Five

Question 63

Twelve pairs of ribs attach to which section of the spinal column?
Select one:
A. Thoracic
B. Sacral
C. Lumbar
D. Coccyx

Answer 63

A. Thoracic

Question 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

Answer 64

B. Subcutaneous

Question 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

Answer 65

B. Pituitary

Question 66

Which of the following organs is NOT part of the digestive system?
Select one:
A. Pancreas
B. Stomach
C. Kidney
D. Gallbladder

Answer 66

C. Kidney

Question 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

Answer 67

A. Seesaw respirations

Question 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.

Answer 68

B. Baroreceptors located throughout the body provide information to the brain regarding the blood pressure.

Question 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.

Answer 69

A. The heart is under the control of the autonomic nervous system.

Question 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

Answer 70

B. Cerebellum

Question 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.

Answer 71

A. Leave her on her side and use blanket rolls to immobilize her to the long backboard.

Question 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.

Answer 72

C. apply a cervical collar and immobilize him with a vest-style device.

Question 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.

Answer 73

C. pushing the head of the stretcher while your partner guides the foot.

Question 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

Answer 74

A. A conscious patient complaining of abdominal pain

Question 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.

Answer 75

A. a patient who can be properly assessed while still in the vehicle.

Question 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.

Answer 76

A. from a bed to the ambulance stretcher.

Question 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.

Answer 77

A. with a deformed humerus.

Question 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.

Answer 78

B. avoid pushing the patient with your elbows fully extended.

Question 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.

Answer 79

B. using a wheeled stretcher whenever possible.

Question 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.

Answer 80

C. apply a cervical collar and remove the patient on a long backboard.

Question 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.

Answer 81

A. 13.

Question 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.

Answer 82

D. liver dysfunction.

Question 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

Answer 83

D. Gentle palpation of the pelvis

Question 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.

Answer 84

D. subcutaneous emphysema.

Question 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.

Answer 85

C. is experiencing difficulty breathing.

Question 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.

Answer 86

A. flushed and red.

Question 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.

Answer 87

C. without assistance.

Question 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.

Answer 88

C. two thirds the length from the armpit to the crease at the elbow.

Question 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.

Answer 89

B. suction as needed and insert an airway adjunct.

Question 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.

Answer 90

C. be able to speak in complete sentences without unusual pauses.

Question 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.

Answer 91

A. maintain stabilization of the head.

Question 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.

Answer 92

B. shallow chest movement.

Question 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

Answer 93

A. 2

Question 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.

Answer 94

A. reevaluate his or her airway status.

Question 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

Answer 95

A. radial

Question 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.

Answer 96

B. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

Question 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

Answer 97

C. 40, 60

Question 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.

Answer 98

C. radiating.

Question 99

Poor peripheral circulation will cause the skin to appear:
Select one:
A. pink.
B. flushed.
C. cyanotic.
D. ashen.

Answer 99

D. ashen.

Question 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.

Answer 100

D. the patient receives definitive care.

Question 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.

Answer 101

C. locate injuries not found in the primary assessment.

Question 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.

Answer 102

D. patients with a significant MOI and unresponsive medical patients.

Question 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.

Answer 103

D. introduce yourself to the patient.

Question 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.

Answer 104

A. tidal volume is markedly reduced.

Question 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.

Answer 105

B. subcutaneous emphysema.

Question 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.

Answer 106

A. cyanosis.

Question 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.

Answer 107

D. repeating statements back to him or her.

Question 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.

Answer 108

A. rapid.

Question 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

Answer 109

D. Posterior

Question 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.

Answer 110

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.

Question 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.

Answer 111

D. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.

Question 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.

Answer 112

C. with the bevel facing the septum if inserted into the right nare.

Question 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.

Answer 113

D. 500 psi.

Question 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.

Answer 114

D. mouth-to-mask technique with a one-way valve.

Question 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%

Answer 115

C. Exposure to carbon monoxide and an oxygen saturation of 95%

Question 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.

Answer 116

B. lung tissue injury and gastric distention.

Question 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.

Answer 117

B. adequate amounts of surfactant.

Question 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.

Answer 118

A. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.

Question 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.

Answer 119

D. reservoir bag is fully inflated.

Question 120

Structures of the lower airway include all of the following, EXCEPT:
Select one:
A. the epiglottis.
B. alveoli.
C. bronchioles.
D. the trachea.

Answer 120

A. the epiglottis.

Question 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.

Answer 121

B. low blood oxygen levels.

Question 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.

Answer 122

B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.

Question 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

Answer 123

C. 104, 40

Question 124

The primary waste product of aerobic metabolism is:
Select one:
A. lactic acid.
B. adenosine triphosphate.
C. pyruvic acid.
D. carbon dioxide.

Answer 124

D. carbon dioxide.

Question 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.

Answer 125

D. corner of the mouth to the earlobe.

Question 126

Which of the following is a late sign of hypoxia?
Select one:
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Anxiety

Answer 126

C. Cyanosis

Question 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

Answer 127

B. Bourdon-gauge flowmeter

Question 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.

Answer 128

C. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

Question 129

Which of the following structures is contained within the mediastinum?
Select one:
A. Bronchioles
B. Larynx
C. Lungs
D. Esophagus

Answer 129

D. Esophagus

Question 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.

Answer 130

D. stand behind him and administer abdominal thrusts.

Question 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

Answer 131

A. 90

Question 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.

Answer 132

B. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

Question 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.

Answer 133

A. begin ventilations using the mouth-to-mask technique.

Question 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.

Answer 134

C. reduce the rate or volume of the ventilations you are delivering.

Question 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.

Answer 135

D. remove her dentures, resume ventilations, and assess for adequate chest rise.

Question 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.

Answer 136

C. allow recoil of the chest between compressions to draw air into the lungs.

Question 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.

Answer 137

B. administer oxygen via a nonrebreathing mask.

Question 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.

Answer 138

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.

Question 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.

Answer 139

C. requires CPR.

Question 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%.

Answer 140

D. 44%.

Question 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.

Answer 141

C. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

Question 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.

Answer 142

C. explain to her that you will assist her ventilations.

Question 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.

Answer 143

C. is a passive process caused by increased intrathoracic pressure.

Question 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.

Answer 144

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.

Question 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.

Answer 145

D. suctioning while withdrawing the catheter from the oropharynx.

Question 146

The diaphragm is innervated by the \_\_\_\_\_\_\_\_\_ nerve, which allows it to contract.
Select one:
A. phrenic
B. hypoglossal
C. vagus
D. vestibulocochlear

Answer 146

A. phrenic

Question 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.

Answer 147

C. epiglottis.

Question 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.

Answer 148

B. hypoxia due to prolonged suction attempts.

Question 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

Answer 149

D. 2,000

Question 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.

Answer 150

B. external respiration.