Midterm 3 trauma Flashcards by Tracy Johnson

During transport of a patient with a head injury, which of the following will provide you with the MOST information regarding the patient’s condition?

A: Heart rate
B: Mental status
C: Pupil size
D: Blood pressure

B: Mental status

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Which of the following sets of vital signs is MOST suggestive of increased intracranial pressure in a patient who has experienced a traumatic brain injury?

A: BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min
B: BP, 84/42 mm Hg; pulse, 60 beats/min; respirations, 32 breaths/min
C: BP, 92/60 mm Hg; pulse, 120 beats/min; respirations, 24 breaths/min
D: BP, 160/72 mm Hg; pulse, 100 beats/min; respirations, 12 breaths/min

A: BP, 176/98 mm Hg; pulse, 50 beats/min; respirations, 10 breaths/min

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When caring for a trauma patient with signs of intraabdominal bleeding, it is MOST important for the EMT to:

A: apply and inflate the pneumatic antishock garment.
B: transport rapidly to an appropriate medical facility.
C: perform an in-depth abdominal assessment.
D: auscultate bowel sounds for at least 2 minutes.

B: transport rapidly to an appropriate medical facility.

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A man was struck in the side of the head with a steel pipe. Blood-tinged fluid is draining from the ear and bruising appears behind the ear. The MOST appropriate treatment for this patient includes:

A: controlling the drainage from the ear and immobilizing the entire spine.
B: elevating the lower extremities and providing immediate transport.
C: applying high-flow oxygen and packing the ear with sterile gauze pads.
D: immobilizing the spine, administering oxygen, and monitoring for vomiting.

D: immobilizing the spine, administering oxygen, and monitoring for vomiting.

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A 40-year-old man has burns to the entire head, anterior chest, and both anterior upper extremities. Using the adult Rule of Nines, what percentage of his total body surface area has been burned?

A: 45%
B: 27%
C: 36%
D: 18%

B: 27%

Reason:

Using the adult Rule of Nines, the head accounts for 9% of the total body surface area (TBSA), the anterior chest for 9% (the entire anterior trunk [chest and abdomen] accounts for 18%), and the anterior upper extremities for 4.5% each (each entire upper extremity is 9% of the TBSA). On the basis of this, the patient has sustained 27% TBSA burns.

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During your assessment of a patient who experienced blunt facial trauma, you note the presence of a hyphema. This indicates:

A: a fracture of the nasal bone.
B: an orbital blowout fracture.
C: that the pupils are unequal.
D: direct trauma to the eyeball.

D: direct trauma to the eyeball.

Reason:

Some patients with blunt trauma to the eyeball (globe) may present with a hyphema, or bleeding into the anterior chamber of the eye, that obscures a portion of or the entire iris. This condition may seriously impair vision and should be considered a sight-threatening emergency. A fracture of the orbital floor (blowout fracture) is characterized by double vision and an inability of the patient to move his or her eyes above the midline (paralysis of an upward gaze) following blunt facial trauma. In an orbital blowout fracture, fragments of fractured bone can entrap some of the muscles that control eye movement. Anisocoria is the term used to describe unequal pupils. Unequal pupils following head trauma indicates increased intracranial pressure.

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A 19-year-old female has a closed, swollen deformity to her left forearm. You are unable to palpate a radial pulse and the skin distal to the injury is cold and pale. Several attempts to contact medical control have failed and you are approximately 45 miles away from the closest hospital. You should:

A: begin transport at once, gently manipulate her arm en route until distal circulation is restored, and apply an air splint.
B: make one attempt to restore distal circulation by applying gentle manual traction in line with the long axis of the limb.
C: apply an air splint to her forearm, keep her arm below the level of her heart, place an icepack over the injury, and transport.
D: splint her entire arm with rigid board splints, elevate the limb above the level of her heart, and transport immediately.

B: make one attempt to restore distal circulation by applying gentle manual traction in line with the long axis of the limb.

Cold, pale skin and an absent distal pulse indicates that blood flow distal to the injury is compromised. You should notify medical control, who will likely direct you to attempt to restore distal circulation. However, if you are unable to contact medical control and your transport time will be lengthy, you should make ONE attempt to restore distal circulation by applying gentle manual traction in line with the long axis of the limb. Be careful, as excessive manipulation can worsen the vascular problem. If you are unsuccessful after one attempt, splint the limb in the most comfortable position for the patient and transport at once. If distal circulation is restored, splint the limb in whatever position allows the strongest distal pulse. You should elevate the limb above the level of the heart to help minimize swelling. An icepack may also help reduce pain and swelling.

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A woman stabbed her boyfriend in the cheek with a dinner fork during an argument. Police have the woman in custody. The patient still has the fork impaled in his cheek. He is conscious and alert, breathing adequately, and has blood in his oropharynx. You should:

A: suction his oropharynx, carefully cut the fork to make it shorter, control any external bleeding, and secure the fork in place.
B: apply high-flow oxygen via a nonrebreathing mask, carefully remove the fork, and control any external bleeding.
C: carefully remove the fork, suction his oropharynx as needed, and pack the inside of his cheek with sterile gauze pads.
D: suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings.

D: suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings.

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Upon discovering an open chest wound, you should:

A: immediately reassess the patient’s ventilatory status.
B: quickly cover the wound with a porous trauma dressing.
C: begin assisted ventilation and prepare for transport.
D: prevent air from entering the open wound.

D: prevent air from entering the open wound.

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A patient with a closed head injury opens his eyes in response to pain, is mumbling words that you cannot understand, and pushes your hand away when you apply a painful stimulus. His Glasgow Coma Scale (GCS) score is:

A: 7
B: 8
C: 9
D: 6

C: 9
Reason:

The Glasgow Coma Scale (GCS) is a valuable tool used when assessing patients with a neurological injury. It assesses three parameters: eye opening, verbal response, and motor response. A minimum score on the GCS is 3 and a maximum score is 15. A patient who opens his or her eyes in response to pain would receive a score of 2. Mumbling speech, moaning, or incomprehensible words equate to a score of 2 for verbal response. Localization of a painful stimulus, such as pushing your hand away from the source of pain, equates to a score of 5. Therefore, the patient has a GCS score of 9. It is important to note that a patient’s GCS score should be reassessed frequently. Review the entire GCS in your EMT text and commit it to memory.

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During a soccer game, an 18-year-old woman injured her knee. Her knee is in a flexed position and is obviously deformed. You should:

A: assess circulatory function distal to her injury.
B: immobilize the knee in the position in which it was found.
C: straighten the knee to facilitate immobilization.
D: manually stabilize the leg above and below the knee.

D: manually stabilize the leg above and below the knee.

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A high-school student was splashed in the eyes with a strong acid chemical during a lab experiment. He is in severe pain and is unable to open his eyes. You should:

A: cover both of his eyes with sterile gauze and transport at once.
B: flush both eyes with sterile water for no more than 5 minutes.
C: force his eyes open and assess for the presence of severe burns.
D: continuously flush his eyes with saline for at least 20 minutes.

D: continuously flush his eyes with saline for at least 20 minutes.

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When applying a vest-style spinal immobilization device to a patient with traumatic neck pain, you should:

A: ask the patient to fully exhale as you secure the torso.
B: secure the torso section prior to immobilizing the head.
C: immobilize the head prior to securing the torso straps.
D: gently flex the head forward as you position the device.

B: secure the torso section prior to immobilizing the head.

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A young male has trauma to multiple body systems after he fell approximately 35 feet. He is semiconscious, has an unstable chest wall, numerous long bone fractures, and a large hematoma to his head. He will have the GREATEST chance for survival if you:

A: request an ALS ambulance.
B: keep him warm and elevate his legs.
C: give him high-flow oxygen early.
D: rapidly transport him to a trauma center.

D: rapidly transport him to a trauma center.

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A 23-year-old male was struck across the face with a baseball bat. His eyes are swollen shut, he has massive facial bruising and deformities, and has blood in his mouth. Your MOST immediate concern should be:

A: spinal trauma.
B: airway compromise.
C: permanent vision loss.
D: intracranial bleeding.

B: airway compromise.

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Displaced fractures of the proximal femur are characterized by:

A: lengthening and internal rotation of the leg.
B: a flexed hip joint and inward thigh rotation.
C: shortening and external rotation of the leg.
D: hip joint extension and external leg rotation.

C: shortening and external rotation of the leg.

Fractures of the proximal (upper) part of the femur are especially common in older people, particularly those with osteoporosis, but may also occur as a result of high-energy trauma in younger patients. Although they are usually called hip fractures, they rarely involve the hip joint. Instead, the break goes through the neck of the femur, the middle region, or across the proximal shaft. Patients with displaced fractures of the proximal femur display a very characteristic deformity. They lie with the leg externally rotated, and the injured leg is usually shorter than the uninjured leg. If the fracture is not displaced, this deformity is not present. A flexed hip joint and internal rotation of the thigh are characteristic of a posterior hip dislocation. With the less common anterior hip dislocation, the limb is in the opposite position, extended straight out, externally rotated, and pointing away from the midline of the body.

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After stopping the burning process, emergency care for a 68-year-old male with partial- and full-thickness burns to his chest and upper extremities includes all of the following, EXCEPT:

A: covering the burns with dry, sterile dressings.
B: avoiding the use of burn ointments or antiseptics.
C: flushing the burns with cool water for 10 minutes.
D: preparing to assist the patient’s ventilations.

C: flushing the burns with cool water for 10 minutes.

Reason:
Unless the patient is on fire, do not apply water to a full-thickness (third-degree) burn, especially if the patient is already prone to hypothermia and infection (ie, older adults, small children). Cover the burns with dry, sterile dressings or a sterile burn sheet. The use of burn creams, ointments, or antiseptics should be avoided; these increase the risk of infection and will only need to be removed at the hospital. Apply high-flow oxygen, treat any associated injuries, and rapidly transport the patient. If the patient is breathing inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]), assist ventilations with a bag-mask device.

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General care for an amputated body part includes:

A: wrapping the amputated part in a moist, sterile dressing and keeping it warm.
B: immersing the amputated part in ice cold water to prevent further damage.
C: wrapping the amputated part in a moist, sterile dressing and placing it on ice.
D: thoroughly cleaning the amputated part and wrapping it in a sterile dressing.

C: wrapping the amputated part in a moist, sterile dressing and placing it on ice.

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When assessing and treating a patient with a gunshot wound, you should routinely:

A: determine why the patient was shot.
B: evaluate the pulses proximal to the wound.
C: look for the presence of an exit wound.
D: apply ice directly to the wound.

C: look for the presence of an exit wound.

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Despite direct pressure, a large laceration continues to spurt large amounts of bright red blood. You should:

A: apply a tourniquet proximal to the injury until the bleeding stops.
B: elevate the extremity and apply a tight pressure dressing.
C: place additional dressings on the wound until the bleeding stops.
D: apply pressure to the pulse point that is proximal to the injury.

A: apply a tourniquet proximal to the injury until the bleeding stops.

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Shock following major trauma is MOST often the result of:

A: head injury.
B: spinal injury.
C: hemorrhage.
D: long bone fractures.

C: hemorrhage

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A young man fell and landed on his outstretched hand, resulting in pain and deformity to the left midshaft forearm. Distal circulation should be assessed at which of the following pulse locations?

A: Pedal
B: Radial
C: Popliteal
D: Brachial

B: Radial

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A 44-year-old male experienced burns to his anterior trunk and both arms. He is conscious and alert, but is in extreme pain. Assessment of the burns reveals reddening and blisters. This patient has ________________ burns that cover _____ of his total body surface area.

A: full-thickness, 18%
B: partial-thickness, 36%
C: first-degree, 27%
D: second-degree, 45%

B: partial-thickness, 36%

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You are assessing a young male who was stabbed in the right lower chest. He is semiconscious and has labored breathing, collapsed jugular veins, and absent breath sounds on the right side of his chest. This patient MOST likely has a:

A: ruptured spleen.
B: liver laceration.
C: hemothorax.
D: pneumothorax.

C: hemothorax

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Patients with significant closed head injuries often have pupillary abnormalities and: A: tachycardia. B: paralysis. C: hypertension. D: paresthesia.

C: hypertension

You are called to a local nightclub for an injured patient. Law enforcement personnel have secured the scene. Upon arrival, you see a young man who is lying on the ground screaming in pain; bright red blood is spurting from an apparent stab wound to his groin area. You should: A: apply 100% oxygen. B: prevent hypothermia. C: control the bleeding. D: ensure an open airway.

C: control the bleeding.

Which of the following mechanisms of injury would necessitate performing a rapid head-to-toe assessment? A: An impaled object in the patient’s lower extremity with minimal venous bleeding B: A 5 foot, 9 inch tall adult who fell 12 feet from a roof and landed on his side C: A stable patient involved in a motor-vehicle crash, whose passenger was killed D: Amputation of three toes from the patient’s left foot with controlled bleeding

C: A stable patient involved in a motor-vehicle crash, whose passenger was killed

A gang member was cut on the left side of the neck during a fight and is bleeding heavily from the wound. His airway is patent and his breathing is adequate. You should immediately: A: apply high-flow oxygen via a nonrebreathing mask at 15 L/min. B: cover the wound with an occlusive dressing and apply direct pressure. C: apply a tight pressure dressing and secure it in place with tape. D: perform a head-to-toe assessment to find and treat other injuries.

B: cover the wound with an occlusive dressing and apply direct pressure.

A 42-year-old man was ejected from his car after it struck a bridge pillar at a high rate of speed. You find him in a prone position approximately 50 feet from his car. He is not moving and does not appear to be breathing. You should: A: use the jaw-thrust maneuver. B: administer high-flow oxygen. C: assess his breathing effort. D: manually stabilize his head.

D: manually stabilize his head.

The presence of subcutaneous emphysema following blunt trauma to the anterior neck should make you MOST suspicious for a: A: ruptured esophagus. B: fractured larynx. C: pneumothorax. D: carotid artery injury.

B: fractured larynx.

Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. These are signs of a/an: A: pneumothorax. B: flail chest. C: isolated rib fracture. D: pulmonary contusion.

B: flail chest

In which of the following circumstances would external bleeding be the LEAST difficult to control? A: Lacerated jugular vein; BP of 100/60 mm Hg B: Lacerated brachial artery; BP of 140/90 mm Hg C: Lacerated carotid artery; BP of 90/50 mm Hg D: Lacerated femoral vein; BP of 70/40 mm Hg

D: Lacerated femoral vein; BP of 70/40 mm Hg

Which of the following signs would you expect to see in the early stages of shock? A: Restlessness B: Unconsciousness C: Hypotension D: Thready pulses

A: Restlessness

Which of the following injury mechanisms is associated with hangings? A: Subluxation B: Distraction C: Axial loading D: Hyperextension

B: Distraction

A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow, and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-flow oxygen, you should: A: perform a detailed physical exam at the scene to ensure that you locate and treat less obvious injuries. B: suspect that the patient has a tension pneumothorax and notify the trauma center as soon as possible. C: control the bleeding from the stab wound with a sterile porous dressing and reassess his vital signs. D: cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly.

D: cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly

Which of the following patients would be MOST in need of a rapid head-to-toe assessment? A: A 60-year-old man who fell from a standing position and has small abrasions on his cheek B: A 43-year-old woman with a unilaterally swollen, painful deformity of the midshaft femur C: A responsive 25-year-old woman who fell 9 feet from a roof and landed on her side D: A responsive 22-year-old man with a small caliber gunshot wound to the abdomen

D: A responsive 22-year-old man with a small caliber gunshot wound to the abdomen

Which of the following BEST describes the mechanism of injury? A: The energy of an object in motion B: The product of mass, force of gravity, and height C: Your concern for potentially serious injuries D: The way in which traumatic injuries occur

D: The way in which traumatic injuries occur

Appropriate care for an amputated body part includes all of the following, EXCEPT: A: placing it directly on ice to prevent tissue damage. B: keeping the part cool, but not allowing it to freeze. C: laying the wrapped body part on a bed of ice. D: wrapping it in a sterile dressing and placing it in a plastic bag.

A: placing it directly on ice to prevent tissue damage.

A 40-year-old man has burns to the entire head, anterior chest, and both anterior upper extremities. Using the adult Rule of Nines, what percentage of his total body surface area has been burned? A: 18% B: 45% C: 27% D: 36%

C: 27%

Which of the following is MOST indicative of decompensated shock in a trauma patient with internal bleeding? A: Tachycardia B: Hypotension C: Restlessness D: Clammy skin

B: Hypotension

A 44-year-old man has a traumatic leg amputation just below the knee. He is unresponsive; is breathing rapidly and shallowly; and has pale, cool, clammy skin. He is lying in a large pool of blood and the wound is bleeding profusely. To control this bleeding, you should: A: cover the wound with a trauma dressing and apply a proximal tourniquet. B: apply an icepack to the wound to constrict the vessels and stop the bleeding. C: apply a pressure dressing and elevate the injured extremity at least 12 inches. D: locate the femoral artery and apply pressure to it until the bleeding stops.

A: cover the wound with a trauma dressing and apply a proximal tourniquet.

A 33-year-old factory worker was pinned between two pieces of machinery. When you arrive at the scene, you find him lying supine on the ground complaining of severe pain to his pelvis. He is restless, diaphoretic, and tachycardic. After performing a rapid head-to-toe assessment, you should: A: carefully log roll him to check his back. B: palpate his pelvis to assess for crepitus. C: perform a detailed secondary exam. D: prepare for immediate transport.

D: prepare for immediate transport.

If a vehicle strikes a tree at 60 MPH, the unrestrained driver would likely experience the MOST severe injuries during the: A: second collision. B: third collision. C: first collision. D: fourth collision.

B: third collision.

Following blunt injury to the anterior torso, a patient is coughing up bright red blood. You should be MOST suspicious of: A: bleeding within the lungs. B: intraabdominal bleeding. C: gastrointestinal bleeding. D: severe myocardial damage.

A: bleeding within the lungs.

A 22-year-old man was stabbed in the chest with a large knife. The patient is pulseless and apneic, and the knife is impaled in the center of his chest. Treatment should include: A: stabilizing the knife, applying an occlusive dressing, and providing rapid transport. B: stabilizing the knife, starting CPR, and providing rapid transport. C: removing the knife, applying an occlusive dressing, and providing rapid transport. D: removing the knife, starting CPR, and providing rapid transport.

D: removing the knife, starting CPR, and providing rapid transport.

You arrive at a residence where you find a man lying unresponsive in his front yard. There were no witnesses to the event. In assessing this man, you should assume that he: A: is having a heart attack. B: has a heat-related emergency. C: has sustained an injury. D: is having a diabetic reaction.

C: has sustained an injury.

You are performing a secondary assessment on a severely injured patient while en route to a trauma center. During the assessment, you note that the patient's respiratory rate has increased. You should: A: count the number of respirations per minute. B: immediately notify the receiving facility. C: repeat the primary assessment and treat as needed. D: assess his oxygen saturation with a pulse oximeter.

C: repeat the primary assessment and treat as needed.

A 21-year-old man partially amputated his right arm when the chainsaw he was using to trim trees slipped. You can feel a weak radial pulse and his arm is cool to the touch. Dark red blood is flowing heavily from the wound. You should: A: carefully pack sterile dressings into the wound and fully splint the extremity. B: apply a tourniquet proximal to the injury and tighten it until the bleeding stops. C: apply bulky compression dressings to the wound and splint the extremity. D: control the bleeding, manipulate the arm to improve circulation, and apply a splint.

C: apply bulky compression dressings to the wound and splint the extremity.

If a passenger strikes his or her head on the windshield during a motor-vehicle crash: A: the anterior part of the brain sustains a compression injury, while the posterior part sustains a stretching injury. B: the posterior portion of the brain will receive the initial impact, resulting in severe intracerebral hemorrhage. C: you will always see a starburst fracture of the windshield at the location where the patient struck his or her head. D: he or she will likely experience a hyperflexion injury, resulting in fractures of the vertebrae in the cervical spine.

A: the anterior part of the brain sustains a compression injury, while the posterior part sustains a stretching injury.

A 21-year-old male was bitten on the left forearm by a dog. He is conscious and alert and denies any other injuries. An animal control officer is at the scene and has contained the dog. Your assessment of the patient's arm reveals a large avulsion with a peeled back flap of skin. Distal circulation is adequate and the patient is able to feel and move his fingers. In addition to bleeding control, you should: A: irrigate the wound for at least 15 minutes. B: perform a rapid head-to-toe assessment. C: apply oxygen via a nonrebreathing mask. D: replace the avulsed flap to its original position.

D: replace the avulsed flap to its original position.

Which of the following is the MOST reliable indicator of a fracture to a spinal vertebra? A: Decreased grip strength in the upper extremities B: Lack of pain at the site of the injury C: Decreased movement on one side of the body D: Palpable pain at the site of the injury

D: Palpable pain at the site of the injury

An elderly woman, who was removed from her burning house by firefighters, has full-thickness burns to approximately 50% of her body. Appropriate treatment for this patient should include: A: peeling burned clothing from the skin and removing all rings, necklaces, and bracelets. B: cooling the burns with sterile saline and covering them with dry, sterile burn pads. C: covering the burns with dry, sterile dressings and preventing further loss of body heat. D: applying moist, sterile dressings to the burned areas and preventing hypothermia.

C: covering the burns with dry, sterile dressings and preventing further loss of body heat.

During the rapid head-to-toe assessment of a patient with multiple injuries, you expose the chest and find an open wound with blood bubbling from it. You should: A: prevent air from entering the wound. B: apply high-flow supplemental oxygen. C: place a porous dressing over the wound. D: stop your assessment and transport.

A: prevent air from entering the wound.

Which of the following assessment parameters is the MOST reliable when determining if a patient with a head injury is improving or deteriorating? A: rate and depth of breathing. B: pupillary reaction. C: systolic blood pressure. D: level of consciousness.

D: level of consciousness.

A 22-year-old female woman was shot by her husband. Law enforcement is at the scene and has the husband in custody. The patient is conscious, but extremely restless, and is pale and diaphoretic. As your partner administers high-flow oxygen, you should: A: take her BP to detect hypotension. B: look for and control any bleeding. C: compare her carotid and radial pulses. D: keep her warm by applying blankets.

B: look for and control any bleeding.

Internal or external bleeding would be especially severe in a patient: A: who takes aspirin. B: with heart disease. C: with hemophilia. D: who is hypotensive.

C: with hemophilia

Despite direct pressure, a large laceration to the medial aspect of the arm continues to bleed profusely. You should: A: pack the inside of the laceration with sterile gauze. B: quickly apply a tourniquet proximal to the injury. C: continue direct pressure and elevate the extremity. D: locate and apply pressure to the brachial artery.

B: quickly apply a tourniquet proximal to the injury.

Priority treatment for a large avulsion includes: A: cleaning the wound. B: assessing distal circulation. C: controlling any bleeding. D: immobilizing the injured area.

C: controlling any bleeding.

Firefighters have rescued a man from his burning house. He is conscious and alert, but is experiencing significant respiratory distress. He has a brassy cough and singed nasal hairs. The MOST immediate threat to this patient's life is: A: severe burns. B: hypothermia. C: severe infection. D: airway swelling.

D: airway swelling.

A 56-year-old man was the unrestrained driver of a small passenger car that rolled over twice after he rounded a corner too fast. He is unresponsive; has rapid, shallow respirations; and has a rapid, weak pulse. His left arm is completely amputated just below the elbow. As you and your partner are treating the patient, other responders are trying to find the amputated arm. Which of the following statements regarding this scenario is correct? A: Quickly move the patient to the ambulance, continue treatment, and wait for the other responders to recover his arm. B: You should transport the patient immediately, even if the other responders recover his arm before you depart the scene. C: If the patient’s arm has not been recovered by the time you are ready to transport, you should transport without delay. D: Your priority should be to recover the man’s arm because a vascular surgeon may be able to successfully reattach it.

C: If the patient’s arm has not been recovered by the time you are ready to transport, you should transport without delay.

A young male has a large laceration to his lateral neck, directly over his jugular vein. His airway is patent and his breathing is adequate. Your MOST immediate priority should be to: A: obtain vital signs to determine if he is hypotensive. B: perform a rapid assessment to detect other injuries. C: apply high-flow oxygen via a nonrebreathing mask. D: keep air out of the wound and control the bleeding.

D: keep air out of the wound and control the bleeding.

An adult patient opens his eyes in response to a painful stimulus, moans when you ask him questions, and pulls his arm away when you palpate it. What is his Glasgow Coma Scale (GCS) score? A: 6 B: 7 C: 9 D: 8

D: 8 Reason: The Glasgow Coma Score (GCS) assesses three neurologic parameters: eye opening, verbal response, and motor response. Your patient's GCS score is 8. For eye opening, he receives 2 points for opening his eyes in response to pain. For verbal response, he receives 2 points for moaning or making unintelligible sounds. For motor response, he receives 4 points for withdrawing to pain. The GCS is a valuable neurologic assessment tool; it should be reassessed frequently in seriously injured patients—especially patients with a head injury.

Which of the following is MOST indicative of decompensated shock in a trauma patient with internal bleeding? A: Restlessness B: Clammy skin C: Tachycardia D: Hypotension

D: Hypotension

A soft-tissue injury that results in a flap of torn skin is called a/an: A: abrasion. B: avulsion. C: incision. D: laceration.

B: avulsion

Initial treatment for a patient with external blood loss depends upon: A: his or her signs and symptoms. B: the amount of estimated blood loss. C: whether or not hypotension is present. D: his or her past medical history.

A: his or her signs and symptoms.

A 40-year-old man was hit in the nose during a fight. He has bruising under his left eye and a nosebleed. After taking standard precautions, you should:

ensure that he is sitting up and leaning forward

Prior to your arrival at the scene, a young female was removed from the water after being submerged for an unknown period of time. You should manage her airway appropriately while considering the possibility of: A: spinal injury. B: hyperthermia. C: airway obstruction. D: internal bleeding.

A: spinal injury.

In addition to high-flow oxygen, the MOST appropriate treatment for a patient with widespread full-thickness burns should include: A: moist; sterile dressings; burn ointment; and rapid transport. B: dry; sterile dressings; burn ointment; and rapid transport. C: dry, sterile dressings; warmth; and rapid transport. D: moist; sterile dressings; warmth; and rapid transport.

C: dry, sterile dressings; warmth; and rapid transport.

Following a head injury, a young female is semiconscious and is bleeding from the nose and left ear. You should: A: control the bleeding from her nose by pinching her nostrils closed. B: place a pressure dressing over her ear to prevent blood loss. C: insert a nasal airway to keep her tongue from blocking the airway. D: cover her ear and nose with a loose gauze pad to collect the blood.

D: cover her ear and nose with a loose gauze pad to collect the blood

Which of the following actions is MOST important when immobilizing a patient with a suspected spinal injury? A: Select and apply the appropriate size of extrication collar. B: Secure the patient’s head prior to immobilizing the torso. C: Check range of motion by asking the patient to move the head. D: A vest-style immobilization device should routinely be used.

A: Select and apply the appropriate size of extrication collar.

Basic shock treatment includes: A: applying oxygen, elevating the lower extremities per protocol, and providing warmth. B: applying and inflating the PASG, applying oxygen, and thermal management. C: elevating the lower extremities, applying and inflating the PASG, and applying oxygen. D: applying oxygen, elevating the upper body, and taking measures to prevent hypothermia.

A: applying oxygen, elevating the lower extremities per protocol, and providing warmth.

When assessing distal circulation in a patient with a swollen deformed femur, you should: A: ask the patient to wiggle his toes. B: touch his foot with a blunt object. C: assess the pulse behind the knee. D: palpate for a dorsalis pedis pulse.

D: palpate for a dorsalis pedis pulse.

During a soccer game, a 20-year-old man collided shoulder-to-shoulder with another player. He has pain and a noticeable anterior bulge to the left shoulder. Which of the following is the MOST effective method of immobilizing this injury? A: A sling to support the left arm and swathes to maintain downward traction B: A long board splint with the left arm immobilized in the extended position C: An air-inflatable splint with the left arm immobilized in the flexed position D: A sling to support the left arm and swathes to secure the arm to the body

D: A sling to support the left arm and swathes to secure the arm to the body

A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and severely deformed. Her leg is cold to the touch and you are unable to palpate a distal pulse. You should: A: apply gentle longitudinal traction as you straighten her leg and then apply a traction splint. B: manually stabilize her injury and contact medical control for further stabilization instructions. C: place a pillow behind her knee and stabilize the injury by applying padded board splints. D: carefully straighten her leg until you restore a distal pulse and then apply padded board splints.

B: manually stabilize her injury and contact medical control for further stabilization instructions.

Following penetrating trauma to the abdomen, a 50-year-old woman has a large laceration with a loop of protruding bowel. How should you manage this injury? A: Apply a tight pressure dressing to control any external bleeding. B: Apply a moist, sterile dressing covered by a dry, sterile dressing. C: Carefully replace the bowel and apply an occlusive dressing. D: Apply a dry, sterile dressing covered by an occlusive dressing.

B: Apply a moist, sterile dressing covered by a dry, sterile dressing

Which of the following is the MOST reliable indicator of a fracture to a spinal vertebra? A: Decreased grip strength in the upper extremities B: Lack of pain at the site of the injury C: Palpable pain at the site of the injury D: Decreased movement on one side of the body

C: Palpable pain at the site of the injury

In which of the following circumstances would external bleeding be the LEAST difficult to control? A: Lacerated brachial artery; BP of 140/90 mm Hg B: Lacerated carotid artery; BP of 90/50 mm Hg C: Lacerated jugular vein; BP of 100/60 mm Hg D: Lacerated femoral vein; BP of 70/40 mm Hg

D: Lacerated femoral vein; BP of 70/40 mm Hg

The pneumatic antishock garment may be indicated for patients with: A: pelvic instability and signs of shock. B: blunt chest trauma and hypotension. C: any severe injury above the nipple line. D: femur fractures and crackles in the lungs.

A: pelvic instability and signs of shock.

A 33-year-old male struck a parked car with his motorcycle and was ejected from the motorcycle. He was not wearing a helmet. He is unresponsive, has a depressed area to his forehead, bilaterally deformed femurs, and widespread abrasions with capillary bleeding. Which of the following statements regarding this patient is false? A: Internal hemorrhage cannot be controlled in the field and requires prompt surgical intervention. B: You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock. C: Femur fractures are a common injury when a motorcyclist is ejected from his or her motorcycle. D: You should suspect that the patient has a skull fracture and increased intracranial pressure.

B: You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock.

An unresponsive patient with multi-systems trauma has slow, shallow breathing; weak radial pulses; and severe bleeding from a lower extremity wound. You should direct your partner to: A: radio for a paramedic ambulance to respond to the scene. B: apply oxygen via nonrebreathing mask while you control the bleeding. C: assist the patient's ventilations while you control the bleeding. D: prepare the long spine board and straps for rapid spinal immobilization.

C: assist the patient's ventilations while you control the bleeding.

A 23-year-old unrestrained female struck the steering wheel with her chest when her passenger car collided with a tree at a high rate of speed. Your assessment reveals that she is conscious, but has signs of shock and an irregular pulse. The MOST appropriate treatment for this patient includes: A: applying an AED in case she develops cardiac arrest, high-flow oxygen, full spinal precautions, and rapid transport. B: high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport. C: insertion of an oral airway, assisted ventilations with a bag-mask device, full spinal precautions, and rapid transport. D: high-flow oxygen, summoning a paramedic unit to the scene to assess her cardiac rhythm, a cervical collar, and transport as soon as possible.

B: high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport.

A 19-year-old male was assaulted and has trauma to multiple body systems. After performing your primary assessment and treating any immediate life-threatening injuries, you should: A: transport at once and intercept with ALS. B: obtain a full set of baseline vital signs. C: perform a rapid head-to-toe assessment. D: fully immobilize his spine and transport.

C: perform a rapid head-to-toe assessment.

When caring for a critically injured patient, it is MOST appropriate to perform your secondary assessment: A: while you are en route to the hospital. B: immediately after taking baseline vital signs. C: after all life threats have been ruled out. D: immediately following the primary assessment.

A: while you are en route to the hospital.

Rapid extrication of a patient from an automobile should be performed by: A: maintaining support of the head, grasping the patient by the clothing, and rapidly removing the patient from the car. B: applying a vest-style extrication device and sliding the patient out of the car onto a long spine board for full immobilization. C: applying a cervical collar and removing the patient from the car using the direct carry method. D: applying a cervical collar, sliding a long spine board under the patient’s buttocks, and removing the patient from the car.

D: applying a cervical collar, sliding a long spine board under the patient’s buttocks, and removing the patient from the car.

28, 44,49,53

During your rapid assessment of a critically-injured patient, you should assess the chest for: A: crepitus and distention. B: symmetry and pain. C: rigidity and guarding. D: distention and guarding.

B: symmetry and pain.

Priority treatment for a large avulsion includes: A: cleaning the wound. B: immobilizing the injured area. C: assessing distal circulation. D: controlling any bleeding.

D: controlling any bleeding.

A gang member was cut on the left side of the neck during a fight and is bleeding heavily from the wound. His airway is patent and his breathing is adequate. You should immediately: A: apply high-flow oxygen via a nonrebreathing mask at 15 L/min. B: apply a tight pressure dressing and secure it in place with tape. C: perform a head-to-toe assessment to find and treat other injuries. D: cover the wound with an occlusive dressing and apply direct pressure.

D: cover the wound with an occlusive dressing and apply direct pressure.

A football player complains of severe neck pain and tingling in his arms and legs after being tackled. He is conscious and alert, has a patent airway, and is breathing adequately. He is in a supine position and is still wearing his helmet, which is tight-fitting. The MOST appropriate treatment for this patient includes: A: manually stabilizing his head, carefully removing his helmet, administering high-flow oxygen, applying a cervical collar, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. B: manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. C: carefully removing his helmet, manually stabilizing his head, applying a cervical collar, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer. D: manually stabilizing his head, leaving his helmet on, applying a vest-style spinal immobilization device, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.

B: manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.

Which of the following indicates that a patient is in decompensated shock? A: Tachycardia and tachypnea B: Diaphoresis and pallor C: Restlessness and anxiety D: Falling blood pressure

D: Falling blood pressure

During which part of your assessment would you MOST likely discover a small caliber gunshot wound to the back with minimal bleeding? A: Primary assessment B: General impression C: Rapid head-to-toe assessment D: Detailed secondary assessment

C: Rapid head-to-toe assessment

C: hemothorax Reason: You should suspect a hemothorax if a patient with chest trauma presents with shock, especially if the injury was caused by penetrating trauma. Hemothorax occurs when blood collects in the pleural space and compresses the lung, resulting in shock and respiratory compromise. Other signs include collapsed jugular veins (due to low blood volume), labored breathing, and decreased or absent breath sounds on the side of the injury. A pneumothorax (air in the pleural space) is also associated with difficulty breathing and unilaterally decreased or absent breath sounds; however, the jugular veins are usually not collapsed. If excessive air accumulates within the pleural space, however, pressure will shift across the mediastinum and affect the uninjured lung (tension pneumothorax); if this occurs, the jugular veins may become engorged (distended). Splenic injury is unlikely; the patient’s injury is on the right side and the spleen is on the left. A liver laceration can cause severe shock; however, it is not associated with unilaterally decreased breath sounds or labored breathing.

Which of the following is MOST indicative of decompensated shock in a trauma patient with internal bleeding? A: Clammy skin B: Tachycardia C: Restlessness D: Hypotension

D: Hypotension

A young male has an open abdominal wound through which a small loop of bowel is protruding. There is minimal bleeding. The BEST way to treat his injury is to: A: gently clean the exposed loop of bowel with warm sterile saline, carefully replace it back into the wound, and cover it with a dry sterile dressing. B: apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing. C: apply dry sterile gauze pads to the wound and then keep them continuously moist by pouring sterile saline or water on them throughout transport. D: cover the wound with a dry sterile trauma dressing and tightly secure it in place by circumferentially wrapping roller gauze around the abdomen.

B: apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing.

Which of the following is MOST indicative of compensated shock in an adult? A: Unresponsive, pallor, absent radial pulses, tachypnea B: Weak carotid pulse, cool skin, increased respiratory rate C: Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg D: Confusion, mottling, tachycardia, BP of 88/60 mm Hg

C: Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg

In contrast to an incision, a laceration: A: bleeds more severely. B: is a jagged cut. C: usually involves an artery. D: is a superficial injury.

B: is a jagged cut.

Damaged small blood vessels beneath the skin following blunt trauma causes: A: ecchymosis. B: cyanosis. C: mottling. D: hematoma.

A: ecchymosis

A patient experienced blunt chest trauma and has asymmetrical chest wall movement. This MOST likely indicates: A: decreased air movement into one lung. B: shallow breathing secondary to severe pain. C: accumulation of blood in both of the lungs. D: several ribs broken in numerous places.

A: decreased air movement into one lung.

A young male experienced a syncopal episode after working in the heat for several hours. He is conscious and alert; has cool, clammy skin; and complains of nausea and lightheadedness. You should: A: advise him to go home and rest. B: provide rapid cooling. C: transport him on his side. D: give him cold water to drink.

C: transport him on his side.

Which of the following devices is contraindicated in patients with blunt chest trauma? A: Oral airway B: Nasal airway C: Bag-mask device D: Oxygen-powered ventilator

D: Oxygen-powered ventilator

Hypoxia-induced unresponsiveness during a submersion injury is usually the result of: A: associated hypothermia. B: laryngospasm. C: water in the lungs. D: a cardiac dysrhythmia.

B: laryngospasm

A 5-year-old child in compensated shock secondary to severe vomiting and diarrhea would be expected to have: A: a weakly palpable carotid pulse. B: strong, bounding radial pulses. C: a slow capillary refill time. D: slow, shallow respirations.

C: a slow capillary refill time. | Xxxxx

In order to maintain neutral alignment of an 18-month-old child’s airway, you should: A: hyperextend the head. B: place a rolled towel behind the head. C: pad in between the shoulder blades. D: ensure that the head is slightly flexed.

C: pad in between the shoulder blades.

A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child’s age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury? A: Upper thorax injury B: Lower leg injury C: Pelvic injury D: Head injury

C: Pelvic injury

Which of the following is the MOST common cause of shock in infants and children? A: Dehydration B: Cardiac failure C: Accidental poisoning D: Severe allergic reaction

A: Dehydration

After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should: A: assess for a carotid pulse. B: immediately perform CPR. C: open the airway and ventilate. D: reanalyze the cardiac rhythm.

B: immediately perform CPR.

You receive a call for a 3-year-old girl with respiratory distress. When you enter her residence, you see the mother holding the child, who does not acknowledge your presence. This finding indicates that the child: A: is afraid of your presence. B: probably is sleeping. C: is reacting normally for her age. D: has severe hypoxia.

D: has severe hypoxia.

You are responding to a call for a 2-year-old child who fell from a second-story window. With the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child’s: A: abdomen. B: lower extremities. C: chest. D: head.

D: head

Immediately upon delivery of a newborn’s head, you should: A: suction the nose. B: suction the mouth. C: cover the eyes. D: dry the face.

B: suction the mouth

The MAIN reason why small children should ride in the backseat of a vehicle is because: A: the back of the front seat will provide a cushion during a crash. B: they are much less likely to be ejected from the vehicle. C: they can experience severe injury or death if the airbag deploys. D: their legs are highly prone to injury from striking the dashboard.

C: they can experience severe injury or death if the airbag deploys.

Appropriate treatment for an 18-year-old woman with severe vaginal bleeding may include all of the following, EXCEPT: A: high concentrations of oxygen. B: placing sterile dressings into the vagina. C: keeping her warm with blankets. D: covering the vagina with a trauma dressing.

B: placing sterile dressings into the vagina.

You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should: A: begin rapid cooling measures at once. B: allow the mother to take her child to the doctor. C: provide supportive care and transport. D: give him acetaminophen or ibuprofen.

C: provide supportive care and transport.

The appropriate technique for performing two-rescuer CPR on a 4-year-old child includes: A: 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute. B: 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs. C: 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds. D: 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.

B: 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.

Which of the following would MOST likely occur in conjunction with a breech presentation? A: Prolapsed umbilical cord B: Maternal hypertension C: Premature rupture of the amniotic sac D: Vertex presentation

A: Prolapsed umbilical cord

You should suspect physical abuse of a 4-year-old child if you observe: A: that the child clings to his or her parent. B: bruises to the anterior tibial area. C: purple and yellow bruises to the thighs. D: curious siblings who are watching you.

C: purple and yellow bruises to the thighs.

You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should: A: insert a nasopharyngeal airway and increase the oxygen flow. B: begin positive-pressure ventilations and reassess the child. C: lower the extremities and reassess the child. D: listen to the lungs with a stethoscope for abnormal breath sounds.

C: lower the extremities and reassess the child.

Which artery should you palpate when assessing for a pulse in an unresponsive 6-month-old patient? A: Femoral B: Radial C: Brachial D: Carotid

C: Brachial

Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn? A: Initiate positive-pressure ventilations. B: Provide blow-by oxygen with oxygen tubing. C: Assess the newborn’s skin condition and color. D: Start chest compressions and contact medical control.

A: Initiate positive-pressure ventilations.

A 30-year-old woman has severe lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect: A: a ruptured ovarian cyst. B: a spontaneous abortion. C: an ectopic pregnancy. D: a normal pregnancy.

C: an ectopic pregnancy.

When you begin to assess a woman in labor, she states that her contractions are occurring every 4 to 5 minutes and lasting approximately 30 seconds each. Which of the following questions would be MOST appropriate to ask next? A: Have you had regular prenatal care? B: How many other children do you have? C: At how many weeks gestation are you? D: Has your bag of waters broken yet?

C: At how many weeks gestation are you?

The MOST important initial steps of assessing and managing a newborn include: A: clearing the airway and keeping the infant warm. B: drying and warming the infant and obtaining an APGAR score. C: suctioning the airway and obtaining a heart rate. D: keeping the infant warm and counting respirations.

A: clearing the airway and keeping the infant warm.

Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert and her vital signs are stable. Treatment for her should include: A: treating her for shock and providing rapid transport. B: administering oxygen and massaging the uterus. C: massaging the uterus if signs of shock develop. D: carefully packing the vagina with sterile dressings.

B: administering oxygen and massaging the uterus.

A 6-year-old boy complains of pain to the right lower quadrant of his abdomen. Assessment of this child's abdomen should include: A: auscultating bowel sounds for 2 minutes. B: avoiding palpation of the abdomen. C: palpating the right lower quadrant first. D: palpating the left upper quadrant first.

D: palpating the left upper quadrant first.

A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for: A: convulsions. B: hypotension. C: combativeness. D: respiratory distress.

A: convulsions

You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be: A: taking her temperature to see how high it is. B: determining if the child has a history of croup. C: preparing to treat her for a febrile seizure. D: assessing the need for ventilation assistance.

D: assessing the need for ventilation assistance.

A 9-year-old girl was struck by a car while she was crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs has MOST likely been injured? A: Spleen B: Kidney C: Pancreas D: Liver

A: Spleen

You should assist with the delivery of the baby's head by: A: placing your fingers on the bony part of the skull and applying gentle pressure. B: carefully rotating its head to where it is facing up when it delivers. C: placing the palm of your hand firmly against the back of the baby’s skull. D: grasping each side of the baby’s head and gently pulling to facilitate delivery.

A: placing your fingers on the bony part of the skull and applying gentle pressure.

When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to: A: explain to the patient that she must be examined. B: ask a female EMT to attempt to assess the patient. C: transport the patient without performing an assessment. D: obtain a signed refusal and return to service.

B: ask a female EMT to attempt to assess the patient.

You are assessing a 5-year-old boy with major trauma. His blood pressure is 70/40 mm Hg and his pulse rate is 140 beats/min. and weak. The child's blood pressure: A: suggests increased intracranial pressure. B: reflects adequate compensation. C: indicates decompensated shock. D: is appropriate based on his age.

C: indicates decompensated shock.

In contrast to the contractions associated with true labor, Braxton-Hicks contractions: A: do not increase in intensity and are alleviated by a change in position. B: may be intensified by activity and are accompanied by a pink discharge. C: consistently become stronger and are not alleviated by changing position. D: generally follow rupture of the amniotic sac and occur with regularity.

A: do not increase in intensity and are alleviated by a change in position.

When is it MOST appropriate to clamp and cut the umbilical cord? A: After the placenta has completely delivered B: Before the newborn has taken its first breath C: Immediately following delivery of the newborn D: As soon as the cord has stopped pulsating

D: As soon as the cord has stopped pulsating

Upon delivery of the baby’s head, you note that the umbilical cord is wrapped around its neck. You should: A: make one attempt to gently remove the cord from around its neck. B: immediately clamp and cut the cord and continue the delivery. C: keep the cord warm and moist and transport without delay. D: give the mother high-flow oxygen and transport her on her side.

A: make one attempt to gently remove the cord from around its neck.

Which of the following is a sign of an altered mental status in a small child? A: Fear of the EMT's presence. B: Consistent eye contact with the EMT. C: Inattention to the EMT’s presence. D: Recognition of the parents.

C: Inattention to the EMT’s presence.

During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. You should: A: ask the mother to take short, quick breaths until you arrive at the hospital. B: advise your partner to stop the ambulance and assist with the delivery. C: allow the head to deliver and check for the location of the cord. D: apply gentle pressure to the baby's head and notify the hospital immediately.

B: advise your partner to stop the ambulance and assist with the delivery.

Which of the following statements regarding pediatric anatomy is correct? A: The occiput is proportionately larger when compared to an adult. B: Airway obstruction is common in children because of their large uvula. C: The child’s trachea is more rigid and less prone to collapse. D: Relative to the overall size of the airway, a child’s epiglottis is smaller.

A: The occiput is proportionately larger when compared to an adult.

Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include: A: positive-pressure ventilation, chest compressions, and rapid transport. B: high-flow oxygen via nonrebreathing mask and rapid transport. C: assisted ventilation with a bag-mask device and rapid transport. D: back slaps and chest thrusts while attempting artificial ventilations.

A: positive-pressure ventilation, chest compressions, and rapid transport.

A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves: A: ventilations with a flow-restricted, oxygen-powered device. B: a nonrebreathing mask with the flow rate at 6 to 8 L/min. C: gently restraining her and assisting her ventilations. D: asking the mom to hold an oxygen mask near her face.

D: asking the mom to hold an oxygen mask near her face.

A 29-year-old woman, who is 38 weeks pregnant, presents with heavy vaginal bleeding, a blood pressure of 70/50 mm Hg, and a heart rate of 130 beats/min. She is pale and diaphoretic, and denies abdominal cramping or pain. Her signs and symptoms are MOST consistent with a/an: A: placenta previa. B: ruptured ovarian cyst. C: ruptured ectopic pregnancy. D: abruptio placenta.

A: placenta previa.

After the baby’s head delivers, it is usually tilted: A: posteriorly, face down. B: with the face up. C: anteriorly, with the chin up. D: posteriorly, to one side.

D: posteriorly, to one side.

Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord? A: Left side with legs elevated B: Supine with hips elevated C: Supine with legs elevated D: Left lateral recumbent

B: Supine with hips elevated

A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. The appropriate compression to ventilation ratio for this child is: A: 30:2 B: 5:1 C: 15:2 D: 3:1

A: 30:2

You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child? A: Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring. B: Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given. C: Oxygen via nonrebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport. D: Oxygen via nonrebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.

A: Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Supplemental oxygen via the blow-by technique is MOST appropriate for a child who presents with respiratory difficulty and: A: is breathing with a significant reduction in tidal volume. B: has facial cyanosis and a decreased level of consciousness. C: is agitated, tachycardic, and clinging to his or her parent. D: has a heart rate of 70 beats/min and signs of physical exhaustion.

C: is agitated, tachycardic, and clinging to his or her parent.

A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing: A: a condition unrelated to pregnancy. B: preeclampsia. C: a hypertensive emergency. D: gestational diabetes.

B: preeclampsia

In which of the following situations would the EMT MOST likely deliver a baby at the scene? A: Contractions are 8 to 10 minutes apart and irregular. B: The amniotic sac has ruptured and contractions occur regularly. C: A tornado has struck and blocked the only route to the hospital. D: The hospital is 15 miles away and crowning is not present.

C: A tornado has struck and blocked the only route to the hospital.

Which of the following injuries is MOST indicative of child abuse? A: Burned hand with splash marks B: Multiple bruises to the shins C: Bruising to the upper back D: Small laceration to the chin

C: Bruising to the upper back

A child typically begins to develop stranger anxiety when he or she is a/an: A: infant. B: neonate. C: preschooler. D: toddler.

D: toddler

A 5-year-old child experienced partial-thickness burns to his head, anterior chest, and both upper extremities. What percentage of his total body surface area has been burned? A: 63% B: 72% C: 45% D: 54%

C: 45%

You and your partner are performing CPR on an infant with suspected sudden infant death syndrome (SIDS). An important aspect in dealing with such cases is: A: remembering that most infants with SIDS can be successfully resuscitated. B: carefully inspecting the environment in which the infant was found. C: focusing all of your attention on the infant, with little parental interaction. D: discouraging the presence of the parents during your resuscitation attempt.

B: carefully inspecting the environment in which the infant was found.

Which of the following statements regarding the length-based resuscitation tape measure is correct? A: The resuscitation tape estimates a child’s age based on his or her height. B: The tape measure can be used in children who weigh up to 75 pounds. C: It is not a reliable tool in children who are less than 5 years of age. D: The red end of the tape measure is placed at the heel of the child’s foot.

B: The tape measure can be used in children who weigh up to 75 pounds.

Prevention of cardiac arrest in infants and small children should focus primarily on: A: avoiding upsetting the child. B: keeping the child warm. C: ensuring adequate ventilation. D: providing immediate transport.

C: ensuring adequate ventilation.

After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of: A: 8 to 10 breaths/min. B: 10 to 12 breaths/min. C: 6 to 8 breaths/min. D: 12 to 20 breaths/min.

A: 8 to 10 breaths/min.

You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred? A: Allergic reaction B: Acute asthma attack C: Heat illness D: Poison oak exposure

A: Allergic reaction

Your assessmment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first? A: Begin artificial ventilations. B: Resuction the mouth. C: Begin chest compressions. D: Briskly dry off the infant.

A: Begin artificial ventilations.

The function of the uterus is to: A: house the fetus as it grows for 40 weeks. B: provide a cushion and protect the fetus from infection. C: dilate and expel the baby from the cervix. D: provide oxygen and other nutrients to the fetus.

A: house the fetus as it grows for 40 weeks.

You will know that the third stage of labor has begun when: A: the entire baby has delivered. B: the placenta has delivered. C: the mother’s contractions become regular. D: the baby’s head is visible at the vaginal opening.

A: the entire baby has delivered.

Oxygen and other nutrients are transferred to the developing fetus via the: A: uterine blood vessels. B: umbilical vein. C: umbilical arteries. D: amniotic fluid.

B: umbilical vein.

A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should: A: remove the tracheostomy tube and clean it. B: carefully suction the tracheostomy tube. C: ventilate through the tracheostomy tube. D: place an oxygen mask over the tracheostomy tube.

B: carefully suction the tracheostomy tube.

Your assessment of a mother in labor reveals that a fetal limb is protruding from the vagina. Management of this situation should include: A: positioning the mother in a semi-Fowler’s position, administering oxygen, and providing transport. B: giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur. C: applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord. D: positioning the mother with her hips elevated, administering high-flow oxygen, and providing transport.

D: positioning the mother with her hips elevated, administering high-flow oxygen, and providing transport.

The preferred method for inserting an oropharyngeal airway in a small child is to: A: depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. B: insert the airway as you would in an adult, but use an airway that is one size smaller than you would normally use. C: insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees. D: open the airway with the tongue-jaw lift maneuver and insert the airway until you meet slight resistance.

A: depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.

Of the following, the MOST detrimental effect of gastric distention in infants and children is: A: decreased ventilatory volume. B: tracheal rupture. C: less effective chest compressions. D: acute rupture of the diaphragm.

A: decreased ventilatory volume.

General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include: A: placing the child supine and palpating the abdomen. B: palpating the painful area of the abdomen first. C: examining the child in the parent’s arms. D: separating the child from the parent to ensure a reliable examination.

C: examining the child in the parent’s arms.

A prolapsed umbilical cord is dangerous because the: A: baby’s head may compress the cord, cutting off its supply of oxygen. B: cord might pull the placenta from the uterine wall during delivery. C: mother may die of hypoxia due to compromised placental blood flow. D: cord may be wrapped around the baby’s neck, causing strangulation.

A: baby’s head may compress the cord, cutting off its supply of oxygen

The purpose of the pediatric assessment triangle is to: A: determine if the child’s problem is respiratory or circulatory in nature. B: form a general impression of the child without touching him or her. C: identify if the child has a medical condition or a traumatic injury. D: detect immediate life threats through a quick hands-on assessment.

B: form a general impression of the child without touching him or her.

You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should: A: perform compressions and ventilations at a ratio of 30:2. B: hyperventilate her because she is severely hypoxic. C: allow the chest to fully recoil in between compressions. D: attach the AED pads after 5 minutes of high-quality CPR.

C: allow the chest to fully recoil in between compressions.

Management for a women who presents with a prolapsed umbilical cord includes all of the following, EXCEPT: A: placing the mother in a position that elevates her hips. B: relieving pressure off of the cord by gently pulling on it. C: lifting the baby’s head off of the umbilical cord. D: ensuring that the cord stays moist during transport.

B: relieving pressure off of the cord by gently pulling on it.

Which of the following is a more reliable indicator of perfusion in children than it is in adults? A: Heart rate B: Capillary refill C: Respiratory rate D: Blood pressure

B: Capillary refill

After clearing the airway of a newborn who is not in distress, it is MOST important for you to: A: obtain an APGAR score. B: apply blow-by oxygen. C: clamp and cut the cord. D: keep the newborn warm.

D: keep the newborn warm.

Which of the following signs is MOST indicative of inadequate breathing in an infant? A: Expiratory grunting B: Sunken fontanelles C: Heart rate of 130 beats/min D: Abdominal breathing

A: Expiratory grunting

The MOST effective way to prevent cardiopulmonary arrest in a newborn is to: A: suction its mouth and nose every 3 minutes. B: ensure effective oxygenation and ventilation. C: give blow-by oxygen as soon as it is born. D: perform an Apgar assessment every 5 minutes.

B: ensure effective oxygenation and ventilation.

You are dispatched to a residence for a child having a seizure. When you arrive at the scene, the 4-year-old child’s grandfather tells you that he has had several full body seizures over the past 20 minutes, but never woke up in between the seizures. The child’s skin is hot and flushed. This is MOST indicative of: A: an absence seizure. B: status epilepticus. C: a focal motor seizure. D: a febrile seizure.

B: status epilepticus

A newborn is considered to be premature if it: A: is born before 37 weeks gestation. B: is born to a heroin-addicted mother. C: weighs less than 6.5 pounds. D: has meconium in or around its mouth.

A: is born before 37 weeks gestation.

Which of the following assessment parameters is a more reliable indicator of perfusion in infants than adults? A: Blood pressure B: Pulse quality C: Capillary refill D: Level of orientation

C: Capillary refill

A 6-year-old boy presents with a high fever, a headache, and a stiff neck. He is conscious, but is not acting as a normal 6-year-old boy should. His mother told you that he vomited once before your arrival. You should be MOST concerned with: A: treating him for severe dehydration. B: the risk of permanent neurological damage. C: the potential for a febrile seizure. D: performing a secondary assessment at the scene.

B: the risk of permanent neurological damage.

While performing a visual inspection of a 30-year-old woman in labor, you can see the umbilical cord at the vaginal opening. After providing high-flow oxygen, you should: A: place the mother on her left side and provide rapid transport. B: massage the uterus to facilitate delivery of the fetus. C: elevate the mother’s lower extremities and provide rapid transport. D: relieve pressure from the cord with your gloved fingers.

D: relieve pressure from the cord with your gloved fingers.

Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. You should: A: start CPR if the heart rate is less than 80 beats/min. B: gently flick the soles of its feet for up to 60 seconds. C: immediately resuction its mouth and nose. D: begin ventilations with a bag-mask device.

D: begin ventilations with a bag-mask device.

A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should: A: give 15 mL of ipecac and contact medical control. B: administer 1 g/kg of activated charcoal. C: give oxygen and perform a head-to-toe exam. D: contact poison control and give him oxygen.

D: contact poison control and give him oxygen.

You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should: A: give the newborn high-flow oxygen via a nonrebreathing mask and transport. B: massage the lower part of the mother’s uterus until the placenta delivers. C: reassess the newborn every 5 minutes and transport after the placenta delivers. D: keep the newborn warm, give oxygen to the mother if needed, and transport.

D: keep the newborn warm, give oxygen to the mother if needed, and transport

Upon delivery of a baby’s head, you see that the umbilical cord is wrapped around its neck. Initial treatment for this condition should include: A: gently pulling on the cord to facilitate removal. B: trying to remove the cord from around the neck. C: clamping and cutting the umbilical cord. D: keeping the cord moist and providing rapid transport.

B: trying to remove the cord from around the neck.

During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should: A: insert your gloved fingers into the vagina and try to turn the baby. B: gently push the protruding arm back into the vagina. C: encourage the mother to push and give her high-flow oxygen. D: cover the arm with a sterile towel and transport immediately.

D: cover the arm with a sterile towel and transport immediately.

You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before, but had a miscarriage at 19 weeks. You should document her obstetric history as: A: gravida 1, para 1. B: gravida 2, para 0. C: gravida 2, para 1. D: gravida 0, para 2.

C: gravida 2, para 1

``` A 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her: A: in the prone position B: on her left side. C: in a semisitting position. D: in the supine position. ```

B: on her left side.

Of the following, the MOST detrimental effect of gastric distention in infants and children is: A: tracheal rupture. B: acute rupture of the diaphragm. C: less effective chest compressions. D: decreased ventilatory volume.

D: decreased ventilatory volume.

You are dispatched to a residence where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should: A: tell the neighbor to continue rescue breathing as you apply the AED. B: ask the neighbor how long the child was submerged under the water. C: begin chest compressions and reassess in 2 minutes. D: assess for a carotid pulse for no more than 10 seconds.

D: assess for a carotid pulse for no more than 10 seconds.

Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert and her vital signs are stable. Treatment for her should include: A: carefully packing the vagina with sterile dressings. B: massaging the uterus if signs of shock develop. C: administering oxygen and massaging the uterus. D: treating her for shock and providing rapid transport.

C: administering oxygen and massaging the uterus.

Which of the following techniques represents the MOST appropriate method of opening the airway of an infant with no suspected neck injury? A: Perform the technique as you would for an older child or adult. B: Tilt the head back without hyperextending the neck. C: Lift up the chin and hyperextend the neck. D: Gently lift the chin while maintaining slight flexion of the neck.

B: Tilt the head back without hyperextending the neck.

Which of the following is an abnormal finding? A: Systolic BP of 100 mm Hg in a 10-year-old child B: Rapid, irregular breathing in a newly born infant C: Heart rate of 80 beats/min in a 3-month-old infant D: Respiratory rate of 26 breaths/min in a 2-year-old child

C: Heart rate of 80 beats/min in a 3-month-old infant

If a woman is having her first child, the first stage of labor: A: is shorter than in women who have had other children. B: is typically very short and only lasts about 2 hours. C: is usually the longest and lasts an average of 16 hours. D: generally does not allow time for you to transport.

C: is usually the longest and lasts an average of 16 hours.

When assessing a 30-year-old female who was sexually assaulted, it is MOST important for you to: A: have a female EMT perform the assessment. B: recognize that the patient is a walking crime scene. C: ensure that all life-threatening injuries are treated. D: discourage her from showering or changing clothes.

C: ensure that all life-threatening injuries are treated.

The transition phase of the pediatric assessment process would be the LEAST appropriate if: A: your transport time is greater than 30 minutes. B: the child is unstable and needs rapid transport. C: a parent is available to help keep the child calm. D: you determine that the child’s condition is stable.

B: the child is unstable and needs rapid transport.

You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before, but had a miscarriage at 19 weeks. You should document her obstetric history as: A: gravida 2, para 0. B: gravida 1, para 1. C: gravida 2, para 1. D: gravida 0, para 2.

A: gravida 2, para 0.

A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect: A: foreign body airway obstruction. B: croup. C: epiglottitis. D: lower respiratory infection.

A: foreign body airway obstruction.

Which of the following statements regarding crowning is correct? A: It is safe to transport the patient during crowning if the hospital is close. B: Crowning represents the end of the second stage of labor. C: Crowning always occurs immediately after the amniotic sac has ruptured. D: Gentle pressure should be applied to the baby’s head during crowning.

D: Gentle pressure should be applied to the baby’s head during crowning

You are assessing a 5-year-old boy with major trauma. His blood pressure is 70/40 mm Hg and his pulse rate is 140 beats/min. and weak. The child's blood pressure: A: is appropriate based on his age. B: indicates decompensated shock. C: suggests increased intracranial pressure. D: reflects adequate compensation.

B: indicates decompensated shock.

Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color, includes: A: supplemental oxygen and transport. B: assisted ventilations, back slaps, and transport. C: oxygen, back slaps, and transport. D: subdiaphragmatic thrusts until the object is expelled.

A: supplemental oxygen and transport.

Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child? A: Skin color and temperature B: Systolic blood pressure C: Presence of peripheral pulses D: Capillary refill time

B: Systolic blood pressure

You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation? A: Transport the child to the hospital regardless of the parents’ wishes. B: Call the police and have the parents arrested. C: Advise the parents that the child needs to be transported. D: Inform the parents of your suspicions.

C: Advise the parents that the child needs to be transported.

Which of the following statements regarding two-rescuer child CPR is correct? A: Compress the chest with one or two hands to a depth that is equal to one third the diameter of the chest B: The chest should not be allowed to fully recoil in between compressions as this may impair venous return C: A compression to ventilation ratio of 15:2 should be delivered without pauses in compressions to deliver ventilations D: The chest should be compressed with one hand and a compression to ventilation ratio of 30:2 should be delivered

A: Compress the chest with one or two hands to a depth that is equal to one third the diameter of the chest

The 5-minute Apgar assessment of a newborn reveals a heart rate of 130 beats/min, cyanosis to the hands and feet, and rapid respirations. The infant cries when you flick the soles of its feet and resists attempts to straighten its legs. These findings equate to an Apgar score of: A: 10 B: 8 C: 9 D: 7

C: 9

Which of the following signs or symptoms is more common in children than adults following an isolated head injury? A: Changes in pupillary reaction B: Nausea and vomiting C: Altered mental status D: Tachycardia and diaphoresis

B: Nausea and vomiting

Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment this child includes: A: offering oxygen and providing transport. B: rapidly cooling the child in cold water. C: keeping the child warm and providing transport. D: allowing the parents to transport the child.

A: offering oxygen and providing transport.

A sudden onset of respiratory distress in a 5-year-old child with no fever is MOST likely the result of: A: infection of the lower airways. B: inflammation of the upper airway. C: a foreign body airway obstruction. D: a progressive upper airway infection.

C: a foreign body airway obstruction.

Which of the following signs is MOST indicative of inadequate breathing in an infant? A: Expiratory grunting B: Abdominal breathing C: Heart rate of 130 beats/min D: Sunken fontanelles

A: Expiratory grunting

Seizures in children MOST often are the result of: A: a temperature greater than 102°F. B: an abrupt rise in body temperature. C: a life-threatening infection. D: an inflammatory process in the brain.

B: an abrupt rise in body temperature. | Xxxxx

When driving in emergency mode on a multilane highway, the emergency vehicle operator should keep to the: A: extreme right lane so motorists can yield to the left. B: right shoulder so that traffic flow is not disrupted. C: center lane so the traffic can flow around the ambulance. D: extreme left lane so motorists can yield to the right.

D: extreme left lane so motorists can yield to the right.

Proper guidelines for safe reaching include all of the following, EXCEPT: A: avoiding hyperextension of your back. B: avoiding twisting of your back. C: keeping your back in a locked-in position. D: reaching no more than 30” in front of your body.

D: reaching no more than 30” in front of your body.

When sizing up a motor-vehicle crash in which a small passenger car struck a bridge pillar and sustained severe damage, you should: A: ensure that there are no hazards and then try to open one of the doors. B: break the driver’s side window and gain rapid access to the patient. C: disconnect the battery cables and then request heavy extrication tools. D: immediately approach the vehicle and determine if it is stable.

A: ensure that there are no hazards and then try to open one of the doors.

After arriving at a mass-casualty incident where other ambulances are already present, you should notify the dispatcher and then: A: report to the staging area. B: repeat the triage process. C: obtain information from the fire service commander. D: initiate care for the most critically injured patients.

A: report to the staging area.

After assisting a patient with her epinephrine auto-injector, you should: A: place the device in a puncture-proof container. B: give it to the patient to have it refilled. C: replace the cover and place it in the trash can. D: place the device in a red biohazard bag.

A: place the device in a puncture-proof container.

When requesting medical direction for a patient who was involved in a major motor-vehicle accident, you should do all of the following, EXCEPT: A: question an order if it seems to be inappropriate. B: use proper medical terminology when speaking. C: use radio codes to describe the situation. D: describe the severity of damage to the patient’s vehicle.

C: use radio codes to describe the situation.

Which of the following vaccinations is NOT currently recommended by the Centers for Disease Control and Prevention (CDC)? A: Tetanus, diphtheria, and pertussis B: Smallpox C: Measles, mumps, rubella D: Hepatitis B

B: Smallpox

You and your partner have secured a trauma patient to a long backboard and are preparing to lift the backboard onto the stretcher. When doing so, you should: A: ensure that the strongest EMT is positioned at the head of the backboard. B: lift the backboard from the sides instead of from the ends. C: be sure to lift the backboard with the powerful muscles of your back. D: recall that most of the patient’s weight is at the foot end of the backboard.

A: ensure that the strongest EMT is positioned at the head of the backboard.

Proper body mechanics when lifting and moving a patient include: A: maintaining a slight curvature of your back. B: twisting at the waist when moving around a corner. C: using the muscles of your lower back to lift. D: keeping the weight as close to you as possible.

D: keeping the weight as close to you as possible.

A conscious and alert 92-year-old woman with chest pain is refusing EMS treatment and transport to the hospital. Her family insists that you transport her. This situation is MOST appropriately managed by: A: obtaining a signed refusal from a family member. B: transporting the patient as you explain your actions. C: transporting the patient as the family wishes. D: advising the patient of the risks of refusing care.

D: advising the patient of the risks of refusing care.

At the scene of a mass-casualty incident, you notice a bystander who is emotionally upset. An appropriate action to take would be to: A: assign the bystander a simple, non-patient-care task. B: notify the police and have the bystander removed. C: tell the bystander to leave the scene at once. D: have the bystander assist you with patient care.

A: assign the bystander a simple, non-patient-care task.

Upon arriving at the scene of an overturned tanker truck, you see a clear liquid leaking from the rear of the tank. The driver is still in the vehicle and you can see that his face is covered with blood. You should: A: ensure that the ambulance is downwind and downhill from the tanker. B: request fire department assistance if they are not already en route. C: put on gloves, a gown, and a mask and quickly remove the driver. D: approach the rear of the tanker to identify the type of fluid leaking.

B: request fire department assistance if they are not already en route.

You arrive at the scene of an 80-year-old woman who is weak and lightheaded. Her son, who called 911, is present and asks you to transport his mother to the hospital. You should: A: assess the woman and determine if she wishes to be treated and transported. B: advise the son that he can probably drive his mother to the hospital. C: comply with the son’s request and transport the woman to the hospital. D: take the woman’s vital signs and apply supplemental oxygen if necessary.

A: assess the woman and determine if she wishes to be treated and transported.

Your partner, a veteran EMT of 20 years, has been showing up late to work with increasing frequency over the last several shifts. When he arrives, he is in a bad mood and is clearly not interested in being at work. His behavior is MOST consistent with: A: drug use. B: acute stress. C: burnout. D: delirium.

C: burnout

While caring for an injured patient, you remove blood-soaked clothing in order to treat his injuries. You should dispose of the clothing by: A: placing it in a biohazard bag. B: leaving it at the scene. C: placing it in a regular trash can. D: leaving it at the hospital.

A: placing it in a biohazard bag.

Upon arriving at a scene in which a tanker truck overturned and is spilling an unknown liquid on the ground, you should: A: turn off your warning lights. B: stay downhill from the scene. C: quickly identify the material. D: park upwind from the scene.

D: park upwind from the scene.

As you step out of the ambulance at the scene of a nighttime motor vehicle crash on the highway, your MOST immediate concern should be: A: rapid assessment of all injured patients. B: the presence of oncoming traffic. C: placing safety flares by the ambulance. D: whether the car will catch on fire.

B: the presence of oncoming traffic.

As soon as you begin transport of a patient to the hospital, you should: A: conduct a detailed examination. B: advise dispatch of your status. C: contact medical control. D: notify the receiving facility.

B: advise dispatch of your status.

Following an apparent terrorist attack, numerous patients present with shortness of breath and persistent coughing. A green haze is noted in the area in which the patients are located. Which of the following agents should you suspect they were exposed to? A: V agent (VX) B: Phosgene oxime C: Chlorine (CL) D: Tabun (GA)

C: Chlorine (CL)

According to the United States Department of Transportation (USDOT), minimum staffing for a basic life support ambulance includes: A: at least one EMT in the patient compartment. B: at least two EMTs in the patient compartment. C: a minimum of two EMTs in the ambulance. D: an EMT who functions as the driver.

A: at least one EMT in the patient compartment.

Following a call in which a 6-week-old infant in cardiac arrest did not survive, your partner is exhibiting significant anxiety and irritability. How can you MOST effectively help him? A: Tell him that he needs psychiatric help. B: Recommend at least 12 hours of sleep. C: Allow him to voice his feelings to you. D: Report his behavior to the medical director.

C: Allow him to voice his feelings to you.

The safest emergency vehicle operator is one who: A: is physically fit. B: drives with due regard. C: has a positive attitude. D: drives with lights and siren.

B: drives with due regard.

When the incident command system is activated at the scene, you should expect to: A: report back to your section officer in between assignments. B: receive instructions and then function independently. C: be assigned one responsibility for the duration of the incident. D: be immediately directed to the established treatment area.

A: report back to your section officer in between assignments.

You arrive at the scene of a young male who was stabbed when a burglar broke into his house. Law enforcement officers are present. The patient, who is unresponsive with several stab wounds to the chest, is lying in a narrow space between a couch and coffee table. You should: A: move the coffee table, document what you did, and begin treatment. B: obtain permission from law enforcement before moving any furniture. C: treat the patient where he is, without moving the coffee table. D: move the coffee table, begin patient care, and notify a police officer.

D: move the coffee table, begin patient care, and notify a police officer.

Failure of the EMT to obtain consent from a responsive patient before taking his or her blood pressure may constitute: A: battery. B: assault. C: abandonment. D: negligence.

A: battery

When is it MOST appropriate to complete your patient care report for a critically ill or injured patient? A: Promptly after the primary assessment B: Any time before you arrive at the hospital C: After the ambulance has been restocked at the station D: As soon as all patient care activities are completed

D: As soon as all patient care activities are completed

In which of the following situations is an emergency move of a patient from his or her wrecked vehicle clearly indicated? A: Your primary assessment reveals that the patient has signs and symptoms of shock. B: Gas is leaking from the vehicle and there is a small fire in the engine compartment. C: The patient appears unresponsive and a high-power line is lying across the hood. D: The patient has an altered mental status; diaphoresis; and rapid, shallow breathing.

B: Gas is leaking from the vehicle and there is a small fire in the engine compartment.

You receive a call at 3:00 a.m. for a patient who is slumped over the steering wheel of his car, which is parked on the shoulder of the road. Your unit and a police officer arrive at the scene at the same time. You should: A: shine a spotlight in the side view mirror of the patient’s vehicle. B: stay in your unit until the police officer checks the patient. C: approach the vehicle from the front to ensure maximum visibility. D: park the ambulance 25 feet in front of the patient’s vehicle.

B: stay in your unit until the police officer checks the patient.

How does a unified incident command system differ from a single incident command system? A: In a unified incident command system, plans are made in advance by all agencies that assume a shared responsibility for decision making B: In a unified incident command system, a single incident commander is identified and will function as such, regardless of the type of incident C: In a unified incident command system, a single person is in charge of the entire incident, even if multiple agencies respond to the scene D: In a unified incident command system, one agency with several incident commanders has the majority of responsibility for incident management

A: In a unified incident command system, plans are made in advance by all agencies that assume a shared responsibility for decision making

Which of the following creates a secure loop at the working end of a rope, which can be used to attach the end of the rope to a fixed object or a piece of equipment? A: Clove hitch B: Figure eight on a bite C: Figure eight knot D: Half hitch

B: Figure eight on a bite

A patient presents with severe bradycardia, hypersalivation, vomiting, and excessive tearing. Which of the following agents would MOST likely cause his signs and symptoms? A: Phosgene B: Soman C: Chlorine D: Anthrax

B: Soman

During the triage process, which of the following injuries or conditions would classify a patient as a high priority? A: A large avulsion to the arm and an altered mental status B: Pulselessness and apnea C: Unilateral femur fracture and tachycardia D: Partial-thickness burns with no respiratory difficulty

A: A large avulsion to the arm and an altered mental status

Upon arriving at the scene of a multiple vehicle crash, you can see that at least two patients have been ejected from their vehicles. You should: A: treat the most critical patient first. B: request at least one more ambulance. C: gather all of the patients together. D: immediately triage the two patients.

B: request at least one more ambulance.

The EMT should avoid focusing all of his or her attention on a single critical patient during the triage process because: A: all of his or her supplies will likely be depleted on that one patient. B: the patient will most likely die before he or she can be transported. C: three EMTs are required to effectively manage a critical patient. D: other patients may die of problems that may have been corrected.

D: other patients may die of problems that may have been corrected.

A 52-year-old woman crashed her minivan into a tree. She is pinned at the legs by the steering wheel and is semiconscious. After gaining access to the patient, you should: A: perform a primary assessment and provide any life-saving care before extrication. B: immediately apply high-flow oxygen to the patient and allow extrication to begin. C: have the fire department disentangle the patient and quickly remove her from the car. D: rapidly assess her from head to toe, obtain vital signs, and apply a cervical collar.

A: perform a primary assessment and provide any life-saving care before extrication.

Which of the following practices will provide you with the highest degree of safety when responding to an emergency call? A: Always requesting fire department assistance B: Routinely using the lights and siren C: Asking the police to escort you to the scene D: Wearing your seatbelt and shoulder harness

D: Wearing your seatbelt and shoulder harness

You are caring for a 6-year-old child with a swollen, painful deformity to the left forearm. As you communicate with the parents of this child, you should: A: use appropriate medical terminology at all times. B: tell them that the child will be transported to the hospital. C: ask them repeatedly how the child was injured. D: make sure that they remain aware of what you are doing.

D: make sure that they remain aware of what you are doing.

Medical control has ordered you to administer one tube of oral glucose to a hypoglycemic patient. Immediately after receiving this order, you should: A: ask medical control to repeat the order word for word. B: document the order on the prehospital care report. C: administer the medication and reassess the patient. D: repeat the order back to medical control word for word.

D: repeat the order back to medical control word for word.

As an EMT, your primary responsibility is to: A: transport all patients to the hospital. B: provide competent patient care. C: ensure the safety of your partner. D: keep yourself as safe as possible.

D: keep yourself as safe as possible.

While en route back to your station from the emergency department, you discover that you forgot to include vital patient information on the front of your patient care report (PCR). Having left a copy of your PCR with the emergency department staff, you should: A: document the information on the front of your original PCR. B: do nothing, since you already left a copy of the PCR at the hospital. C: include the information on an addendum and furnish it to the hospital. D: notify the emergency department staff and advise them of your error.

C: include the information on an addendum and furnish it to the hospital.

You arrive at the scene where a man fell approximately 40 feet and landed on his head. He is unresponsive, has agonal gasps, and a weak carotid pulse. Further assessment reveals an open head injury with exposed brain matter. Upon identifying this patient as an organ donor, you should: A: provide rapid transport only because the patient likely will not survive. B: manage the patient aggressively and provide rapid transport. C: request authorization from medical control not to initiate care. D: recognize that the patient’s injuries disqualify him as an organ donor.

B: manage the patient aggressively and provide rapid transport.

Which of the following is an example of the EMT providing care based on standing orders? A: Following assessment of a patient with a terminal illness, the EMT notifies the patient’s personal physician to determine whether he or she requires any special care. B: Prior to administering oral glucose to a patient with hypoglycemia, the EMT confirms the proper dosage and requests authorization from the base station physician. C: The EMT defibrillates a patient with the automated external defibrillator, directs immediate resumption of CPR, and then contacts medical control for further guidance. D: After confirming that a patient’s blood pressure is adequate, the EMT contacts medical control and requests permission to assist the patient with his prescribed nitroglycerin.

C: The EMT defibrillates a patient with the automated external defibrillator, directs immediate resumption of CPR, and then contacts medical control for further guidance.

A man armed with a shotgun has taken two people hostage and has shot one of them. Upon arriving at the scene, you should: A: be sure and turn up your portable radio loud enough so that you can remain aware of the entire situation. B: leave your lights and siren on because this will let the injured person know that you have arrived and are there to help. C: have the incident commander guide you to a shielded staging area and wait for the tactical team to bring the patient to you. D: inform the incident commander that you will assume responsibility for the entire incident since there is a confirmed patient.

C: have the incident commander guide you to a shielded staging area and wait for the tactical team to bring the patient to you.

The role of triage officer at a mass-casualty incident should be assumed by the: A: most knowledgeable EMS provider. B: EMS provider with the most years in EMS. C: first EMS provider who is willing to perform the task. D: EMS medical director via telephone communication.

A: most knowledgeable EMS provider.

All of the following are considered key components at the scene of a mass-casualty incident, EXCEPT: A: an on-site communication system. B: an on-scene emergency physician. C: an adequately staffed treatment area. D: a supply area near the treatment area.

B: an on-scene emergency physician.

The information that would be of LEAST pertinence when educating the public on injury prevention is: A: building a childproof fence around a pool. B: the proper usage of child safety seats. C: teaching children to wear bicycle helmets. D: how to provide rescue breathing.

D: how to provide rescue breathing.

Who has ultimate authority for all issues regarding patient care at the scene of a mass-casualty incident? A: EMS medical director B: Incident commander C: Most experienced EMT D: Treatment officer

A: EMS medical director

While triaging patients at a mass-casualty incident, you encounter a responsive middle-aged female with a respiratory rate of 26 breaths/min. What should you do next? A: Administer high-flow oxygen at once B: Assess her ability to follow commands C: Assess for bilateral radial pulses D: Triage her as immediate (red tag)

C: Assess for bilateral radial pulses

Which of the following scene size-up findings is LEAST suggestive of an unsafe environment? A: A large man standing in his yard awaiting your arrival B: Screaming and yelling coming from inside a residence C: Liquid draining from a car that struck a telephone pole D: The sound of breaking glass as you approach a residence

A: A large man standing in his yard awaiting your arrival

The ultimate goal of any EMS quality improvement program is to: A: provide protocols to all EMTs and hold them accountable if protocols are not followed. B: recognize all EMTs who demonstrate consistency in providing competent patient care. C: ensure that all personnel receive an adequate number of continuing education hours. D: deliver a consistently high standard of care to all patients who are encountered.

D: deliver a consistently high standard of care to all patients who are encountered.

Most crashes involving ambulances occur: A: at intersections. B: at stop signs. C: at stop lights. D: on the highway.

A: at intersections.

The primary clinical feature associated with exposure to a vesicant agent is: A: muscle twitching. B: vomiting blood. C: skin blistering. D: tachycardia.

C: skin blistering.

Which of the following is the MOST practical method of standard precautions when treating multiple patients during a mass-casualty incident? A: Changing your gloves in between contact with different patients B: Placing clean gloves over soiled gloves in between patient contacts C: Asking each patient you treat if he or she has a communicable disease D: Thoroughly washing your hands in between patient contacts

A: Changing your gloves in between contact with different patients

The immobilization device MOST appropriate to use for a patient with multiple injuries and unstable vital signs is the: A: short spine board immobilization device. B: vest-style immobilization device. C: long spine board immobilization device. D: scoop immobilization device.

C: long spine board immobilization device.

When using the power lift to lift a stretcher, you should: A: bend at the waist and keep your back straight. B: maintain a slight inward curve to your back. C: ensure that you lift with your palms facing up. D: place your hands palms down on the stretcher.

C: ensure that you lift with your palms facing up.

You are called to a local state park where a hiker fell from a cliff into a thick, wooded area with rough terrain. It is cold and foggy and a thunderstorm is approaching. You will MOST likely move the patient to the ambulance by: A: requesting a helicopter to hoist the patient out of the wooded area and carry him to a site near the ambulance. B: bringing the ambulance stretcher to the patient, loading him onto it, and removing him from the wooded area. C: placing the patient in a basket stretcher and using at least four people to carry him to the ambulance. D: assisting the patient in walking from the wooded area to the ambulance if his injuries are not life-threatening.

C: placing the patient in a basket stretcher and using at least four people to carry him to the ambulance.

While caring for a trauma patient, blood splashes into an EMT’s eyes. This is an example of: A: transmission. B: infection. C: exposure. D: indirect contact.

C: exposure.

You are the first ambulance to arrive at the scene of a motor-vehicle crash. As you approach the scene, you see three patients, two who have been ejected from their vehicles and the other who is still in his vehicle. You should: A: begin triaging and treating the most critically injured. B: call medical control and apprise him or her of the situation. C: request additional ambulances to respond to the scene. D: notify the local trauma center so they can prepare for the patients.

C: request additional ambulances to respond to the scene.

Which of the following situations presents the greatest risk for suicide? A: A man who was recently diagnosed with stage 4 lung cancer B: A woman who is planning a family trip, but gets called away to work C: A woman who quit her job for one that pays a lot more D: An EMT who saved a drowning child and receives no media attention

A: A man who was recently diagnosed with stage 4 lung cancer

Which of the following statements regarding the high-efficiency particulate air (HEPA) respirator is correct? A: A surgical mask provides better protection against tuberculosis than a HEPA respirator. B: Long sideburns or a beard will prevent the proper fit of a HEPA respirator. C: A HEPA respirator is necessary only if the patient with suspected tuberculosis is coughing. D: A HEPA respirator should be placed on any patient with tuberculosis.

B: Long sideburns or a beard will prevent the proper fit of a HEPA respirator.

While caring for an emotionally disturbed 30-year-old male, he suddenly becomes violent and needs to be physically restrained. During the restraint procedure, you should: A: maintain communication with him and closely monitor his airway. B: place him in a prone position and secure straps across his back. C: approach the patient from the front and converge on him quickly. D: ensure that at least three people are available to safely restrain him.

A: maintain communication with him and closely monitor his airway.

Which of the following statements regarding the use of an escort vehicle when en route to an emergency call is correct? A: With an escort vehicle, the risk of an accident at an intersection is reduced significantly. B: An escort vehicle should be used only if you are unfamiliar with the patient’s location. C: To avoid getting separated from the escort vehicle, you should closely follow it. D: An escort vehicle will allow you to arrive at the scene quicker.

B: An escort vehicle should be used only if you are unfamiliar with the patient’s location.

The scene size-up includes all of the following components, EXCEPT: A: assessing the need for assistance. B: donning personal protective gear. C: evaluating the mechanism of injury. D: determining if the scene is safe.

B: donning personal protective gear.

You are called to transport a patient with terminal lung cancer from a skilled nursing facility to the emergency department for evaluation of possible pneumonia. As you are reviewing the transfer paperwork, you see that the patient has a valid "do not attempt resuscitation" order. During transport, you should: A: disregard the DNAR order because it is only valid in the hospital setting. B: provide supportive care, such as oxygen, and keep the patient comfortable. C: perform CPR for only 2 minutes if the patient develops cardiac arrest. D: monitor the patient because a DNAR order prohibits you from providing care.

B: provide supportive care, such as oxygen, and keep the patient comfortable.

While treating a patient in cardiac arrest, you turn the AED on and attach the pads to the patient. However, when the AED begins to analyze the patient's cardiac rhythm, it signals "low battery" and then shuts off. The patient subsequently died. Which of the following statements regarding this scenario is MOST correct? A: The manufacturer of the AED will be held liable for negligence. B: The crew that preceded you may be held liable for negligence. C: Most errors associated with the AED involve equipment failure. D: You and your partner may be held liable for negligence.

D: You and your partner may be held liable for negligence.

Which of the following components is NOT part of an injury or illness prevention program? A: Educating teenage students on the dangers of drinking and driving B: Teaching new parents how to properly install a child safety seat C: Inspecting the home of young parents for child safety locks D: Training a group of daycare employees on infant and child CPR

D: Training a group of daycare employees on infant and child CPR

Your actions at the scene of a critically injured patient who was shot during a robbery should include: A: caring for the patient while manipulating the scene minimally. B: performing a primary assessment only. C: providing care when the police authorize you to. D: starting immediate care as you would with any other patient.

A: caring for the patient while manipulating the scene minimally.

A 70-year-old man with a history of emphysema and congestive heart failure is in cardiac arrest. His wife tells you that he collapsed about 5 minutes before your arrival. Your partner begins one-rescuer CPR as you prepare the AED. As you are applying the AED pads, the man’s wife tells you that she wants you to let him die in peace. You should: A: cease resuscitation only if the AED does not indicate a shock. B: perform rescue breathing only and contact medical control. C: comply with her request and cease all resuscitative efforts. D: continue performing CPR and ask her if he has a living will.

D: continue performing CPR and ask her if he has a living will.

While assisting a paramedic in starting an IV on a patient, you are inadvertently stuck by the contaminated needle while attempting to place it in the sharps container. You should: A: seek medical care as soon as possible. B: hold the paramedic liable for the needle stick. C: notify your supervisor and request an HIV test. D: cease patient care immediately.

A: seek medical care as soon as possible.

While you are inside a crashed vehicle assessing a patient who is entrapped, the rescue team should be: A: actively extricating the patient using whichever extrication method they deem necessary. B: assessing exactly how the patient is trapped and determining the safest way to extricate. C: preparing for a simple extrication process since you were obviously able to access the patient. D: awaiting specific instructions from you as to how to proceed with the extrication process.

B: assessing exactly how the patient is trapped and determining the safest way to extricate.

When providing care to multiple patients at the scene of a mass-casualty incident, your goal should remain focused on: A: immobilizing all patients at the scene. B: initiating CPR for those in cardiac arrest. C: keeping all bystanders at a safe distance. D: transporting patients to the hospital.

D: transporting patients to the hospital.

Which of the following actions demonstrates an EMT's knowledge of crime scene preservation? A: Placing a knife in a plastic zip-lock bag and giving it to a law enforcement officer for safe-keeping B: Advising a law enforcement officer after moving a coffee table to access a critically injured patient C: Requesting approval from law enforcement before controlling severe bleeding from a patient's arm D: Carefully cutting through the hole in a patient's clothing that was made by a large caliber firearm

B: Advising a law enforcement officer after moving a coffee table to access a critically injured patient

You are cleaning the back of the ambulance after transporting a patient with major trauma. Which of the following contaminated items should NOT be placed in a plastic biohazard bag? A: Rigid suction catheter B: Plastic IV catheter C: Blood-soaked gauze pads D: Suction canister

B: Plastic IV catheter

In most states, the EMT is required to report which of the following occurrences? A: Injury to a minor B: Drug overdose C: Animal bite D: Motor vehicle crash

C: Animal bite

While en route to the scene of an injured person, dispatch advises you that law enforcement personnel are at the scene. This indicates that: A: the patient is critically injured. B: the scene is safe for you to enter. C: a crime has been committed. D: the scene is potentially unsafe.

D: the scene is potentially unsafe.

When calling your radio report to the receiving hospital, you should: A: only give your report to a physician. B: include the patient’s name. C: be brief, concise, and factual. D: break your report into 60-second increments.

C: be brief, concise, and factual.

Upon arriving at the scene of a crash involving a large truck, you immediately note the presence of an orange placard on the side of the tank that the truck is pulling. This indicates that the vehicle is carrying a/an ______________ agent. A: explosive B: corrosive C: flammable D: radioactive

A: explosive

You are called to treat a 55-year-old man who is experiencing difficulty breathing. After making contact with your patient, he extends his arm out to allow you to take his blood pressure. This is an example of: A: informed consent. B: actual consent. C: implied consent. D: formal consent.

B: actual consent.

Which of the following situations is an example of abandonment? A: An EMT departs the scene after a paramedic arrives. B: An EMT gives a verbal report to an emergency nurse. C: A paramedic transfers care to an advanced EMT. D: An EMT transfers care of a patient to a paramedic.

C: A paramedic transfers care to an advanced EMT.

You have completed your patient care report and left a copy at the hospital when you realize that you forgot to document a pertinent finding on the front of the report. You should: A: take no action and report the event to your supervisor. B: attach an addendum to the original run report. C: write the information on the original run report. D: complete a new run report and add the information.

B: attach an addendum to the original run report.

Which of the following is considered minimum personal protective equipment (PPE) when suctioning an unresponsive patient's airway? A: Gloves and full facial protection B: Gloves, head cover, and eye protection C: Gloves and a mask D: Gloves, gown, and eye protection

A: Gloves and full facial protection

You are dispatched to a call for an unresponsive patient. Which of the following is the MOST important information that you should initially obtain from the dispatcher? A: The exact location of the patient B: Whether or not the patient is breathing C: The patient’s sex and approximate age D: The call back number of the caller

A: The exact location of the patient

Which of the following patients has the highest priority at the scene of a mass-casualty incident? A: 38-year-old woman who remains apneic after you manually open her airway B: 29-year-old man who is pulseless and apneic with an abdominal evisceration C: 35-year-old unresponsive woman with snoring respirations and severe burns D: 44-year-old unresponsive man with an open head injury and agonal gasps

C: 35-year-old unresponsive woman with snoring respirations and severe burns

The technique of rapid extrication from a vehicle involves: A: applying a vest-style extrication device, sliding a long backboard under the patient’s buttocks, and removing him or her from the vehicle. B: manually stabilizing the head, applying a cervical collar, and removing the patient from the vehicle onto a long backboard. C: applying a cervical collar, grasping the patient by the clothing, and quickly removing him or her onto the stretcher. D: grabbing the patient by his or her clothing, protecting his or her spine as much as possible, and dragging him or her from the vehicle.

B: manually stabilizing the head, applying a cervical collar, and removing the patient from the vehicle onto a long backboard.

While functioning at a large-scale terrorist incident, it is important for the EMT to: A: identify the person or persons responsible for the event. B: begin immediate treatment of the most critically injured. C: use triage and base patient care on available resources. D: avoid placing any casualty in a "delayed" treatment status.

C: use triage and base patient care on available resources.

You are giving a presentation to a group of laypeople on the importance of calling EMS immediately for cardiac arrest patients. What point should you emphasize the MOST? A: CPR and defibrillation are key factors in patient survival. B: Laypeople are incapable of providing adequate CPR. C: Cardiac drug therapy is the most important EMS treatment. D: Rapid transport significantly reduces patient mortality.

A: CPR and defibrillation are key factors in patient survival.

You are called to a residence for a woman in cardiac arrest. Shortly after starting CPR, the patient’s husband presents you with an unsigned document that states “do not attempt resuscitation.” You should: A: contact medical control prior to continuing any resuscitative efforts. B: stop all resuscitative efforts in accordance with the document. C: stop CPR until the document can be validated by a physician. D: continue CPR until you have contacted medical control for guidance.

D: continue CPR until you have contacted medical control for guidance.

Which of the following situations would necessitate treatment using implied consent? A: An 18-year-old man who is now fully alert after receiving oral glucose B: A 65-year-old man who is confused and suspected of having a severe stroke C: A 17-year-old pregnant woman with an isolated extremity injury D: A 25-year-old man who is restless and has severe chest pain and diaphoresis

B: A 65-year-old man who is confused and suspected of having a severe stroke Reason: A patient may be treated under the law of implied consent, also called the emergency doctrine, any time he or she is unresponsive or otherwise lacks decision-making capacity (ie, confused, under the influence of drugs or alcohol). In cases such as these, the EMT should assume that the patient would consent to treatment and transport if he or she were able to make an informed decision. Examples of such patients include those who are intoxicated or who otherwise have an altered mental status (ie, stroke, hypoglycemia). Patients younger than 18 years of age may also be treated under the law of implied consent, unless the patient is female and is emancipated or pregnant.

The MOST effective means of preventing the spread of disease is: A: wearing a mask with all patients. B: up-to-date immunizations. C: effective handwashing. D: wearing gloves with all patients.

C: effective handwashing.

A set of regulations and ethical considerations that define the extent or limits of an EMT’s job is called: A: the Medical Practices Act. B: a duty to act. C: scope of practice. D: confidentiality.

C: scope of practice.

You arrive at the scene of a traffic accident in which multiple vehicles are involved. You see at least two patients who are lying on the road and are not moving. You should: A: begin triaging the patients. B: request additional ambulances. C: begin immediate patient care. D: notify medical control for advice.

B: request additional ambulances.

When called to the scene of a structural fire to stand by in case any injuries occur at the scene, you should: A: park the ambulance close to the fire so you can rapidly access any patients. B: enter the structure with the firefighters so you can provide immediate care to any victims. C: ensure that your ambulance does not block or hinder other arriving fire apparatus. D: depart the scene and return to service after the fire has been completely extinguished.

C: ensure that your ambulance does not block or hinder other arriving fire apparatus.

Which of the following statements BEST describes a mass-casualty incident? A: At least half of the patients are critically injured. B: The number of patients overwhelms your resources. C: More than three vehicles are involved in the incident. D: More than five patients are involved.

B: The number of patients overwhelms your resources.

A 30-year-old woman crashed her car into a tree at a high rate of speed. She is conscious and alert and has stable vital signs. She has some small lacerations and abrasions to her arms and face, but no obviously life-threatening injuries. As you are loading her into the ambulance, she tells you that she does not want to go to the hospital. You should: A: advise her that she is probably too emotionally upset to be able to refuse EMS treatment and transport. B: obtain a signed refusal from the patient and ask a law enforcement officer to transport her to the hospital. C: ask a law enforcement officer to administer a breathalyzer test to determine if she has been drinking alcohol. D: advise the patient that she should be transported to the hospital because of the seriousness of the crash.

D: advise the patient that she should be transported to the hospital because of the seriousness of the crash.