Operations

Question 1

Which of the following patients could you legally treat and transport without consent?

A) 17-year-old conscious male who sustained a fractured femur
B) A 6-month-old infant in respiratory distress whose parents refuse care
C) A 16-year-old married female who is awake and alert after falling
D) An adult patient who is alert after the administration of dextrose

Answer 1

Answer: A

Patients younger than 18 years cannot legally give consent to treatment, nor can they legally refuse transport. Exceptions to this include female minors who are emancipated or married. Before treating or transporting a child, you must obtain consent from at least one parent. Patients who awaken after the administration of glucose present a unique challenge; however, provided that they are conscious and alert, are of legal age, and have decision-making capacity at the time of refusal, they can legally refuse further treatment or transport. Contact medical control when faced with such a situation.

Question 2

You are triaging first-grade students at a school bus crash and encounter a small child who is unresponsive and apneic. After opening the child’s airway, he remains apneic. You should:

A) assess for a palpable pulse.
B) provide five rescue breaths.
C) place a red tag on the child.
D) place a black tag on the child

Answer 2

Answer: A

The JumpSTART triage system is intended for use in children younger than 8 years of age or who appear to weigh less than 100 pounds. According to the JumpSTART triage system, if you encounter an unresponsive apneic child, you should open his or her airway. If breathing resumes, he or she is triaged as immediate (red tag). If breathing does not resume, assess for a palpable pulse. If there is no pulse, he or she is triaged as deceased (black tag). If a pulse is present, provide 5 rescue breaths. If breathing resumes, triage him or her as immediate. If the child remains apneic after 5 rescue breaths, triage him or her as deceased.

Question 3

While caring for a conscious patient, you contact medical control and receive orders to perform an intervention. You should:

A) ask medical control to repeat the order.
B) perform the intervention and reassess the patient.
C) obtain the patient’s consent and perform the intervention.
D) repeat the order word for word back to medical control.

Answer 3

Answer: D

When receiving any order from medical control, your first action should be to repeat the order back word for word as you heard it. This confirms that you heard the order correctly. After confirming the order, you must obtain consent from the patient, ensuring that you inform him or her of the risks and benefits of the intervention. If the patient consents, perform the intervention, reassess the patient, and document the patient’s response to the intervention.

Question 4

You are completing your patient care report but cannot remember the reading of the last blood pressure that you took, so you enter a fictitious value. The MOST detrimental result of your action would be:

A) revocation of your AEMT certification.
B) suspension by your local EMS system.
C) litigation brought against you by the patient’s family.
D) substandard care that has been provided to the patient.

Answer 4

Answer: D

Among all of the legal ramifications that accompany the falsification of a patient care report, substandard care of the patient would be the greatest detrimental result, in the prehospital setting and the subsequent care provided at the hospital.

Question 5

An effective method for reducing stress in an obviously anxious bystander at the scene of an emergency is to:

A) tell the bystander to leave the scene at once.
B) assign the bystander minor tasks unrelated to patient care.
C) recruit the bystander for such tasks as crowd and traffic control.
D) advise the bystander to keep at a safe distance and observe the situation.

Answer 5

Answer: B

One of the most effective ways to reduce stress and anxiety in a bystander at the scene of an emergency is to assign the bystander minor tasks that are not related to patient care, such as providing rescuers with water or other needed supplies. The goal is to occupy the bystander’s mind and make the bystander feel as though he or she is helping. It is not safe to tell an obviously upset bystander to go home, because he or she deserves appropriate care and attention as well. Such functions as crowd and traffic control are responsibilities of law enforcement.

Question 6

You are providing care to a critically injured patient involved in a shooting. Which of the following statements regarding the completion of your patient care report is correct?

A) You should complete the patient care form after you have stabilized the patient
B) You should complete the prehospital care report after your arrival at the receiving facility
C) You should use a verbal report in place of a written report when managing any critical patient
D) You should document all actions immediately after they are performed to ensure accuracy

Answer 6

Answer: B

The patient care report is an important aspect of patient care. It should be completed for all patients as soon as possible; however, you should not delay care of a critically ill or injured patient for the purpose of completing the patient care report. Focus your efforts on caring for the patient and complete your patient care report after transferring care at the hospital.

Question 7

During a triage operation, you encounter a 5-year-old boy who has been injured. He is conscious, cannot walk, and has a respiratory rate of 50 breaths/min. You should:

A) move him to the treatment area and administer high-flow oxygen.
B) assign him an immediate triage category and move to the next patient.
C) assign him a delayed triage category and move to the next patient.
D) assess for a peripheral pulse and determine his level of orientation.

Answer 7

Answer: B

The JumpSTART triage system is intended for use in children younger than 8 years of age or who appear to weigh less than 100 pounds. According to the JumpSTART triage system, if the child’s respiratory rate is less than 15 breaths/min or greater than 45 breaths/min, he or she should be assigned an immediate triage category (red tag). After placing a red tag on the child, move to the next patient. If the respiratory rate is between 15 and 45 breaths/min, the next step would be to assess for a palpable pulse. The only treatment provided during the JumpSTART triage system would be to deliver 5 rescue breaths if the child remains apneic (and has a palpable pulse) after positioning the upper airway.

Question 8

To ensure the safest response to an emergency scene, you should:

A) always operate the ambulance with due regard for others.
B) use police escorts when proceeding through intersections.
C) continuously use your siren until you arrive at the scene.
D) exceed the speed limit only when responding to a critical call.

Answer 8

Answer: A

Whether you are operating an ambulance in an emergent or nonemergent mode, you must always drive with due regard for those around you, which means that you must be prepared for erratic movements of other drivers and never assume that they will see or hear you. The use of escorts is discouraged because of the risk of a “wake effect” collision, which occurs after a police or other escort vehicle clears a red light or intersection for you and proceeds. The other drivers may not be expecting a second response vehicle, thus leading to an accident in the intersection. Siren use does not guarantee a safe response, and increased speed clearly increases the risk of a crash.

Question 9

You are providing care to a patient with chest pain and elect to start an IV line. However, you did not advise the patient of your decision before starting the IV line. As a result, you could be held liable for:

A) assault.
B) battery.
C) breach of duty.
D) proximate cause.

Answer 9

Answer: B

Battery is defined as touching the patient without his or her expressed consent. You should never assume that a conscious patient will readily accept your treatment and must apprise the patient of what you intend to do before carrying out the task. Assault is defined as instilling fear in a patient without touching him or her. Breach of duty occurs when the AEMT failed to act as another prudent AEMT would have acted under the same or similar circumstances. Proximate cause is defined as the direct relationship between the AEMT’s actions (or inactions) and the patient’s injury or illness.

Question 10

What level of protection is required for a hazardous material that has a toxicity level of 4?

A) A
B) B
C) C
D) D

Answer 10

Answer: A

The toxicity level, as indicated on the placard, dictates the level of protective equipment that must be worn. A hazardous material with a toxicity level of 4, the highest level of toxicity (minimal exposure causes death), requires level A protection. Level A protection is fully encapsulated, chemical-resistant protective clothing that provides full body protection; a self-contained breathing apparatus; and special, sealed equipment. Although most AEMTs do not specialize in hazardous materials, it is still important to know the different levels of hazardous material toxicity and the protective equipment that is required for each level. Use your Emergency Response Guidebook when responding to any potential hazardous materials incident.

Question 11

Which of the following statements regarding the anger stage of the grieving process is correct?

A) Displaced anger is not a personal attack on the individual to whom it is directed
B) The anger stage is typically the last emotional outlet that the patient experiences
C) The patient’s anger is typically contained within, with little evidence of the patient’s feelings
D) When the patient is faced with a terminal illness, anger is not a typical stage of grieving

Answer 11

Answer: A

The first stage of the grieving process is typically the anger stage. Not only is the patient angry at him- or herself, as in the case of a person with a terminal illness, but he or she can also project that anger toward others, including EMS personnel. It is important to understand that this displaced anger is not a personal attack on the person to whom it is directed. All stages of the grieving process, no matter how unpleasant they can be for the patient, family, and rescuer, are healthy responses that ultimately allow the patient or family member to come to terms with the situation.

Question 12

Which of the following is the MOST effective way to reduce the stress and anxiety in a patient who is experiencing severe chest pain or discomfort?

A) Provide reassurance and a safe, comfortable transport
B) Administer high-flow oxygen by nonrebreathing mask
C) Allow a family member to drive the patient to the hospital
D) Assure the patient that he or she is not having a heart attack

Answer 12

Answer: A

Reassurance and a safe, comfortable transport to the hospital are both very effective ways to reduce stress and anxiety in a patient. You should never lie to a patient about his or her potential condition. Clearly, a patient with a suspected acute myocardial infarction should be transported to the hospital by ambulance, not by a private vehicle. Oxygen is used to treat hypoxemia, not stress and anxiety.

Question 13

Which of the following practices would provide you with the BEST protection from legal liability?

A) Constantly reinforce your knowledge through continuing education
B) Treat all patients and their family members with courtesy and respect
C) Maintain a consistently high standard of care when treating all patients
D) Deliver patients to their choice hospital, regardless of their clinical condition

Answer 13

Answer: C

Your best protection from legal liability is to consistently provide a high standard of care to all patients, including performing thorough assessments, providing appropriate and timely treatment, and thoroughly documenting the call. You should treat all patients and their family members with courtesy and respect, regardless of how they may treat you. Continuing education is intended to expand your knowledge base of new trends in emergency medical care. In general, patients should be transported to the hospital of their choice, unless their clinical condition warrants transport to a closer or more appropriate facility.

Question 14

In which of the following situations is proximate cause on the part of the AEMT clearly established?

A) severely hypoxic chronic obstructive pulmonary disease patient is given low-flow oxygen and subsequently develops cardiac arrest
B) A conscious and alert patient with chest pain refuses oxygen and is diagnosed with a myocardial infarction at the hospital
C) An AEMT establishes an IV line of normal saline at a keep-vein-open rate on a patient with obvious pulmonary edema
D) A mentally competent adult involved in a minor motor vehicle crash refuses care and is subsequently diagnosed with a spinal fracture

Answer 14

Answer: A

Proximate cause is defined as a direct relationship between the AEMT’s actions or inactions and the patient’s injury or illness. In this particular case, if the AEMT had treated the patient appropriately (administered high-flow oxygen or assisted ventilations), the patient’s outcome may have been different. If an error is made and the AEMT takes the appropriate action to correct the error, the risk of being accused of negligence is minimized. Proximate cause could not be established in any of the other choices in this question because the patient either refused care, in whole or in part, or was treated appropriately by the AEMT.

Question 15

As you are loading a conscious and alert middle-aged man with severe chest pain into the ambulance, he tells you that he does not want to go to the hospital. Which of the following statements regarding this type of situation is correct?

A) Once a patient is in the ambulance, you must transport the patient to the hospital
B) A mentally competent adult can withdraw consent at any time he or she chooses
C) Any sick or injured patient must be transported to the hospital with or without consent
D) A patient can only refuse care if there is a mentally competent witness to assume responsibility for the patient

Answer 15

Answer: B

A mentally competent adult has the legal right to refuse care and to withdraw consent once it has been given. To further treat and transport a mentally competent patient who withdraws consent could constitute assault, battery, or false imprisonment.

Question 16

When approaching a vehicle at night in which a patient is slumped over the steering wheel, you should:

A) position the ambulance in front of the vehicle when possible.
B) approach the patient from the front of the car for maximum visibility.
C) ask the patient to get out of the vehicle and then provide emergency care.
D) shine a light in the side view mirror until you determine that it is safe to approach.

Answer 16

Answer: D

You and your partner’s safety are of primary concern; therefore, the best approach to take in the situation in which a patient is slumped over the steering wheel of the car is to approach the vehicle from the rear. Shining a light into the side view mirror prevents the person from seeing you until you can determine that the patient is safe to contact. Unfortunately, it is common for individuals to fake illness or injury with the intent of harming the responding personnel.

Question 17

You and your partner arrive at the scene of a motor vehicle crash, quickly size up the scene, and note that there are two patients who are critically injured. Which of the following should be your MOST immediate priority?

A) Contact medical control and request direction
B) Call for a second ambulance to respond to the scene
C) Stabilize both patients and then call for another ambulance
D) Immediately load both patients in the ambulance and transport

Answer 17

Answer: B

Considering that you can only manage one critical patient effectively per ambulance (with two AEMTs), you should call for additional resources immediately on determining that there are more patients than you and your partner can effectively manage. After requesting additional help, you should then provide care to the best of your ability until help arrives.

Question 18

An off-duty AEMT stops at the scene of a cardiac arrest on the highway. During the course of providing care to the patient, he correctly inserts an advanced airway device. Which of the following statements about the AEMT’s actions is correct?

A) The AEMT could be held liable for practicing medicine without a license
B) The AEMT was off duty and is therefore protected by the Good Samaritan law
C) The AEMT performed in accordance with the standard of care for his level of training
D) The AEMT is legally covered provided that he notifies his medical director after the incident

Answer 18

Answer: A

Even though the AEMT performed the skill appropriately and in the correct circumstance, advanced life support providers are not allowed to function as such when not on duty or affiliated with an EMS system under the auspices of a medical director. Doing so is considered practicing medicine without a license.

Question 19

Which of the following statements regarding ionizing radiation is correct?

A) Beta radiation is less penetrating than alpha radiation and cannot move through most objects
B) Neutron particles easily penetrate through lead and require several feet of concrete to stop them
C) Ionizing radiation is stable by nature and changes its structure in a natural process called decay
D) Gamma rays are more penetrating than beta radiation, but can still be stopped by thick clothing

Answer 19

Answer: B

Ionizing radiation is energy that is emitted in the form of rays or particles. This energy can be found in radioactive material, such as rocks and metals. Radioactive material is any material that emits radiation. This material is unstable, and it attempts to stabilize itself by changing its structure in a natural process called decay. As the substance decays, it emits radiation until it stabilizes. The energy that is emitted from a strong radiologic source is alpha, beta, gamma (x-ray), or neutron radiation. Alpha is the least harmful type of penetrating radiation and cannot move through most objects. In fact, a sheet of paper or the body’s skin easily stops it. Beta radiation is slightly more penetrating that alpha and requires a layer of clothing to stop it. Gamma rays are far faster and stronger than alpha and beta rays. These rays easily penetrate through the human body and require lead or several inches of concrete to stop them. Neutron particles are among the most powerful forms of radiation. Neutrons easily penetrate through lead and require several feet of concrete to stop them. It is important to note that any form of ionizing radiation is harmful if ingested.

Question 20

Your ultimate goal in caring for a patient with an acute psychiatric crisis should be to:

A) obtain as much information as you can.
B) safely transport the patient to the hospital.
C) gather all medications that the patient is taking.
D) determine if the patient is a threat to him- or herself.

Answer 20

Answer: B

Acute psychiatric crises present a challenge for the prehospital care provider. As an AEMT, your ultimate goal should be to transport the patient to an appropriate medical facility, while ensuring the safety of yourself, your partner, and the patient. Definitive care for these patients can only be provided in a hospital setting. When caring for a patient with an acute psychiatric crisis, you should get law enforcement involved.

Question 21

During a mass-casualty incident, incoming personnel gather at a central point, where they are sent to various areas of the scene. This central point is referred to as the:

A) staging area
B) triage sector.
C) command post.
D) transport sector.

Answer 21

Answer: A

The staging area in a mass-casualty incident (MCI) is where all incoming resources congregate and are sent to the most appropriate locations by the staging officer, who should be in constant communication with the incident commander.

Question 22

What is the MOST common reason that victims of spousal abuse do not report the crime?

A) Inconvenience
B) Feelings of guilt
C) Fear of retribution
D) Love for their spouse

Answer 22

Answer: C

Male and female patients who have been abused by their spouses typically do not report the crime to the authorities because of the fear of retribution from their spouse. These patients generally want to come forward; however, they are simply scared.

Question 23

Which of the following situations BEST depicts gross negligence?

A) An AEMT documents that a laryngoscope handle is fully functional, although he knows that the batteries are dead
B) An AEMT incorrectly inserts a supraglottic airway device, but quickly recognizes the error and takes corrective action
C) An AEMT administers epinephrine to a patient in anaphylactic shock after contact with medical control is unsuccessful
D) An AEMT administers oral glucose to a conscious diabetic, who subsequently loses consciousness and aspirates the glucose

Answer 23

Answer: A

Gross negligence occurs when the AEMT knowingly performs an action that is clearly inappropriate. Documenting that a piece of equipment is functional when it clearly is not is an example of gross negligence. Direct harm could come to a patient if the equipment is needed but is non-functional. If a mistake is made and corrective action is taken, the likelihood of being accused of gross negligence is minimized. Patients clinical conditions are dynamic; they can change at any moment. If a patient is conscious and has a low blood sugar level, oral glucose is an appropriate intervention. It is beyond the AEMT’s control that the patient subsequently loses consciousness, and although the AEMT should immediately suction the patient’s airway, aspiration may still occur.

Question 24

Which of the following requires immediate removal of an ambulance from service?

A) Belt noise
B) Tire squeal
C) Brake fade
D) Rightward drift

Answer 24

Answer: C

Any mechanical malfunction of an ambulance should be addressed by a mechanic as soon as possible; however, not all problems require immediate removal of the unit from service. Tire squeal for example, warrants a mechanic’s attention as soon as possible, but does not necessarily require immediate removal of the ambulance from service. Tire squeal is a singing sound that occurs when you turn the vehicle, especially at parking speeds. Squealing is normal on very smooth concrete, but not on asphalt. The most common cause of tire squeal is an underinflated tire, a problem that can easily be fixed by checking the tire pressure and adding air as needed. Belt noise is a chirping or squealing sound, synchronous with engine speed (not road speed). It is usually related to a load on one of the appliances operated by a drive belt. Belt noise is always significant and will eventually keep an ambulance from operating; however, it does not warrant immediate removal of the ambulance from service. Drift is a finding that when you let go of the steering wheel, the vehicle consistently wanders left or right. Any vehicle may normally drift slightly to the right because most roads are built with a crown in the center (so water drains toward the gutters). A vehicle should not consistently drift to the left, however. Any problem with the vehicle’s brake system warrants immediate removal of the vehicle from service. Brake fade is a sensation that an ambulance has lost its power brakes. Common causes of brake fade are overheating of brake surfaces, loss of vacuum, loss of brake fluid, wet or greasy brake drums, or a failed master cylinder. Even a single instance of brake fade warrants immediate removal of the vehicle from service.

Question 25

When lifting a patient who is on an ambulance stretcher, you should:

A) avoid using the muscles of your legs.
B) hold your breath as you lift the patient.
C) position your palms up whenever possible.
D) keep the muscles of your abdomen relaxe

Answer 25

Answer: C

Proper technique when lifting a patient involves keeping your palms up whenever possible, which prevents unnecessary stress and potential injury to the wrists. When lifting, you should always use the powerful muscles of your legs. Take a deep breath just before lifting, and then breathe out as you lift.

Question 26

When removing a patient from a house without a carrying device, you should:

A) take long steps to expedite your exit.
B) walk backward when moving the patient.
C) avoid twisting when moving around a corner.
D) carry the patient over your shoulder if possible.

Answer 26

Answer: C

When you are lifting or moving a patient with or without a carrying device, you should avoid twisting when you move around corners. Failure to do so could result in injury to your back.

Question 27

As you and your team are treating an elderly woman who is in cardiac arrest, a man approaches you and states that the patient is his mother and that she wished not to be resuscitated. You should:

A) continue resuscitation and ask for a valid living will.
B) cease resuscitative efforts and ask to see a do-not-resuscitate order.
C) transport the patient to the hospital, providing only basic life support.
D) politely ask the man to leave and resume resuscitation.

Answer 27

Answer: A

When in doubt, resuscitate. You should not withhold resuscitative efforts while awaiting proper documentation. Even after such paperwork is provided, you must notify medical control and seek advice as to whether or not you should proceed with the resuscitation or terminate your efforts. Follow your local protocols.

Question 28

Which of the following is a component of a public injury prevention program?

A) Rescue breathing
B) One-rescuer CPR
C) Operation of an AED
D) Proper seat belt usage

Answer 28

Answer: D

The key word in this question is “prevention.” If the public is taught how to use a seat belt properly, the risk of injury can be minimized, if not prevented altogether. CPR, rescue breathing, and operating an automated external defibrillator (AED) are important, but are not needed until an injury or illness has already occurred.

Question 29

During a mass-casualty incident, the individual who is responsible for communicating with hospitals to ascertain their capabilities is the:

A) triage officer.
B) staging officer.
C) support officer.
D) transport officer.

Answer 29

Answer: D

Communication with area hospitals to determine their capabilities is the responsibility of the transport officer. By identifying which hospitals are capable of what types of services, the transport officer can direct exiting ambulances from the MCI scene to the most appropriate facility. The triage officer is responsible for initial prioritization of patients to determine who requires treatment first. The staging officer is responsible for coordinating incoming ambulances and directing them to the appropriate locations at the scene.

Question 30

A patient who complains of abdominal pain informs you that she is HIV-positive. Which of the following is appropriate personal protective equipment?

A) Gloves and safety glasses
B) Gloves and a full face mask
C) Gloves, gown, and a mask
D) Gloves and a HEPA mask

Answer 30

Answer: A

Gloves only are no longer considered minimum personal protective equipment by most EMS systems. Safety glasses, which protect your eyes from all angles, should be worn as well. Unless a patient is bleeding heavily or actively coughing, gloves and safety glasses are appropriate. If there is any chance of body fluid splatter (ie, coughing up blood, major penetrating trauma), a full face mask and gown should also be worn. Unless oxygen by face mask is indicated, consider placing a surgical mask on the patient who is potentially immunocompromised; this will help protect him or her from external pathogens. A high-efficiency particulate air (HEPA) mask (N-95 or higher) should be worn by the AEMT when caring for a patient with suspected tuberculosis.

Question 31

The MOST effective method for preventing the spread of disease is to:

A) wear gloves with every patient that you contact.
B) ensure that all of your immunizations are up-to-date.
C) wear a mask when caring for patients with tuberculosis.
D) wash your hands frequently, especially between patients.

Answer 31

Answer: D

According to the Centers for Disease Control and Prevention, frequent hand washing, especially in between patients, is the most effective means of preventing the spread of disease. Adherence to standard precautions (gloves, mask, and gown) minimizes risk of disease exposure. Up-to-date immunizations protect you from certain infections if you are exposed.

Question 32

You are dispatched to a local ranch where a tractor has overturned and pinned the operator. On arrival at the scene, your MOST immediate priority should be to:

A) direct your partner to stabilize the patient’s head.
B) assess the patient’s breathing and provide oxygen.
C) assess the degree to which the patient is entrapped.
D) determine whether the scene is safe for you to enter.

Answer 32

Answer: D

On arriving at the scene of any emergency (medical or trauma), you should always conduct a scene size-up. This begins by surveying the area to ensure that there are no dangers or hazards that would pose a threat to you or your crew. Remember, the life you save, or attempt to save, may TAKE your own. After dealing with any scene hazards, gain access to the patient and begin assessing and treating him or her.

Question 33

Which of the following is the MOST effective way to reduce morbidity and mortality resulting from trauma?

A) Limit on-scene time to no more than 10 minutes
B) Recognize and manage the early signs of shock
C) Coordinate and conduct injury prevention programs
D) Immediately transport patients with a significant mechanism of injury

Answer 33

Answer: C

Clearly, prevention is the best medicine. As an AEMT, you are a consequence manager, which means that your services are not needed until after the fact. Recognizing early signs of shock, minimizing on-scene time, and recognizing patients with a significant mechanism of injury are all critical to the outcome of the patient, but these could be nonissues if the injury were prevented in the first place.

Question 34

You and several other AEMTs are at the scene of a building explosion. The incident commander has directed you to set up your triage area in a location adjacent to the building. When functioning at this scene, situational awareness is MOST critical because:

A) all patients must be quickly accounted for to ensure that the building is empty.
B) the patient count will likely be high and will require a rapid triage approach.
C) this could be a terrorist event and a secondary explosive device may be present.
D) bystander gathering frequently complicates operations at a mass-casualty incident.

Answer 34

Answer: C

Terrorists have been known to plant additional explosives that are set to explode after the initial bomb. This type of secondary device is intended primarily to injure responders and to secure media coverage because the media generally arrive on scene just after the initial response. Secondary devices may include various types of electronic equipment, such as cell phones or pagers that are detonated when “answered.” Do not rely on others to secure your safety. It is every AEMT’s responsibility to constantly assess and reassess the scene for safety (situational awareness). Clearly, it is important to ensure that all patients are accounted for and properly triaged; however, this must not supersede the safety of you and your coworkers. Keeping bystanders away is also important and is typically the responsibility of law enforcement.

Question 35

Which of the following statements is the MOST appropriate to make when communicating with an emotionally depressed patient?

A) “You look sad”
B) “This will soon pass”
C) “Everything will be OK”
D) “Try not to worry about it”

Answer 35

Answer: A

When communicating with an emotionally upset or depressed patient, you should remain empathetic and simply acknowledge the patient’s feelings. Such statements as “you look sad” or “you sound depressed” are examples of appropriate statements. You should avoid telling the patient that “everything will be all right” or that “these feelings will pass” because these are subjective statements that you cannot guarantee.

Question 36

You receive a call for a cardiac arrest at a nearby residence. When you arrive, you find an elderly woman pulseless and apneic. As you and your partner begin CPR, the patient’s husband hands you a piece of paper with the words “do not resuscitate” handwritten on it. He asks you to stop CPR and to let his wife die in peace. You should:

A) contact medical control as your partner continues CPR.
B) honor the husband’s request and discontinue resuscitation.
C) tell the husband the document is not valid and continue resuscitation.
D) notify medical control of the situation before attempting resuscitation.

Answer 36

Answer: A

A do-not-resuscitate (DNR) order must be validated by a physician. A valid DNR order should be typed and signed by the patient’s physician and a witness; it should not be handwritten. In this scenario, it is best to err on the side of the patient and provide basic life support, contact medical control, and seek his or her guidance. Remember, when in doubt, resuscitate. Follow your local protocols regarding DNR orders.

Question 37

Which of the following describes a critical incident defusing?

A) formal process that involves all personnel involved
B) A formal process that is held no later than 12 hours after the incident
C) An informal process that is held within 2 to 4 hours of the incident
D) An informal process that is held within 24 hours of the incident

Answer 37

Answer: C

A critical incident defusing is an informal process designed to provide immediate relief and support to all who were involved in the incident and is typically performed within 2 to 4 hours after the incident. A critical incident defusing should be held no longer than 12 hours after the incident. A critical incident stress debriefing is a formal process that should occur within 24 hours, but no later than 72 hours, after the incident. The efficacy of critical incident stress management is controversial at the present time; follow your local protocols.

Question 38

On arriving at the scene of an overturned tanker, you note that the tanker is bearing an orange placard. This indicates that the tanker is carrying:

A) a nonflammable gas.
B) an explosive agent.
C) a flammable liquid.
D) a radioactive agent.

Answer 38

Answer: B

The Department of Transportation placard system allows emergency responders to quickly identify the chemical being carried. An orange placard indicates an explosive or blasting agent. A solid green placard indicates a nonflammable gas. A red and white placard indicates a flammable liquid or gas. A yellow and white placard indicates a radioactive agent. When responding to a possible hazardous materials incident, refer to your Emergency Response Guidebook for specific information regarding the type of agent the tanker is carrying. Approach any hazardous materials incident from an area that is upwind and uphill.

Question 39

You are giving a presentation to a group of citizens with no basic life support training on the importance of calling 9-1-1 for patients in cardiac arrest. Which of the following is the MOST important rationale to explain to them for the early notification of EMS?

A) Cardiac drug therapy is a vital component
B) Advanced care is the key factor in survival
C) Rapid transport to the hospital saves more lives
D) Early CPR and defibrillation are crucial to survival

Answer 39

Answer: D

Educating the public is a crucial aspect of a successful illness and injury prevention program. In situations in which you are explaining the importance of early notification of EMS through calling 9-1-1, advise the audience that this action is critical because early CPR and defibrillation are the key factors in the survival of patients with out-of-hospital cardiac arrest.

Question 40

Which of the following examples BEST describes informed consent?

A) You ask the patient if you have permission to initiate treatment
B) You inform the patient of the consequences of refusing EMS care
C) You advise the patient of the potential complications of starting an IV line
D) You initiate treatment with the assumption that the patient would approve

Answer 40

Answer: C

Informed consent is defined as ensuring that the patient is aware of the care that is to be provided and the potential complications associated with the treatment. This gives the patient enough information to make an informed decision about his or her health care. Making a patient aware of the complications of suggested treatment is just as important as making him or her aware of the complications of refusing care (informed refusal). Treating an unresponsive patient is based on the law of implied consent. In these cases, the AEMT assumes that the patient, if conscious, would consent to live-saving treatment.

Question 41

Which of the following statements is inappropriate to document on a patient-care report?

A) “The patient stated that she is HIV positive”
B) “The patient seems to need psychiatric help”
C) “The possible smell of ETOH was noted at the scene”
D) “The patient became very combative during the assessment”

Answer 41

Answer: B

You must always document objective (factual) findings, not your own opinion. Documenting statements that reflect your personal opinion could lead to allegations of libel against you.

Question 42

A 30-year-old man was shot in the side of the head during a drive-by shooting. He is unresponsive with visible brain matter protruding from the wound. He has agonal gasps and a weakly palpable carotid pulse. He is wearing a bracelet that identifies him as an organ donor. You should:

A) treat this patient as you would any other critically injured patient.
B) contact medical control to determine the most appropriate action.
C) recognize that the patient’s injury disqualifies him as an organ donor.
D) provide basic life support only until the police have collected all evidence.

Answer 42

Answer: A

Trauma patients that are identified as organ donors, especially when they have a pulse and respirations, should be treated just as aggressively as any other trauma patient, including rapid transport to the hospital, where their organs potentially can be harvested. Although it is fairly clear that this patient’s injury is not compatible with life, his organs could potentially save several lives.

Question 43

A 67-year-old woman slipped and fell and is complaining of severe pain to her left hip area. Which of the following devices would be MOST effective in moving her out of her house?

A) Stokes basket
B) A scoop stretcher
C) A folding stretcher
D) An ambulance cot

Answer 43

Answer: B

The scoop stretcher, also called an orthopaedic stretcher or split litter, is very effective in moving patients with suspected hip or pelvic fractures. Its contoured design provides excellent support and allows for the placement of padding around the hip and pelvic areas. Additionally, it is easier to manipulate a scoop stretcher in a house.

Question 44

While responding to a call for a cardiac arrest, your ambulance approaches an intersection in which you have a red light. The driver of the ambulance should:

A) slow down and proceed cautiously through the red light.
B) stop and wait for the light to turn green before proceeding.
C) continue through the red light while looking in both directions.
D) stop to look for oncoming traffic and then proceed cautiously.

Answer 44

Answer: D

When approaching an intersection with a red light, you must always come to a complete stop, make sure that there is no oncoming traffic that has the right of way, and then proceed with caution through the red light. Most emergency vehicle crashes occur at intersections because the driver did not properly enter the intersection as described.

Question 45

Your main priority when managing a patient with a behavioral or psychiatric crisis includes:

A) avoiding any confrontation with the patient.
B) safely transporting the patient to the hospital.
C) managing any concomitant medical problems.
D) ensuring the safety of you and your partner.

Answer 45

Answer: D

In all cases, your personal safety and the safety of your partner come first. The other choices listed are obvious concerns when managing a patient with a behavioral or psychiatric crisis, but do not supersede the safety of you and your partner.

Question 46

The ultimate medical authority at the scene of a mass-casualty incident is the:

A) fire chief.
B) lead paramedic.
C) medical director.
D) incident commander.

Answer 46

Answer: C

The incident commander has control over the logistical operations at the scene of a MCI; however, the EMS medical director is ultimately responsible for all patient care-related activities. It is important that the incident commander remain in close contact with the medical director during a MCI.

Question 47

In addition to considering your own safety, the decision to enter a potentially unsafe scene should be based on the:

A) risk of harm to your partner.
B) potential for harm to the patient.
C) quality of care that you can provide.
D) potential risk to bystanders around you.

Answer 47

Answer: A

After ensuring your own personal safety, the decision of whether or not to enter a potentially unsafe scene should be based on the risk of harm to your partner, who should also be looking out for him or herself. Safety and caring for the patient should be your next priority, followed by the safety of any bystanders.

Question 48

Which of the following agents causes profound bradycardia, hypersalivation, and severe vomiting?

A) Lewisite
B) Phosgene
C) Cyanide
D) Soman

Answer 48

Answer: D

Chemical nerve agents (soman, sarin, tabun, V-agent) are among the most deadly chemicals developed. Designed to kill large numbers of people with small quantities, nerve agents can cause cardiac arrest within seconds to minutes. Nerve agents contain organophosphates, which block an essential enzyme in the nervous system, and causes profound stimulation of the parasympathetic nervous system. The clinical signs of nerve agent exposure can be remembered with the mnemonic DUMBELS: diarrhea; urination; miosis (pinpoint pupils); bradycardia and bronchospasm; emesis; lacrimation; and seizures, salivation, and sweating. Lewisite is a vesicant (blister) agent; phosgene is a pulmonary (choking) agent; and cyanide is a metabolic agent.

Question 49

Which of the following situations would MOST likely require involvement of a technical rescue team?

A) Child who was found floating face-down in a swimming pool
B) Obese woman in cardiac arrest who is in a small bedroom
C) Woman who was ejected when her car struck a large tree
D) Man who fell from atop a mountain and landed on a ledge

Answer 49

Answer: D

A technical rescue incident is a complex rescue incident involving vehicle extrication, swiftwater or ice rescue, trench rescue, confined spaces, structural collapse, high-angle rescue, hazardous materials incidents, and wilderness search and rescue. Technical rescue teams have specialized training in dealing with such incidents. A patient who fell and landed on a ledge, for example, would require a high-angle rescue team. A patient who was ejected from a motor-vehicle obviously does not require extrication. A patient found floating in a swimming pool can easily be retrieved without any special equipment. An obese patient in a small bedroom would simply require more manpower (ie, AEMTs, firefighters, law enforcement) in order to move him or her to an area that has more workspace.

Question 50

Effective communication with a patient while providing emergency care includes:

A) repeatedly informing the confused patient that he or she is being transported to the hospital.
B) avoiding explaining procedures that you are performing so as to not frighten the patient.
C) minimizing your conversation with an obviously apprehensive patient to allay the patient’s anxiety.
D) using medical terminology when explaining the patient’s condition so that the patient remains completely informed

Answer 50

Answer: A

An important aspect of effective communication is to make sure your patient is kept constantly informed of what is transpiring throughout the call, especially if he or she is confused. You should always explain procedures to be performed on the patient (informed consent) and should avoid using medical terminology because most people will not understand what you are telling them. Use layman’s terms when communicating with a patient.

Question 51

Which of the following situations BEST describes a mass-casualty incident?

A) At least half of the patients are obviously dead
B) There are two critical patients and one ambulance
C) There are three stable patients and two ambulances
D) There are at least 10 patients, and half of them are critical

Answer 51

Answer: B

The term mass-casualty incident (MCI) implies numerous patients; however, any situation that depletes your resources or ability to effectively manage the situation is an MCI. An example is two critically injured patients and one ambulance. One ambulance and two AEMTs can effectively manage one critical patient. Two critically injured patients would overwhelm them and their resources. An MCI is not defined by patient count, but rather by how effectively your resources can manage the patients, whether they are few or many.

Question 52

You are called to the scene of a middle-aged man who is threatening to kill himself. You see no visible weapons on his person. Your primary concern should be:

A) safely transporting him to the hospital.
B) his ability to injure you or your partner.
C) searching the patient for a knife or gun.
D) gathering any medications that he takes.

Answer 52

Answer: B

You should assume that any patient who is threatening suicide has the potential for also hurting others. In any case involving a psychiatric patient, you and your partner’s safety comes first. It is law enforcement’s job to search the patient for weapons, not yours. After ensuring that you are safe, you may then proceed with assessment, treatment, and transport.

Question 53

An overturned tanker has a solid green placard on its side and rear. What type of hazard does this indicate?

A) Flammable solid
B) Non-flammable gas
C) Radioactive material
D) Explosive/blasting agent

Answer 53

Answer: B

The United States Department of Transportation (USDOT) uses labels, placards, and markings to give responders a general idea of the hazard inside a particular container or cargo tank. These can be found in the Emergency Response Guidebook (ERG). The color of a placard identifies the general type of hazard. A flammable solid is identified by a solid red placard. A non-flammable gas is identified by a solid green placard. Radioactive material is identified by a yellow and white placard. Explosive and blasting agents are identified by a solid orange placard.

Question 54

Where should you position your ambulance when arriving at the scene of a motor-vehicle crash on a two-lane highway?

A) 50 feet before the scene on the same side of the road
B) 100 feet past the scene on the same side of the road
C) 50 feet past the scene on the opposite side of the road
D) 100 feet before the scene on the opposite side of the road

Answer 54

Answer: B

When parking the ambulance at a crash scene, pick a position that will allow for efficient traffic control and flow around a crash scene. Do not park alongside the scene because you may block the movement of other emergency vehicles. Instead, park about 100 feet past the scene on the same side of the road. It is best to park uphill and/or upwind of the scene if smoke or hazardous materials are present.

Question 55

Which of the following is the MOST appropriate method of handling the clothing of a stable patient who sustained a gunshot wound during a robbery?

A) Place all of the patient’s clothing in a plastic bag and turn it over to the police
B) Not remove any of the patient’s clothing until given permission by a police officer
C) Remove the clothing as rapidly as possible to expose and care for the injury
D) Carefully cut a hole in the clothing that is as far away from the wound perimeter as possible

Answer 55

Answer: D

Preserving evidence at a crime scene, provided that it does not interrupt patient care, is an important action for the AEMT to take. In this case, the patient is stable; therefore, the appropriate action is to carefully cut the clothing as far away from the wound perimeter as possible to preserve evidence that may be present on the clothing near the wound. Placing clothing into a plastic bag may result in a buildup of condensation, thus destroying potential evidence.

Question 56

A 65-year-old man has crushing chest pain. He is conscious and alert, but restless and profusely diaphoretic. As your partner is taking his vital signs, he tells you that he does not want to go to the hospital. The MOST appropriate way to manage this situation is to advise the patient that:

A) he should see his doctor immediately.
B) he is too scared to make such a decision.
C) his refusal could ultimately result in death.
D) he should call 9-1-1 if he changes his mind.

Answer 56

Answer: C

Any patient who refuses EMS care must be informed of the potential risks of his or her refusal. The most direct approach is to advise the patient that his or her condition could ultimately result in death. This ensures that the patient is aware of the potential worst-case scenario. If the patient still refuses, has decision-making capacity and is of legal age, and is willing to take that risk, you should obtain a signed refusal. It is important to advise the patient that he or she should call 9-1-1 if he or she changes his or her mind. Carefully document ALL attempts you made to convince the patient to consent to treatment or transport.

Question 57

You are triaging a female patient who was near a building when it exploded. According to the Simple Triage and Rapid Treatment (START) system, what should you do if she is apneic?

A) Place a red tag on her
B) Reposition her airway
C) Give two rescue breaths
D) Classify her as deceased

Answer 57

Answer: B

The Simple Triage and Rapid Treatment (START) system is a 60-second triage method that enables rescuers to rapidly identify those at greatest risk for rapid death. The START system focuses on four assessment parameters: ability to walk, respiratory effort, perfusion status, and mental status. Victims are classified as being delayed, urgent, immediate, or dead/dying. Based on the patient’s classification, an internationally recognized color-coded triage tag is placed on him or her. According to the START system, if a patient is apneic, you should reposition his or her airway and reassess for breathing. If breathing is still absent, the patient is classified as dead/dying and is identified with a black triage tag. If the patient’s breathing resumes, however, he or she is classified as immediate and is identified with a red triage tag.

Question 58

The ultimate goal of any quality assurance program should be to:

A) determine solutions to problems that are identified.
B) reinforce the strict adherence to all system protocols.
C) ensure that high-quality care is consistently provided.
D) recognize and reward those with good performance.

Answer 58

Answer: C

Reinforcing adherence to EMS system protocols, determining solutions to problems that are identified, and recognizing and rewarding personnel with good performance are important components of any quality assurance program, and enable you to achieve the ultimate goal, which is to ensure that high-quality patient care is consistently provided.

Question 59

Which of the following actions demonstrates an AEMT’s knowledge of crime scene preservation?

A) Advising a law enforcement officer after moving a coffee table to access a critically injured patient
B) Carefully cutting through the hole in a patient’s clothing that was made by a large caliber firearm
C) Placing a knife in a plastic zip-lock bag and giving it to a law enforcement officer for safe-keeping
D) Requesting approval from law enforcement before controlling severe bleeding from a patient’s arm

Answer 59

Answer: A

After ensuring your own safety, your priority when caring for a patient at a crime scene is to do just that, care for the patient. If you need to move a piece of furniture to gain access to a critically injured patient, move the furniture, treat the patient, and then advise a law enforcement officer of what you moved and where you moved it to. In this way, you are providing immediate care to the patient, but are remaining aware that the location of any obstacles between you and the patient may serve as evidence. Clearly, you are not going to request approval from a law enforcement officer before treating a critically injured patient. Items that may have fingerprints on them, such as knives or guns, should be placed in a paper bag; condensation can accumulate in plastic bags, potentially destroying any evidence. When removing clothing from a gunshot victim, you should make an effort to cut around (not through) the hole in the clothing that was made by the bullet. The hole in a patient’s clothing may contain gunshot residue and can provide valuable information regarding the type of weapon used and the distance between the assailant and the victim.

Question 60

At the scene of a shooting where a man has been critically wounded, the goal of the AEMT is to:

A) render lifesaving care without regard for other factors.
B) notify law enforcement of findings before providing care.
C) provide effective medical care without disturbing the scene.
D) begin emergency care after all evidence has been collected

Answer 60

Answer: C

The goal of the AEMT at the scene of a crime is to render lifesaving emergency care without disturbing the scene, if at all possible. However, it may be absolutely necessary to move a piece of potential evidence to accomplish this. You should report any and all potential evidence to law enforcement, but not before providing the necessary care to the patient.