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WorksheetsEMS103 MIDTERM
Total questions: 125
Worksheet time: 3hrs 8mins
If a hole is created in the chest wall, air could escape or be drawn in, or if bleeding develops within the chest, air and blood can accumulate in the pleural space. This would force the lung to:
increase respirations.
collapse.
increase the minute volume.
work harder with minimal problems.
The process by which glucose and other nutrients are converted into energy is called:
depolarization.
metabolism.
absorption.
respiration.
You are caring for a 25-year-old male patient who has been shot once in the head. The patient is in extremis (near the point of death) with a noticeable breathing pattern that alternates between no breathing and fast breathing. Your understanding of pathophysiology leads you to believe the breathing pattern may be due to damage to the section of his brain responsible for respiratory control, also known as the:
cerebellum
medulla oblongata
thalamus
frontal lobe
What is the best description of the chest's mechanical functions?
The chest is a closed space, and the pleural space surrounds the lungs; when the diaphragm contracts and the intercostal muscles expand, the chest and lungs move outward and downward, allowing expiration and gas exchange in the lungs.
With the chest being an airtight space, the act of breathing occurs when the the diaphragm and intercostal muscles relax, which causes the lungs to expand and air to flow into the lungs.
The chest is a closed space with only one opening; the trachea, to inspire air; the diaphragm contracts down and the intercostal muscles expand the ribs, causing a negative pressure that fills the lungs with air.
The diaphragm contracts, causing the intercostal muscles that are attached to the lungs to also contract, which moves the air into the lungs.
When you startle a 4-month-old, he throws his arms out, spreads his fingers, then grabs with his fingers and arms. The reaction is known as the:
rooting reflex.
scaffolding reflex.
Moro reflex.
startle reflex.
You are assessing a 12-year-old male patient who has been involved in a bicycle accident. This patient would be classified as being in which stage of life?
Middle school age
Adolescence
Junior school age
School age
In which age group do you anticipate seeing patients who have less efficient cardiovascular systems and a reduction of previous blood volume?
Late adulthood
Infancy
Early adulthood
Middle adulthood
Which of the following is not a common psychosocial challenge of late adulthood?
Concern about death and dying
Financial burdens
Issues of self-worth
Self-destructive behaviors
Infancy is defined as the stage of life from birth to:
A) 18 months.
B) 12 months.
C) 15 months.
D) 9 months.
You are assessing a 6-month-old female patient who, according to the parents, is not acting normally. At this stage of development, the patient should be able to do which of the following?
Sit alone on the floor
Sleep
Respond to the word "no"
Sit upright in a high chair
You are assessing a female patient with depression. She tells you that her psychologist said that she is dealing with "empty-nest syndrome." What age group is this associated with?
Early adulthood
Middle adulthood
Late adulthood
Middle-aged adulthood
During which age group is the body in peak physical condition?
Early adult
Middle adult
Adolescence
Preschool
A 26-month-old toddler is reported to have fallen and lacerated his chin. His mother did not witness the fall. As you proceed through your assessment, your partner reports that she's concerned about his heart rate, which she measures as 64. She's checked it twice. Your knowledge of normal vital signs for a patient this age suggests that his heart rate is:
too fast.
too slow.
within normal range.
not reliable.
Your 4-month-old patient is reported to be irritable and lethargic after feeding poorly for two days. One method for assessing the patient's level of hydration is to look at one of the soft spots on the surface of the skull. This soft spot is known as the:
acromion process.
mandibles.
parietal bones.
anterior fontanelle.
Which of the following is a sign of an inadequate airway?
Movement of air around the mouth and nose
Nasal flaring
Equal expansion of both sides of the chest on inhalation
Regular chest movements
You have performed a head tilt–chin lift maneuver on a 17-month-old boy and are attempting to ventilate him with a bag–valve mask. You are experiencing a lot of resistance with each breath and the chest is barely rising. Prior to attempting ventilations again, you should:
ease the head forward a little.
tilt the head back further.
perform chest thrusts.
finger sweep the airway.
Perhaps the simplest way to determine if a patient has a patent airway is to:
determine the respiratory rate.
auscultate for breath sounds.
say "hello."
check for appropriate chest rise.
Which of the following is a disadvantage of oropharyngeal airways (OPAs)?
They cannot be used in a patient with a gag reflex.
They do not come in pediatric sizes.
They require the use of a water-soluble lubricant.
They cannot be used in patients with a suspected skull fracture.
When suctioning the airway, you should try to limit suctioning to no longer than _______ seconds at a time.
60
45
30
10
Which of the following patients should not have their airway opened using a head-tilt, chin-lift maneuver?
A) A homeless person of undetermined age found lying unresponsive in an alley with no bystanders.
B) A 50-year-old woman who choked on a piece of food while dining in a restaurant and was lowered to the floor by a waiter.
C) A 35-year-old diabetic woman in the driver's seat of the car in her driveway who becomes unresponsive while speaking to her husband.
D) A 25-year-old man who is still unresponsive after a grand mal seizure.
The trachea branches at the _______ and forms two mainstem bronchi.
A) carina
B) alveoli
C) larynx
D) epiglottis
Which of the following structures is found in the lower airway?
Uvula
Pharynx
Tonsils
Bronchi
Which of the following is an advantage of using a nasopharyngeal airway (NPA)?
It is ideal for patients with a suspected skull fracture.
It eliminates the need for manual positioning of the patient's head to keep the airway open.
It may be tolerated by many patients with a gag reflex.
All of the above
On which of the following types of calls should you bring your portable suction unit to the patient's side upon arrival on the scene?
Cardiac arrest
Motor vehicle collision
Seizure
All of the above
Which of the following is true concerning the procedure for inserting a nasopharyngeal airway (NPA)?
The length of the device is not as important as it is with oropharyngeal airways.
The bevel should be turned toward the nasal septum or the base of the nostril.
If a water-soluble lubricant is not available, a silicon spray can be substituted.
It can only be placed in the right nostril.
To be effective, a suction unit must be able to generate air flow of at least _______ liters per minute and create a vacuum of no less than _______ mmHg.
30; 300
300; 330
30; 30
300; 30
Your patient is breathing 4 shallow breaths per minute due to overdosing on his pain medication but he has a palpable radial pulse. He vomited prior to your arrival and is choking. You should:
roll him onto his side to clear the airway.
insert an oropharyngeal airway and ventilate.
perform chest thrusts to clear the lungs.
move the patient to the ambulance and suction.
The jaw-thrust maneuver is the only _______ airway procedure for an unconscious patient with possible head, neck, or spine injury or an unknown mechanism of injury.
prohibited
recommended
discouraged
required
You are ventilating a cardiac arrest patient when he begins to vomit copious amounts of large pieces of undigested food. Which of the following would be most effective in clearing the airway?
Using large bore suction tubing without a tip or catheter attached
Using a rigid pharyngeal suction tip
Irrigating the mouth with sterile water to dilute the material before suctioning
Using a 14 French suction catheter
What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket mask?
16%
21%
50%
100%
Which of the following best describes inadequate breathing?
The respiratory rate is faster than normal.
The respiratory rate is slower than normal.
The minute volume is greater than normal.
The minute volume is less than normal.
Which of the following describes why fast respiration may decrease minute volume?
The rate does not decrease minute volume; it actually increases it.
The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement.
The lungs may not have adequate time to fill and exchange gas.
It is due to the delay in the movement of the intercostal muscles and the pleural space.
The paramedic is intubating a patient and asks you to assist by gently pressing your thumb and index finger to either side of the throat just over the patient's Adam's apple. As you press, you gently direct the throat upward and to the patient's right. What is the purpose of this maneuver?
It prevents the tube from entering the right mainstem bronchus.
It pushes the patient's vocal cords into the paramedic's view.
It lessens the patient's gag reflex and eases tube insertion.
It keeps the tube from becoming displaced and entering the esophagus.
What two measurements are multiplied to calculate the minute volume?
Tidal volume and dead space air
Tidal volume and respiratory rate
Alveolar ventilation and respiratory rate
Respiratory rate and bronchial dilation
A 21-year-old patient presents with labored breathing and audible wheezes, heart rate of 124, respiration 36; he has significantly altered mentation. What is the treatment for this patient?
Ventilate with a bag-valve mask with high oxygen or FROPVD.
Supplement the breaths with high-concentration oxygen through a nonrebreather mask.
Give mouth-to-mouth breathing with a nasal cannula, providing the patient with an increase of oxygen.
Use a pocket mask, which will provide adequate oxygen to improve the patient's condition.
You and your EMT partner are preparing to ventilate an elderly non-trauma patient who has a stoma. Your partner performs the head-tilt, chin-lift maneuver and you ask him to return the patient's head to a neutral position. "Why? This is not a pediatric patient!" your partner protests. What would you say?
Using the head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion.
Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning.
It is not necessary to position the airway of a stoma breather when providing ventilations.
Stoma breathers should only have their airways positioned after placement of the ventilation device.
A ________ is not typically used in the prehospital setting for oxygen administration.
tracheostomy mask
partial rebreather mask
regulator
nasal cannula
The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is called:
oxygenation.
internal respiration.
external respiration.
hyperventilation.
What signs and symptoms would indicate inadequate breathing in a patient?
Rapid breathing, pale skin, and normal mental status
Increased effort to breathe, cyanosis, clammy skin, altered mental status
Increased effort to breathe, increased depth of respiration, normal skin, normal mental status
Decreased depth of respiration, decreased rate of breathing, clammy skin, normal mental status
You are transporting a 44-year-old female with chest pain and sudden respiratory distress. She is agitated, anxious, and refuses to have a nonrebreather mask applied. Which of the following is the best option?
Do not make further attempts to administer oxygen as it will only agitate the patient further.
Consult with medical control about restraining the patient.
Have her breathe into a paper bag to control her hyperventilation.
Use a nasal cannula instead.
Which of the following is the best device to deliver high-concentration oxygen to a breathing patient?
Nasal cannula
Simple face mask
Oropharyngeal airway
Nonrebreather mask
The oxygen flow rate for a nasal cannula should not exceed ________ liters per minute.
8
2
6
4
A 16-year-old patient presents with labored breathing and increased respiratory rate, increased heart rate, and leaning forward with his hands on his knees. His skin is a normal color and his pulse oximetry is 96. This patient is suffering from respiratory:
hypoxia.
arrest.
failure.
distress.
Which of the following statements best describes the exchange of gas in the alveoli?
Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs.
Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs.
Blood moves from the left heart to the lungs, air arrives in the alveoli sacs, and diffusion occurs.
Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis occurs.
At the scene of a vehicle collision in which there are no apparent hazards, which of the following guidelines should be followed for establishing a danger zone?
The danger zone should be 150 feet in all directions.
The danger zone should be 50 feet in all directions.
The danger zone should be 15 feet in all directions.
There is no need to establish a danger zone when there are no apparent hazards.
You should have a keen awareness that there may be injuries based on your scene size-up. This is known as which of the following?
Mechanism of injury
Index of suspicion
Law of inertia
Nature of illness
Which of the following is true concerning the potential for violence at the scene of an EMS call?
The chance for violence is very low at emergency scenes.
Signs of impending violence are obvious if you know what to look for.
You do not need to worry about violence at an emergency scene once the police have secured it.
An unusual lack of activity at the scene may signal impending violence against the EMT.
Which of the following situations requires additional action by the EMT during scene size-up?
A vehicle collision involving a tractor-trailer that appears to be empty.
The sound of a barking and growling dog upon approaching the door to a residence.
A news media helicopter hovering overhead at the scene of a vehicle collision.
A bystander who is smoking a cigarette at the scene of an assault at a local park.
When considering the potential for injury from a fall, which of the following is least important?
Type of surface onto which the patient fell
Height of the fall
Patient's weight
Whether the patient struck anything with his body on the way down
At what point is the scene size-up complete?
When crashed vehicles have been stabilized
When the number of patients has been determined
At the end of the call
Upon stabilization of the c-spine
When should the EMT evaluate the need for Standard Precautions?
An evaluation should be made before arrival on-scene.
An evaluation should be made once a general impression of the patient has been formed.
An evaluation should be made throughout the call.
No evaluation is ever needed, since the precautions are the same for every call.
Which of the following situations will not require additional resources at the scene?
A) A patient with emphysema who is on oxygen therapy at home
B) A call to a manufacturing plant where a worker has his hand caught in a machine
C) A call for a sick person at home during which an odor of natural gas is detected
D) A 300-pound woman complaining of back pain
When determining possible injuries suffered from a gunshot wound, which of the following is true?
The EMT must be aware that bullets cause damage in more than one way.
The EMT must ask the patient or bystanders exactly where the shooter was standing.
Bullets pass in a straight line through the body from the point of entry to the exit wound.
The EMT must determine the caliber of ammunition involved.
Which of the following is not a consideration that should be used by the EMT in establishing the size of the danger zone?
Presence of hazardous materials
Amount of equipment needed
Fire
Wind direction
You are approaching an adult female lying supine on the ground with snoring respirations. You should:
insert an oropharyngeal airway.
insert a nasopharyngeal airway.
open her airway with a jaw-thrust maneuver.
ventilate with a bag-valve mask.
Which of the following is not assessed during the breathing phase of the primary assessment?
The pulse oximetry reading
The depth of respiration
The respiratory rate
The presence of respirations
You are approaching a young adult male lying supine on the ground with his eyes closed. You should:
expose his chest.
ask him if he is okay.
feel for a pulse.
open his airway.
What is the first thing the EMT does during the primary assessment?
Forms a general impression
Determines transport priority
Assesses mental status
Opens the airway
Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness?
Using a cervical collar to keep the chin elevated
Placing the head and neck in a neutral position; using a folded towel under the shoulders if necessary
Hyperextension of the neck; placing a pillow under the back if necessary
Flexing the neck to place the chin on the chest; placing a folded towel under the back of the head if necessary
Which of the following patients is a high priority for transport?
Adult male with difficulty breathing
Adult male with a headache
Adult male with dull abdominal pain
Adult male with sharp lower back pain
You are approaching a 16-year-old male with bright red spurting blood coming from his leg. He is screaming and he begs you to help him. You should:
assess his airway.
control the bleeding.
apply oxygen.
ask him to calm down.
You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back with no signs of trauma; has vomited; and has slow, wet sounding respirations. Which of the following should you do next?
Check for carotid and radial pulses.
Assist respirations with a bag-valve-mask device.
Open the patient's airway using a head-tilt, chin-lift maneuver.
Determine the respiratory rate.
The mnemonic AVPU is used to evaluate which of the following?
Patient's chief complaint
Patient's level of responsiveness
EMT's general impression of the patient's condition
Patient's transport priority
Which of the following is a good indication of a partially occluded airway?
The patient is alert.
The patient has snoring respirations.
The patient is speaking clearly.
The patient is crying loudly.
You have arrived on the scene at a high school football field where a 17-year-old male is lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first?
Apply high-concentration oxygen by nonrebreather mask.
Insert a nasopharyngeal or oropharyngeal airway.
Assist ventilations with a bag-valve-mask device and supplemental oxygen.
Open the patient's airway using a manual maneuver.
You find a teenage male lying supine in his bedroom. You hear gurgling sounds from the patient's mouth and see vomit with pill fragments on the floor. You should:
ventilate with oxygen.
identify the pills.
perform chest thrusts.
suction the airway.
Which of the following is true concerning the primary assessment?
The primary assessment begins by just observing the patient as you enter the room.
The EMT should perform a sternal rub on all patients to test for response to painful stimuli.
External bleeding will be obvious as you enter the room and initially see the patient.
Manual airway maneuvers must be performed on all patients.
Which of the following is the purpose of the primary assessment?
To find all of the patient's signs and symptoms
To discover trends of improvement or deterioration in the patient's condition
To detect dangers to the patient and/or EMS crew
To detect and treat immediately life-threatening problems
Which of the following questions will most likely elicit your patient's chief complaint?
Do you have any medical problems?
How have you been feeling lately?
Have you been drinking today?
What made you call 911 this evening?
When taking blood pressure manually, the cuff should be inflated to what point?
Until the Velcro starts to crackle
Until the patient says it hurts
Until the gauge reads 200 mmHg
30 mmHg beyond the point where the pulse disappears
Vital signs should be reassessed at least every _______ minutes for a stable patient.
15
5
20
10
An increase in the work of breathing is reported as:
obstructed breathing.
shallow breathing.
noisy breathing.
labored breathing.
If capillary refill is assessed in a child patient, how long should it take the normal pink color to return to the nail bed?
5 seconds
3 seconds
2 seconds
4 seconds
The abbreviation mmHg indicates that the blood pressure is measured by which of the following comparisons?
Beats per minute
Atmospheric pressure
Millimeters of mercury
Milligrams per deciliter
You are unable to find a radial pulse on a patient from a motor vehicle crash. You should:
apply the pulse oximeter.
listen for heart sounds.
begin chest compressions.
attempt to find the carotid pulse.
The normal range for blood glucose is between 70 mg/dL and:
110 mg/dL.
120 mg/dL.
100 mg/dL.
90 mg/dL.
You are called to a 72-year-old patient with weakness and headache and an initial blood pressure of 140/92. Her repeat blood pressure at 5 minutes is unchanged. Her condition is called:
hypertension.
prehypertension.
stroke.
hypotension.
In a blood pressure reading of 120/80, what body process does the 120 measure?
Diastolic blood pressure; when the left ventricle contracts and the blood is forced into the arteries
Diastolic blood pressure; when the right ventricle contracts and the blood is forced into the veins
Systolic blood pressure; when the right ventricle contracts and the blood is forced into the veins
Systolic blood pressure; when the left ventricle contracts and the blood is forced into the arteries
You are called to care for a child who has fallen out of a third-story window. You arrive to find the child in his mother's arms. As you approach, you notice the child's skin is pale with dark spots of cyanosis. You would report this uncommon condition of blotchy skin as:
flushed.
jaundiced.
mottling.
cyanotic.
Which of the following is one advantage of using heuristics?
It provides a more accurate diagnosis.
It allows you to treat the patient during diagnosis.
It slows the process of diagnosis.
It speeds up the process of diagnosis.
Mr. Green is complaining of severe difficulty breathing after being stung by a bee. His wife states he has had reactions to bee stings before, but not quite this severe. Which medications should you specifically ask him about?
Epinephrine
Antibiotics
Insulin
Beta-blockers
When assessing a patient's pertinent past history, you should ask which of the following questions?
Are you currently taking any medications?
Have you ever had a reaction to a medication?
Have you been having any medical problems?
Could you describe what happened?
You are on the scene of a 16-year-old patient in respiratory distress. The patient has a history of asthma. After placing the patient on oxygen and performing the primary and secondary assessments, you are confident that the patient is indeed having an asthma attack. How can you be sure your field diagnosis is accurate?
Keep your EMT textbook with you on the ambulance and review it to confirm your diagnosis.
Think of all possible causes of respiratory distress and rule them in or out as potential diagnoses based on your clinical findings.
Constantly reassess the patient to make sure you are correct.
Ask your partner her opinion; if she also agrees that it is asthma, the diagnosis is correct.
You and another EMT are discussing a call he previously ran. The EMT said the patient had classic chest pain symptoms and he treated it as a possible heart attack, but he later found out the patient just had indigestion and was discharged 2 hours later. The EMT was concerned that his patient assessment skills were not as good as they should be, and that the ED physician will no longer trust his judgment. How should you respond to his concerns?
Tell him that his misdiagnosis is a result of anchoring.
Tell him that his misdiagnosis is a result of limited information.
Tell him that his misdiagnosis is a result of confirmation bias.
Tell him that his misdiagnosis is a common EMT mistake caused by illusionary correlation.
_______ are signs or symptoms that suggest the possibility of a particular problem that is very serious.
Differentials
Red flags
Worst-case scenarios
All of the above
You have a patient who is unresponsive on the floor. What is the best way to rule in or rule out trauma as a cause of the patient's unresponsiveness?
Perform a stroke scale on the patient.
Look for bystanders and ask them if they witnessed the incident.
Check the patient's blood glucose to rule out hypoglycemia.
Examine the patient for signs of trauma.
You are on the scene in the bad part of town for an unresponsive 18-year-old type 1 diabetic patient. His mother states that he is very noncompliant with his diabetes management and often goes unresponsive due to low blood sugar. After performing the primary assessment, you believe that this is the most likely cause of his unresponsiveness. However, after taking a capillary glucose reading you are surprised to see that the patient's sugar level is normal. How will you now determine the field diagnosis?
You cannot make a correct diagnosis in the field because you cannot perform all the necessary tests with your limited scope of practice.
Recognize that the mother was lying to you. The patient is not diabetic and you now must assume that everything she told you is wrong.
Recognize that the mother is probably trying to protect her son from jail. Tell her that it is critical that she tell you what drugs he actually took.
Continue patient care by getting a complete SAMPLE history and perform a complete secondary assessment.
When using the memory aid OPQRST, which of the following questions would help you find out about P?
What is your primary complaint?
Does anything make the pain better or worse?
Do you have any past medical history?
Are you having any pain?
You have responded for a patient with shortness of breath. He reports that his breathing problems began this morning and have gotten worse over the last few hours. You ask if he has taken anything to help his symptoms and he tells you that he has used his inhaler several times in the last hour. The information you have just gathered can be classified as:
results of a physical exam.
relevant past medical history.
part of the SAMPLE history.
the history of present illness.
What is the feeling of bone ends rubbing together called?
Edema
Crepitation
Orthopnea
Rhonchi
When using the memory aid SAMPLE, which of the following would you do to determine L?
Look at the patient's pupils.
Listen to the patient's lung sounds.
Ask, "When was the last time you took your medicine?"
Ask, "When was the last time you had anything to eat or drink?"
"If it looks like a duck and quacks like a duck, it must be a duck–except when it isn't" is a way to summarize which of the following?
Overconfidence
Representativeness
Confirmation bias
Illusory correlation
Mr. Hughes is a 49-year-old man complaining of chest pain. To find out about the quality of his chest pain, which of the following questions is most appropriate?
On a scale of 0 to 10, with 10 being the worst, how would you rate your level of pain?
Are you having pain anywhere beside your chest?
Does anything make the pain worse?
Can you describe how the pain in your chest feels?
Your patient is a 22-year-old college student complaining of abdominal pain. She is alert and oriented, although somewhat uncomfortable. Which of the following should be your first action?
Ask the patient to describe the pain and find out if she has other complaints.
Perform a physical examination.
Take the patient's roommate aside and ask about the patient's medical history.
Palpate the patient's abdomen for tenderness and guarding.
Which of the following methods should be used to have a patient rate the amount of pain he is having?
Ask the patient to state whether the pain is mild, moderate, severe, or unbearable.
Have the patient rate the pain on a scale of 0 (no pain) to 10 (worst pain).
Use closed-ended questions to have the patient rate the pain.
Use the memory aid SAMPLE to elicit a pain description from the patient.
While an EMT forms a field diagnosis on the scene of an emergency, how do the steps differ from the traditional approach to diagnosis?
The EMT must perform a patient assessment to begin the process of forming a diagnosis.
The EMT does not have time to form a differential diagnosis and must rely on prior experience when treating a patient.
Due to the limited time spent with the patient, the EMT must rely on a differential diagnosis.
The EMT must rule in or out the most serious conditions associated with the patient's presentation.
Which of the following techniques of physical examination must an EMT master?
Observation, palpation, and auscultation
Visualization, percussion, and auscultation
Percussion, inspection, and palpation
Auscultation, observation, and percussion
When you begin interviewing your patient, he tells you that he has not felt well for several months, ever since he had his gallbladder removed. He goes on to tell you that he cannot get his wife to schedule a doctor's appointment for him and when she remembers to call, the office is always closed. Which of the following is the best way to proceed?
Try to call his doctor to schedule an appointment.
Begin your assessment of his vital signs.
Ask him for a list of his medications.
Ask him why he decided to call 911 today.
You are called for a patient who is complaining of being weak and dizzy. He reports that he does not have enough money to pay for his medications so he has not gotten them refilled. Your service has an automatic blood pressure machine and you use it to measure the patient's blood pressure while you count his respirations. The blood pressure machine reports a blood pressure of 280/140. What should you do next?
Take a manual blood pressure.
Continue with vital sign assessment.
Call immediately for ALS response.
Begin transport immediately.
You are the first on the scene of a 72-year-old patient in cardiac arrest. You have your medical supply kit, oxygen, and an AED. At least 4 to 5 minutes of high-quality CPR has been provided by the police officer who arrived before you. You have confirmed an open airway, apnea, and pulselessness. Which of the following should you do next?
A. Perform bag-valve mask ventilations with supplemental oxygen for 30 seconds before applying the defibrillator pads.
B. Perform one-rescuer CPR until additional personnel arrive.
C. Contact medical direction before taking any action.
D. Apply the defibrillator pads and shock as indicated.
Which of the following people is allowed to continue providing patient care when the patient is to be "cleared" for delivery of a shock via the defibrillator?
A. The provider who is ventilating the patient, so long as the patient has been intubated by a paramedic so that the provider does not directly touch the patient
B. The EMT performing bag-valve mask ventilations
C. Anyone in contact with the patient below the level of the patient's knees
D. None of the above
You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes. He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain. Your nearest facility is 5 minutes away, a Level III Trauma Center is 10 minutes away, and a hospital with cardiac catheterization capabilities is 20 minutes away. The patient is requesting to be transported to his cardiologist's hospital, which is 30 minutes away. Which hospital is the best destination?
A. The nearest hospital with cardiac catheterization
B. The trauma center
C. The nearest facility
D. The hospital the patient requests
What does ventricular fibrillation do?
A. Causes asphyxial cardiac arrest
B. Initiates commotio cordis
C. Forces the heartbeat to become quite rapid
D. Prevents the heart muscle from contracting normally
All of the following are elements of adult high-performance CPR, EXCEPT:
A. compression rate of at least 100 per minute.
B. compressing the patient's chest to no more than 1 inch in depth before allowing full relaxation.
C. maintaining a 302 ratio of ventilations to compressions.
D. placing the heel of one hand on the center of the victim's chest.
In which of the following situations would the administration of aspirin to a cardiac patient be prohibited?
A. The patient has a diastolic blood pressure greater than 90 mmHg.
B. The patient does not currently take aspirin.
C. The patient has a gastrointestinal ulcer.
D. The patient feels dizzy.
Assuming your protocol allows the administration of nitroglycerin when certain conditions exist, what is the maximum number of tablets to be administered in the prehospital setting?
A. 2
B. 1
C. 4
D. 3
What is (are) the first organ(s) perfused by blood leaving the heart?
A. Heart
B. Liver
C. Coronary Arteries
D. Lungs
Which of the following is the result of a portion of the heart muscle dying due to a lack of oxygen?
A. Myocardial infarction
B. Heart failure
C. Angina pectoris
D. Cardiac arrest
Which of the following may be a sign or symptom of a problem with the heart?
A. Fainting or near fainting
B. Nausea, with or without vomiting
C. Chest discomfort
D. All of the above
Your patient is a 30-year-old female who may have overdosed on antidepressant medications. On your arrival, she is lying supine on her bed with her head on a pillow. She is unresponsive to painful stimuli and is snoring. She appears to be pale and her skin is cool and clammy. What should you do first?
A. Remove the patient's pillow.
B. Insert an oropharyngeal airway.
C. Apply oxygen by nonrebreather mask.
D. Check the patient's pulse.
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED advises shock. After defibrillating the patient, what is your next intervention?
A. Place in the recovery position.
B. Continue CPR.
C. Insert a Combitube.
D. Check for a pulse.
Which of the following BEST describes an appropriate shock sequence for the patient in ventricular tachycardia?
A. Shock, shock, shock, shock
B. Shock, shock, shock, pulse check, 2 minutes of CPR, shock, shock, shock
C. Shock, pulse check, shock, pulse check, shock, pulse check
D. Shock, 2 minutes of CPR, reanalyze, shock again if indicated
You are on the scene of a 65-year-old female patient in cardiac arrest. CPR is in progress and the AED has been applied. The AED does not advise shock. What is your next intervention?
A. Stop CPR and place the patient in the recovery position.
B. Continue CPR.
C. Insert a Combitube.
D. Replace the malfunctioning AED.
Which of the following is NOT a reason that an AED may indicate that there is "no shock advised"?
A. The patient's heart has no electrical activity; he is "flat line," or in asystole.
B. The patient is in ventricular fibrillation or ventricular tachycardia.
C. The patient's heart rhythm is normal.
D. The patient has organized electrical activity in the heart but no pulse.
Which of the following is the purpose of the primary assessment?
A. To find all of the patient's signs and symptoms
B. To discover trends of improvement or deterioration in the patient's condition
C. To detect dangers to the patient and/or EMS crew
D. To detect and treat immediately life-threatening problems
A 59-year-old female complains of difficulty breathing. She is hiking at high altitude and tells you that she has no past medical problems. When you auscultate her lungs, you hear rales in her lower lungs. Her vital signs are P 78, R 18, BP 138/76, and SpO2 is 94% on room air. You should suspect:
A. neoplasm.
B. pulmonary edema.
C. pleurisy.
D. aspiration pneumonitis.
A 24-year-old female complains of right-sided chest pain and trouble breathing. She tells you she felt a pop in her chest while coughing before the pain and difficulty breathing started. Her lungs are clear to auscultation. Her vital signs are P 82, R 20, BP 108/72, and SpO2 is 97% on room air. You should suspect:
A. pleural effusion.
B. pleural effusion.
C. tension pneumothorax.
D. spontaneous pneumothorax.
A 5-year-old female who has a history of asthma complains of trouble breathing. She is exhaling through pursed lips, and you auscultate wheezes. Her vital signs are P 110, R 32, BP 106/68, and SpO2 is 89% on room air. After administering oxygen, you should next:
A. assist with the administration of her metered dose inhaler.
B. titrate oxygen administration to 94%.
C. assist her ventilation with a BVM.
D. reassess her vital signs.
An unresponsive 30-year-old female was the unrestrained driver involved in a car crash. Your partner stabilizes her head and tells you she is breathing and has a carotid pulse. As you examine her airway, you see blood, broken teeth, and hear gurgling sounds. You should first:
A. apply a cervical collar.
B. insert an oropharyngeal airway.
C. assist her ventilation.
D. suction her airway.
A 12-year-old male has difficulty breathing. He tells you he has had a cold all week. You auscultate rhonchi in his left lower chest. His vital signs are P 104, R 28, BP 104/74, and SpO2 is 89% on room air. You should suspect:
A. respiratory failure.
B. septic shock.
C. respiratory distress.
D. chronic asthma.
An 18-year-old male complains of abdominal pain and diarrhea. He tells you he has a history of cystic fibrosis. You auscultate rhonchi in his lower lungs. His vital signs are P 88, R 22, BP 126/78, and SpO2 is 93% on room air. You should:
A. administer oxygen by nasal cannula.
B. assist with the administration of an OTC antidiarrheal.
C. assist with the administration of an OTC antiemetic.
D. administer oxygen by non-rebreather mask.
A 47-year-old male complains of difficulty breathing, and he cannot stop coughing. His conjunctivae are pale and moist. He has a 40 pack-year smoking history. You should first:
A. assess his vital signs.
B. administer oxygen.
C. collect a sample of his phlegm.
D. determine his past medical history.
A 24-year-old male complains of difficulty breathing. He is sitting in a chair leaning forward. He tells you that he was exercising when it started. His lung sounds are clear but diminished in the bases bilaterally. His vital signs are P 92, R 22, BP 132/90, and SpO2 is 93% on room air. You should suspect:
A. spontaneous pneumothorax.
B. tension pneumothorax.
C. respiratory distress.
D. respiratory failure.
A 70-year-old male has difficulty breathing. When assessing him, which of the following should influence your decision to assist his ventilation with a BVM?
A. A decrease in his mental status
B. An increase in his respiratory rate
C. A history of COPD
D. An SpO2 below 90% on room air
An unresponsive 94-year-old female was found by her husband in bed. He tells you that she has a history of diabetes. You do not observe chest rise or air movement, but she has a pulse. You should first:
A. ventilate her with a BVM.
B. administer oxygen by non-rebreather mask.
C. assess her vital signs.
D. assess her blood glucose level.
