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129 Cards in this Set
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You just completed splinting a patient's fractured arm. Prior to applying the splint the patient had a distal pulse in the extremity. After splinting, you cannot find a radial pulse. You suspect: (A) the fracture has cut off the circulation. (B) your splint is too tight. (C) this is a normal reaction after splinting. (D) the patient's condition is worsening. |
(B) The patient's condition is worsening, but is probably a direct result of you applying the splint too tight. Loosen the splint and reassess for distal pulse.
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Your patient has what appears to be a dislocated shoulder. Treatment for this patient should be to: (A) sling and swathe the injured shoulder. (B) immobilize the arm to the side of the patient. (C) reset the shoulder and then immobilize. (D) wrap the upper body in a pillow and immobilize both arms. |
(A) The appropriate treatment for a patient with a dislocated shoulder is to sling and swathe. Under no circumstance should an EMT-B attempt to reset a dislocated shoulder.
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You are assessing a 24-year-old male who was involved in a bar room brawl. Witnesses say the patient was struck with a barstool. The patient is unresponsive. You note battle signs on your assessment. This is a sign of: (A) intracranial bleeding. (B) basilar skull fracture. (C) epidural hematoma. (D)subdural hematoma. |
(B) Without further diagnostic exam you cannot rule out any of these possibilities. However, battle signs are indicative of a basilar skull fracture. Battle signs may appear thirty minutes to twelve hours after the initial injury. Raccoon eyes are usually indicative of intracranial bleeding.
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A witness tells you that a patient became unresponsive immediately after being struck by a baseball, but then regained consciousness. The witness also tells you that the patient was complaining of a severe headache during the time she was conscious. The patient is now unresponsive. The right pupil is fixed and dilated. The bystander tells you the patient was struck on the right side of the head. The patient is most likely suffering from: (A) intracranial bleeding. (B) a basilar skull fracture. (C) a subdural hematoma. (D) an epidural hematoma. |
(D) These are classic signs of an epidural hematoma. You need to prepare for seizures. Patients who have an epidural hematoma commonly seize. Patients who have subdural hematoma, present with a deterioration in level of consciousness, dilation in one pupil, abnormal respirations, rising blood pressure, and slowing pulse.
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Which of the following influences the activities of involuntary muscles and glands including the heart? (A) central nervous system. (B) peripheral nervous system. (C) voluntary nervous system. (D) autonomic nervous system. |
(D) The central nervous system refers to the brain and the spinal cord. The peripheral nervous system consists of nerves located outside if the brain and the spinal cord. The voluntary nervous system influences activities of voluntary muscles and movements throughout the body. The autonomic nervous system is therefore what is described in this question.
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When treating an eye injury involving an impaled object, it is important to: (A) cover both eyes and stabilize the object. (B) cover the affected eye and stabilize the object. (C) stabilize the object and do not cover either eye. (D) remove the object and cover both eyes. |
(A) Eyes have sympathetic movement, which means if one eye moves, the other eye moves. Therefore, any time you have an eye injury and you do not want the patient to move their eye, such as the patient with an impaled object in the eye, it is important to not only stabilize the impaled object, but also cover both eyes.
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Your patient is complaining of not being able to feel anything and cannot move any of his extremities. He fails your PMS test and you notice that he has diaphragmatic breathing. You suspect this patient has a spinal cord injury: (A) in the cervical spine region. (B) in the thoracic spine region. (C) in the lumbar spine region. (D) in the sacral spine region. |
(A) Patients with these complaints typically have a spinal cord injury in the neck region. If the patient has the same signs and symptoms but can feel, wave, and squeeze his hands, then the injury is typically below the neck. If the patient has normal breathing, can feel, wiggle or raise their toes or feet, then it typically indicates a lower spinal cord injury.
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You should remove the helmet from a patient in all of the following scenarios EXCEPT: (A) The helmet does not interfere with your ability to assess and reassess airway and breathing. (B) The helmet interferes with your ability to assess and reassess airway and breathing. (C) The helmet interferes with your ability to adequately manage the airway or breathing. (D) The helmet does not fit well and allows excessive movement of the head inside the helmet. |
(A) You should also remove the helmet if it interferes with proper spinal immobilization or the patient is in cardiac arrest.
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You are treating a patient who has a possible spinal injury after failing approximately 12 feet. The patient is warm and dry. The patient's vital signs are pulse 80, respirations 20, and BP 118/76. When you reassess the patient's vital signs 5 minutes later, the pulse and respirations are the same, but the BP has dropped to 80/40. You would suspect that the patient is suffering from: (A) cardiogenic shock. (B) vasogenic shock. (C) neurogenic shock. (D) hypovolemic shock. |
(C) Patients who have a spinal injury may suddenly drop their blood pressure although their vital signs, skin color and temperature remain the same. This is a result of the arteries losing the nerve impulse from the brain and the spinal cord as a result of the injury. This is typically indicative when the patient has injured the upper portion of their spinal cord. This is called relative hypovolemia. The patient's pump, the heart, is intact and functioning properly. The patient's blood volume has not increased, however, their pipes, the blood vessels, have increased or dilated in size. You have the same amount or volume of blood, but now a larger pipe or vessel for the same amount of blood to go through, therefore decreasing the pressure against the arterial walls and dropping the blood pressure.
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When decontaminating a patient's eye that has a foreign body or substance in it, you should always:
(A) have the patient close their unaffected eye and flush the area with water. (B) wash the eye towards the nose so you can watch the substance dislodge from they eye. (C) lay the patient on his back and flush with copious amounts of water. (D) flush the affected eye, flushing away from the unaffected eye with copious amounts of water. |
(D) You should always flush the affected eye away from the unaffected eye. Have the patient lie on the side of their affected eye and flush the ye by holding the eyelid open and flush continuously for at least 15 minutes. You never want to flush towards the unaffected eye, because you will flush the contamination or particles into the unaffected eye.
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A 20-year-old female patient was sexually assaulted. The patient states that she is hemorrhaging profusely from the vagina. You should: (A) do nothing, and transport immediately. (B) apply a sterile sanitary napkin. (C) pack the vagina with sterile dressings. (D) have the patient squeeze her legs together and transport immediately. |
(B) Dealing with these types of events is not easy. The EMT-B needs to be very sensitive to the patient's experience while treating the patient with the appropriate medical care. In this instance you would want to apply a sanitary napkin and apply direct pressure to control the bleeding. You never want to insert or pack anything into the vagina. It is important to have a female EMT-B assist the patient if at all possible. |
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A 45-year-old male was involved in a MVA. The patient is complaining of shortness of breath and chest pain. You recognize that the patient has JVD and the patient's pulse is weak and thready. You believe the patient has a pericardial tamponade. You distinguish that this is the problem wit the patient by noting or discovering: (A) decreased heart sounds. (B) patient has JVD. (C) narrowing pulse pressure. (D) patient is complaining of chest pain. |
(C) All of these are signs and symptoms of pericardial tamponade. A narrowing pulse pressure is indicative of a pericardial tamponade. A narrowing pulse pressure is when the systolic and diastolic grow closer together. Decreased heart sounds may also be a sign, but it is not always indicative of a pericardial tamponade. This may also be a result of a pneumothorax or hemothorax.
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You are dispatched to a local farm. You arrive on the scene to discover that the patient is inside a silo. The patient does not respond to your verbal commands from outside the silo. You should: (A) immediately rescue the patient. (B) enter the silo, with your partner waiting outside. (C) wear an SCBA and enter. (D) empty the contents of the silo. |
(C) The main concern with a silo is the gas that it produces. If one person is already unresponsive in a confined space such as a silo, anyone else who enters will typically be overcome by the same gases. Remember, scene safety and wearing protective equipment is important. It is also important to only use the equipment you have been properly trained to use.
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When treating children, all of the following are important considerations EXCEPT: (A) the fact that they are more susceptible to hypothermia. (B) that padding is needed when immobilizing. (C) that they should be treated just like adults. (D) that they have smaller airways. |
(C) A child's skin surface is larger compared to their body mass, which makes them more susceptible to hypothermia in cold environments. They also tend to have large heads compared to the rest of their body and tend to take more padding when immobilized them on spine boards. Their airways are also smaller and more prone to choking or other airway problems as a result of swelling. A child's airway may be as small as 1/2 the size of a typical adult's trachea. Children are different from adults and must be treated like children.
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Which of the following are signs of early respiratory distress in children? (A) nasal flaring. (B) neck muscle retractions. (C) see-saw respirations. (D) all of the above. |
(D) Signs of early respiratory distress in children are: increased respiratory rate, nasal flaring, intercostals retractions on inspiration, supraclavicular and subcostal retractions n inspirations, neck muscle retractions, audible breathing noises such as stridor, wheezing, or grunting, and see-saw respirations. It is important to identify respiratory distress in children and infants early. These patients tend to compensate for a period of time and then crash fast. Early intervention is important.
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When establishing a landing zone for a medical helicopter, the minimum area secured should be: (A) 100' x 100' (B) 200' x 200' (C) 50' x 50' (D) 60' x 60' |
(A) The minimum area you should secure for a night landing of a medical helicopter is 100' x 100'. During the daylight hours it is 60' x 60'. Keep in mind your local air medical agency may require a larger landing area depending on their policies and the type of helicopter they use.
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A frantic mother hand you her 9-month-old infant. She says that the patient was playing and found a marble. The patient stuck the marble in his mouth and she cannot get him to breathe. You should: (A) deliver 5 back blows followed by 5 chest compressions. (B) deliver 5 back blows followed by 5 abdominal thrusts. (C) sweep the mouth to see if you feel the marble. (D) deliver 5 abdominal thrusts. |
(A) When treating an infant who is chocking, you should never stick your finger in their mouth nor do a blind finger sweep. You should only do a finger sweep if you see the object. The proper treatment for a chocking infant is to deliver 5 back blows, 5 chest thrusts and then look in the mouth for the object. If the patient is unresponsive then try a ventilation and proceed with the same sequence if you cannot get a ventilation into the patient.
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A 4-year-old patient you are treating has a fever of 104f. The patient tells his mother it hurts to swallow. You notice that he is drooling from his mouth and he appears to be mouth breathing. The patient wants to sit in a tripod position. You suspect the patient is suffering from: (A) croup. (B) epiglottitis. (C) asthma. (D) bronchitis. |
(B) The patient is exhibiting signs indicative of epiglottitis. It is important not to agitate this patient and get the patient to definitive care immediately. Try to provide oxygen to the patient, but do not agitate the child or stick anything in the patient's mouth in doing so.
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Which of the following patient moving devices would be most appropriate to lift a patient with a dislocated hip from the floor in a narrow hallway? (A) backboard (B) bed sheet (C) stair chair (D) scoop stretcher |
(D) The most appropriate device to lift a patient from the floor that has a dislocated hip and is lying in a narrow hallway is the scoop stretcher. The scoop stretcher can be split in half and slid under each side of the patient and then reconnected. It allows for miner movement. The other devices would require additional movement of the patient and may aggravate the patient's injury.
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You immobilize a 37-year-old pregnant female on a backboard. The patient states that she is feeling dizzy and weak. Her blood pressure has dropped and she is tachycardic. You should: (A) elevate the foot of the board 6 inches. (B) apply the MAST garment and inflate the legs. (C) raise the right side of the board 6 inches. (D) raise the left side of the board 6 inches. |
(C) Pregnant patients, especially in their late terms, should be transported on their left side. By placing the patient in a supine position, the fetus will place pressure on the inferior vena cava causing the blood pressure to drop, cardiac output to decrease, and the pulse to increase. Raising the right side of the board 6 inches or more will help take the pressure off of the patient's inferior vena cava.
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You are working at a haz mat site. You should establish the medical care of all patients to be performed in the: (A) cold zone. (B) warm zone. (C) hot zone. (D) none of the above. |
(A) With the exception of treating life-threating care such as airway management and immobilization, all medical care should be performed in the cold zone. Without the proper personal protective equipment and training, an EMT-B should remain in the cold zone and treat the patients once they have been effectively decontaminated.
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What three things do you want to remember when dealing with a radioactive incident? (A) time, depth, and shielding. (B) time, distance, and shielding. (C) time, distance, and space. (D) type, distance, and shielding. |
(B) The three most important factors when dealing with radioactive materials are time, distance, and shielding. Radioactive materials are classified into three categories; alpha, beta, and gamma. Gamma is the most intense radioactive material. The length of time you are exposed to gamma radiation cannot be long compared to time exposed to alpha rays. Exposure to alpha rays occurs almost daily from the sun's rays. Distance and protection or shielding from radioactive materials are also important factors. Alpha rays will not penetrate through paper while lead is needed to protect against gamma rays.
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At the scene of a mass casualty, the __________________ is in charge of where the patient goes. (A) EMT-B treating the patient. (B) transportation sector. (C) incident commander. (D) driver of the ambulance. |
(B) During a mass casualty incident, an incident command system needs to be established which includes a transportation sector. The responsibility of this sector is to ensure that patients are transported to the appropriate hospitals. The transported sector coordinates this with the incident commander, the triage sector, and the hospitals, but is responsible for where the patient is transported to and then recording this information.
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You are the triage officer at the scene of a mass casualty incident. Which of the following patients should be treated first? (A) a 37-year-old female patient who is unresponsive. (B) an 18-year-old male patient who is not breathing and has no pulse. (C) a 29-year-old male patient with a femur fracture. (D) an8-year-old patient who is conscious but having trouble breathing. |
(A) In a mass casualty incident, anyone who is pulseless and apneic is classified as dead. Unfortunately, often there are too many patients to care for considering the amount of resources available. A patient with a fractured femur will be stable for the moment. An 8-year-old with trouble breathing may be tagged as a moderate priority, but the unconscious female is a high priority and should be treated first. If the patient's airway can be opened with manual techniques, continue to triage and provide treatment to other patients.
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The 2-person ratio of chest compressions to ventilations for an adult patient is: (A) 30:2 (B) 4:1 (C) 5:1 (D) 15:2 |
(A) The ratio of compressions to breaths for adults is 30:2, regardless of whether you have one rescuer or two rescuers.
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The depth of compressions for a patient that is 6 years old is: (A) 1/2 to 1 inch (B) 1/3 to 1/2 the depth of the chest (C) 1/2 to 3/4 the depth of the chest (D) 2 to 2 1/2 inches |
(B) The chest wall should be compressed 1/3 to 1/2 the depth of the chest.
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You are treating a 35-year-old conscious choking victim. The patient suddenly goes unresponsive. Your next step is to: (A) attempt to ventilate the patient. (B) perform CPR. (C) deliver 5 abdominal thrusts. (D)deliver 5 chest thrusts. |
(B) As a health care provider, once the patient becomes unresponsive you should begin CPR.
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You have successfully converted you cardiac arrest patient out of v-fib with your AED. The patient has a pulse and respirations are 6 per minute. You should: (A) continue CPR. (B) monitor the patient. (C) administer 15 lmp of oxygen via NRM (D) continue to assist the patient with ventilations via a BVM and oxygen. |
(D) Once you have converted a patient out of v-fib and the patient has a pulse, you can stop doing chest compressions. Since this patient only has a respiratory rate of 6 per minute, you would continue to assist ventilations until their respiratory rate id between 12-20 breaths per minute. At that time you would monitor the patient and continue to provide supplemental oxygen at a rate of 15 L/min via non-rebreather mask.
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After arriving at the hospital you notice blood on your stretcher. The most appropriate way to disinfect the stretcher is a(n): (A) 1:10 ratio of bleach to water solution. (B) 1:100 ratio of bleach to water solution. (C) 1:1000 ratio of bleach to water solution. (D)straight bleach solution. |
(A) Since the stretcher comes in direct contact with your skin, you want to use a 1:10 bleach to water solution. In instances of cleaning ambulance floors, counter tops, and seats that are not contaminated with blood, 1:100 bleach to water solution is appropriate. It is never appropriate to use a 100% bleach solution on anything. This may actually do more damage than good.
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You arrive on the scene of a tanker truck carrying a hazardous material. You should position your vehicle: (A) 2,000 feet from the tanker truck. (B) uphill. (C) upwind. (D) all of the above. |
(D) If you are on the scene of a hazardous material incident, you should position your vehicle at least 2,000 feet from the incident. You should remain uphill to avoid any chance of a spill coming in contact with you. You should also be upwind so none of the vapors come through the air and in contact with you. You will need to monitor wind direction and may need to change locations if the wind changes.
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You are treating a child that has bruises at various stages on their body. The child states that she keeps falling down. The patient has what appears to be a fractured wrist. You should: (A) confront the parents about your suspicion of child abuse. (B) contact law enforcement and tell them of your suspicion. (C) treat and transport the child; once at the hospital notify the physician, document your findings, and report the incident as required by your state. (D) document the incident and allow your supervisor to make the decision of what to do after reading the patient care report. |
(C) Child abuse can be a very touchy situation. You do not want to confront the parents with you suspicion. The best way to handle this situation is to treat the patient and transport the patient to the appropriate facility. DO not let the child out of your sight. Once at the hospital, be sure to tell your findings to the physician, but do not be accusatory. Document your findings and make any notification to any state agency as required by your state.
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Which of the following is NOT a primary function of an EMT-B? (A) patient care (B) document patient care (C) billing the patient for service (D) being a patient advocate |
(C) The functions of an EMT-B include: being prepared to treat patient's, being ready to respond when called upon; respond, treat, and transport patients in a safe manner; properly assess your patients; provide prompt and effective patient care; lift and move patients safely; transfer patient care to one of the same level or greater level of care; document patient findings and history, and be a patient advocate. Many agencies bill for patient services; however, it is not a primary function of an EMT-B.
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Which of the following does NOT fall within the scope of practice for an EMT-B? (A) assessing a patient (B) administering oxygen (C) performing a cricothotomy (D) using an AED |
(C) The scope of practice is what the EMT-B is permitted to do within the scope of their training and authorization of their medical director. It is an important concept to know and understand. EMT-Bs are not trained to perform a cricothotomys. By law, a EMT-B must perform their duties within their scope of practice.
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When you grab a backboard, you realize that blood remains from an earlier call. With you hand covered in blood, your first step towards decontamination should be: (A) contacting your infection control officer. (B) washing your hands with soap and water. (C) completing exposure control forms. |
(B) The first line in defense against any infectious disease that comes in contact with your intact skin is to wash it with soap and water. In most instances if you can immediately wash the intact skin surface with water and soap, there is a very good chance you will not be infected should the blood be contaminated with an infectious disease. Once you have thoroughly washed your hands or skin, you will then want to contact your infection control officer and follow the appropriate protocols for the situation.
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You arrive on the scene to find a 37-year-old male sitting on the couch. The patient states he has not felt well for a number of days. Complaining of fatigue, he is experiencing tenderness in the upper right quadrant of his abdomen. Upon further assessment, you notice that this patient's skin is jaundiced. You should suspect this patient to be: (A) HIV positive. (B) suffering from TB. (C) alcohol dependent. (D) hepatitis positive. |
(D) This patient presents with classic signs of hepatitis, most likely hepatitis B positive. The key indicators are the fatigue, not felling well, and tenderness in the upper right quadrant of the abdomen, which is where the liver is located. Hepatitis affects the liver. The jaundiced skin color is also indicative of hepatitis. The EMT-B needs to wear BSI and take universal precautions as he/she would with any other patient. A hepatitis B vaccine is also advisable, but needs to have been administered prior to this call.
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Typically, which of the following is not one of the first things and EMT-B should do when arriving on the scene of an incident? (A) assess the scene for hazards. (B) assess the patient's airway. (C) note the number of patients. (D) note the mechanism of injury. |
(B) When you arrive on the scene of any incident, you want to assess the scene for hazards and make sure the scene is safe before you approach the patient. Second, you want to note how many patients there are so you can determine the number of resources you need. Finally, you want to note the mechanism of injury, which will aid in the assessment of the patient. Assessing the patient's ABC's is important, but these three items need to be determined prior to even touching the patient.
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There are five steps of grief associated with the death and dying process. The typical progression is: (A) denial, anger, bargaining, depression, and acceptance. (B) anger, denial, bargaining, depression, and acceptance. (C) denial, bargaining, anger, depression, and acceptance. (D) depression, denial, anger, bargaining, and acceptance. |
(A) The stages of death and dying typically go through a process that begins with denial. It is the "not me" defense mechanism that builds a defense against reality. Next they experience anger- they do not deserve to die now. Then they begin to bargain, "I am ok with dying, but first let me..." Then they become depressed. They think of all the things they haven't done. And last, they accept the fact that they are going to die. These are typically the five stages and the progression that happens. On occasion, they may not get to the next stage or they may skip stages of the process. You may also find it is not uncommon for the patient's loved ones to experience the five-stage process.
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Which of the following signs and symptoms are associated with the response to a stressful situation? (A) nausea/vomiting, shivering, diarrhea, dry mouth, and sweating. (B) nausea/vomiting, seizures, diarrhea, dry mouth, and sweating. (C) nausea/vomiting, shivering, diarrhea, excess saliva, and sweating. (D) nausea/vomiting, shivering, diarrhea, dry mouth, and seizures. |
(A) An EMT-B may experience a number of signs and symptoms when responding to an emergency or working at the scene of an incident that are normal responses to a stressful situation. They include: upset stomach, nausea and vomiting, shivering or shakes, feeling clumsy, diarrhea, dizziness, dry mouth, pounding heart, sweating, stomach cramping, and/or muscle aches. |
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An EMT-B can take steps toward managing and reducing the stress associated with working in the EMS environment. The following suggestions are all ways to assist in managing stress EXCEPT: (A) balancing your life with work, recreation, family and friends. (B) drinking excessive amounts of alcohol to dull the pain of stress. (C) keeping a positive attitude. (D) realizing that your personality includes physical, mental, emotional, and spiritual needs. |
(B) It is important for the EMT-B to realize and recognize that managing stress is an important aspect of keeping you career in EMS a healthy one. A balance between work, recreation, family and friends is important to maintain this healthy lifestyle. By recognizing that your personality includes physical, mental, emotional, and spiritual needs, you can work towards rounding your activities to include these four areas. It is important to maintain a positive attitude. A positive attitude can also be infectious to those around you. You don't want to squelch you stress by alleviating it with alcohol.
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These are two basic types of law, criminal law and civil law. A situation related to civil law is: (A) prison time for murdering another individual. (B) an issued document that requires you to appear in court. (C) a breach of contract. (D) a traffic citation. |
(C) The easiest way to differentiate between civil and criminal law is that criminal is disciplinary in nature and civil law typically affects your pocketbook. In other words, if you are convicted of a criminal law you could be punished by imprisonment. It may also affect your pocketbook, if there is a fine associated wit the punishment. Civil law, however does not carry any prison time associated with it. A breach of contract is an example of civil law, as are divorce and torts. An example to distinguish how one could be tried in both areas of law and found innocient of one and guilty of another is the infamous O.J. Simpson case. He was acquitted of any wrongdoing in the criminal trail and was found guilty in the civil proceedings.
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You arrive on the scene to discover a patient who refuses to allow you to touch her. You feel the patient is in need of treatment and attempt to take her blood pressure. You have just committed: (A) an assault. (B) battery. (C) negligence. (D) an act befitting your profession. |
(B) An assault is when you put the patient in immediate fear of harm versus battery which is touching the patient without their consent. Granted taking a blood pressure is within an EMT-B's scope of practice, however the patient refused to allow you to touch them. This is considered a battery and you could be criminally charged according to the law.
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The skull is divided into four major areas. These four areas are called: (A) frontal, occipital, temporal, and lobal. (B) frontal, occipital, temporal, and parietal. (C) frontal, occipital, temporal, and partial. (D) frontal, mandibular, temporal, and parietal. |
(B) The skull is divided into four major areas. They are the frontal, which is the anterior section. The posterior section is called the occipital section. The sides are called the temporal section and the top section is called the parietal section.
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The normal time span for a pregnancy averages: (A) 12 weeks. (B) 24 weeks. (C) 36 weeks. (D) 40 weeks. |
(D) The normal pregnancy time period is usually 40 weeks. It consist of three 3-month periods called trimesters.
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Labor and delivery is broken into three stages. The stage where the placenta is delivered is known as the: (A) third stage. (B) second stage. (C) first stage. (D) none of the above. |
(A) The first stage of labor is when the contractions begin until dilation of the cervix. The second stage begins with the full dilation of the cervix and ends with the delivery of the baby. The third stage begins with the delivery of the baby and ends with the delivery of the placenta.
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A 22-year-old female patient is complaining of abdominal pain and vaginal bleeding. She states that her menstrual last period was two months ago. You would suspect the patient has had a: (A) abruption placenta. (B) spontaneous abortion. (C) uterine rupture. (D) placenta previa. |
(B) This is symptoms of a spontaneous abortion. This occurs early in a patient's pregnancy and most often in the first trimester. You need to provide general support care and use sanitary pads for the vaginal bleeding. If any clots or products are present, you should take those along to the hospital.
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You are called to a patient in her third trimester of pregnancy. She states she felt a tearing sensation in her lower abdomen that was very painful. There is no bleeding upon your assessment. You would suspect: (A) abruptio placenta. (B) spontaneous abortion. (C) uterine rupture. (D) placenta previa. |
(C) This patient has most likely suffered a uterine rupture. This occurs in the third trimester of pregnancy and is symptomatic with a painful tearing sensation. There may or may not be bleeding associated with this. This patient needs to be treated for any signs or symptoms she is exhibiting and receive rapid transport to the hospital.
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You have just delivered a baby boy. The baby is wrapped in a blanket and doing well. You are prepared to cut the umbilical cord. Which of the following is the correct procedure to cut the cord? (A) Fasten the first clamp four inches from the infant's belly and the second clamp two inches away from the first clamp. Wait until you no longer feel a pulse in the cord and then cut the cord. (B) Fasten the first clamp two inches from the infant's belly and the second clamp 2 inches away from the first clamp. Wait until you no longer feel a pulse in the cord and then cut the cord. (C) Fasten the first clamp four inches from the infant's belly and the second clamp four inches way from the first clamp. Wait until you feel a pulse and then cut the cord. (D) Fasten the first clamp two inches from the infant's belly and the second clamp four inches away from the first clamp. Wait until you feel a pulse in the cord and then cut the cord. |
(A) The proper procedure for cutting the umbilical cord is to fasten the first clamp four inches from the infant's belly and the second clamp two inches away from the first clamp. Wait until you no longer feel a pulse in the cord and then cut the cord between the two clamps.
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In which of the following situations may an EMT-B place their hand in a patient's vagina? (A) There is never an incident that allows this. (B) a breech birth. (C) to examine the vagina. (D) to relieve pressure on a prolapsed cord. |
(D) The only time an EMT_B is allowed to place their hand in a patient's vagina is when there is a prolapsed cord. This will allow the EMT-B to relieve the pressure off the umbilical cord until the patient can reach the hospital. The presentation of the umbilical cord means that the baby will have to be delivered by cesarean.
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During the delivery of a baby, you note a greenish/blackish fluid in the amniotic fluid meconium. This indicates that: (A) there is blood in the fluid. (B) this is normal and should be expected. (D) the baby had a bowel movement while in the uterus. |
(D) Meconium us a result of the baby having a bowel movement while in the mother's uterus. This usually occurs as a result of some type of stress placed upon the baby. Airway care is imperative with these deliveries. Be careful not to stimulate the infant prior to getting the nose and mouth suctioned. Aspiration of meconium us fatal in 50% of babies.
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The three main bones of the are the: (A) humerus, tibia, and radius. (B) humerus, ulna, and fibula. (C) humerus, tibia, and fibula. (D) humerus, ulna, and radius. |
(D) The three main bones of the arm are the humerus, the ulna, and the radius. The femur, tibia, and the fibula are the three main bones of the leg.
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You are assessing a patient's breathing. The four things you want to determine are: (A) rate, rhythm, and depth. (B) rate, rhythm, and depth. (C) rate, rigidity, and depth. (D) rate, rhythm, and depth. |
(B) When assessing a patient's breathing you want to assess the respiratory rate or how many times the patient breaths in a one-minute period. You want to assess the patient's rhythm: is the patient breathing in normal breaths or breathing fast or slow? The quality of breathing is also important. Does the patient have a difficult time breathing? Last, assess the depth of the patient's breathing which is also known as the tidal volume. The patient may not be getting enough oxygen because they are not getting an adequate tidal volume.
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You are providing rescue breathing to an adult patient using a mouth-to-barrier device. You should provide a tidal volume of: (A) 1600 to 2000 mL. (B) 1300 to 1600 mL. (C) 1000 to 1300 mL. (D) 700 to 1000 mL. |
(D) A common side effect from mouth-to-barrier ventilation is gastric distention so be careful how much volume of air you put into the patient. This can be prevented by giving approximately 700 to 1000 mL over a two-second period.
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You are treating a patient with a laceration. You remember that ______ is/are the component within blood that is necessary to form a clot. (A) red blood cells. (B) white blood cells. (C) platelets. (D) plasma. |
(C) Red blood cells make up the largest component of blood and are responsible for carrying oxygen and carbon dioxide to and from the tissues. White blood cells exist to fight infections. Plasma is a liquid in which blood cells and nutrients are suspended. Therefore, platelets aid in the formation of clotting whenever they come in contact with anything other than the lining of a blood vessel.
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Which layer of the skin contains the sweat glands, sebaceous glands, hair follicles, blood vessels, and nerve endings? (A) dermis (B) epidermis (C) subcutaneous (D) subdermis |
(A) The dermis contains the sweat glands, sebaceous glands, hair follicles, blood vessels, and nerve endings. The epidermis is the outermost layer of the skin and consists of primarily dead cells, which provide a waterproof barrier. The subcutaneous layer is under the dermis and is made up of adipose, which is fat, and connective tissue.
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You arrive on the scene to find an unconscious patient about 14 years of age. Where would you assess for a pulse on this patient? (A) carotid artery (B) brachial artery (C) femoral artery (D) radial artery |
(A) This patient would be considered an adult and you would assess the carotid artery. A patient over the age of 8 is considered to be an adult in most cases in medicine. Patients from 1 to 8 are considered children and under 1 are considered to be infants. In infants and children, assess the pulse at the brachial artery. The femoral artery can be used to assess lower perfusion or to monitor effectiveness of CPR. Typically the femoral pulse is not used readily because of its location. The radial artery can be used to assess the rate of the heart, but should not be used to assess whether the patient has a heartbeat. There may not be a radial pulse but there may be a carotid pulse.
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You are assessing a patient's blood pressure. The relaxation and refilling of the left ventricle is measured by the: (A) systolic pressure. (B) diastolic pressure. (C) pulse pressure. (D) none of the above. |
(B) The systolic pressure is the first sound heard when taking a blood pressure. It is the pressure created by the contraction of the left ventricle forcing blood into the body. The second sound, or actually when the sound stops, is the diastolic pressure. This occurs when the left ventricle relaxes and refills with blood. The pulse pressure is the difference between the systolic and the diastolic pressure.
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When gathering a patient's medical history, the acronym SAMPLE is used. This acronym stands for: (A) signs and symptoms, allergies, medical history, previous occurrences, last oral intake, and events. (B) stable or unstable, allergies, medications, pertinent medical history, last meal, and events. (D) signs and symptoms, allergies, medications, pertinent medical history, last oral intake, and events. |
(D) SAMPLE stands for: signs and symptoms- essentially your physical assessment of the patient. Allergies- is the patient allergic to anything? Medications- what medication does the patient take? Pertinent medical history- what medical history is pertinent to the care of the patient? Last oral intake- when did the patient eat last? What did they have to eat? Determining why EMS was called is an important aspect of your assessment. What events led up to the patient calling for EMS?
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Your patient is on the second floor of his home. While carrying, the patient should be moved: (A) feet first. (B) head first. (D) none of the above. |
(A) When moving a patient down the stairs, the patient should go feet first. When moving a patient up the stairs, the patient should go head first. This creates and environment that is most comfortable and least frightening for the patient. Most of your equipment is designed with this movement in mind.
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Which of the following is not considered a significant mechanism of injury for an adult? (A) roll-over of vehicle. (B) falls greater than 10 feet. (C) penetrations of head, chest, or abdomen. (D) ejection from vehicle. |
(B) Falls greater than 10 feet are considered a significant mechanism of injury in a child or infant, but not in an adult. A fall greater than 20 feet is considered a significant mechanism of injury in an adult.
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When you listen to the lungs of an asthma patient you would expect to hear: (A) wheezes. (B) rales. (C) stridor. (D) rhonchi. |
(A) Wheezes are indicative of asthma. In some instances they can be heard without the aid of a stethoscope. If the patient has a history of asthma but is not wheezing they could still be having an asthma attack. In severe cases the asthma progresses to a point where there is not wheezing. If the patient has a prescription inhaler, contact medical control to get orders to assist in administering the inhaler.
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Your patient is lying in the doorway of her home, which is on fire. You are first on scene. You should: (A) wait for the fire department. (B) treat the patient where you found her. (C) immediately move the patient. (D) perform an initial assessment to determine what to do next. |
(C) There are few times when you will need to move the patient immediately; this is called emergency move. As long as you can reach the patient and move them to safety, you should go ahead perform the rescue. Since the patient is in the doorway and fire can be seen, an emergency move is appropriate in this scenario. If you arrive on the scene and the patient is still in the house, it is better to wait for fire personnel to arrive on the scene to perform the rescue. Never stay and treat a patient with impending danger, move to a safer spot.
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You are treating an unresponsive patient and do not suspect that the patient has a neck or spinal injury. You should place this patient in which position? (A) supine (B) recovery (C) prone (D) trendelenburg |
(B) A patient who is unconscious and not suspected of having a spine or neck injury should be placed in the recovery position. When placing the patient in the recovery position, they should be placed on their left side so that when transported the patient will be facing the ambulance bench seat. The recovery position will aid in keeping the airway clear.
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You are treating a patient who becomes unresponsive. The patient was complaining of chest pain prior to becoming unresponsive. Your first step is to: (A) administer nitroglycerin. (B) open the airway using the head-tilt chin lift. (C) assess for a pulse. (D) assess vital signs. |
(B) When treating a patient who becomes unconscious, your first priority is to ensure an open airway. Unless you suspect the patient has a possible c-spine injury, you would open the airway with the head-tilt chin-lift method. After you get their airway open, then assess for breathing. Never give an unconscious patient anything by mouth.
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You are suctioning your patient's airway. One of the biggest side effects of suctioning is: (A) hypoxia. (B) aspiration. |
(A) The greatest concern when suctioning is hypoxia. Suction for no more than 15 seconds at a time and then attempt ventilations. There are incidents when continuous suctioning may be needed, however, keep in mind, the patient's state of hypoxia becomes increasingly worse. The suction catheter clogging is another concern, but it is not the greatest concern. It is much easier to replace the suction catheter than caring for a patient who becomes more hypoxic.
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A common method for documenting a patient assessment on a patient care report form is: (A) DCAPP BTLS. (B) SOAP. (C) ABCDE. (D) OPQRST. |
(B) The soap method is a common method to document your patient care. It covers the majority of your findings and treatment. S is for subjective or the information the patient tells you. O is for objective or your findings upon assessing the patient. A is for Assessment or your evaluation of the patient. The P is for your plan or the action you are going to take as the EMT-B to care for this patient.
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Your patient has been having seizure without gaining responsiveness between seizures. You are concerned about protecting his airway. You want to insert a nasopharyngeal airway. To properly size the airway you should: (A) measure from the tip of the ear to the tip of the nose. (B) measure from the tip of the ear to the tip of the mouth. (C) measure from the tip of the nose to the tip of the chin. (D) measure from the tip of the nose to the corner of the mouth to the tip of the ear. |
(A) In order to insert the proper nasopharyngeal airway, measure from the tip of the ear to the tip of the nose. If inserting an oropharyngeal airway, measure from the corner of the mouth to the tip of the ear.
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You are using a flow-restricted oxygen-powered ventilator. To prevent distention, the maximum flow rate should be set at: (A) 10 L/min. (B) 15 L/min. (D) 40 L/min. |
(D) Gastric distention is a concern when using a flow-restricted oxygen-powered ventilator. The flow rate should not be set at any greater than 40 L/min.
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To decrease gastric distention during artificial ventilation, you should: (A) apply the Sellick maneuver. (B) decrease the amount of ventilation you administer. (C) tilt the patient's head back further. (D) apply pressure tot he abdomen. |
(A) In order to decrease gastric distention and the possibility of the patient regurgitating and aspirating their vomit, you should use the Sellick maneuver. This is accomplished by applying pressure tot he cricoid cartilage just below the Adam's Apple. You should not push on the patient's stomach if they do have gastric distention. Remember, what goes in must come out and there will be vomitus that comes back out with the air from the stomach. Be sure to have your suction unit close by.
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You arrive on the scene to find a patient with lacerations to her arms and legs. During your initial assessment the patient's husband begins wielding a knife at you and tells you to leave her alone or he will stab you. You should: (A) continue treating the patient. (B) retreat to a safe location and wait for law enforcement. (C) have your partner approach the husband and try to reason with him. (D) attempt to get the knife from the patient. |
(B) Any time the scene is not safe leave the scene immediately. Granted there will be incidents where the EMT-B will be in risky situations. Every call could potentially go bad. This particular incident has gone bad and the EMT-B needs to retreat to a safe location and notify law enforcement. Once law enforcement secures the scene, the patient. Never attempt to disarm anyone. Law enforcement officers are specially trained to do this. |
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You are treating a patient at a local restaurant. An individual approaches you and tells you he is a doctor. You should: (A) allow the physician to take over since he is more qualified. (B) have the physician perform invasive skills that you cannot perform. (C) ask the physician for his credentials and follow your protocols. (D) allow the physician to help you on the scene and then transport the patient to the hospital without the physician. |
(C) The first thing you want to find out is if the doctor is indeed a doctor and what type of doctor. A podiatrist will not be very helpful for a patient who is having chest pain, nor will a cardiologist be helpful for a patient having a baby. It is imperative that all local protocols are followed and that the physician accompany the patient to the hospital to assume all medical and legal responsibilities for the patient. |
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Your patient is unresponsive and responds when ever you pinch his feet. This patient's level of consciousness is classified as: (A) A- Alert. (B) V- Responds to verbal stimulus. (C) P- Responds to painful stimulus. (D) U- Unresponsive. |
(C) AVPU is used to assess the patient's level of consciousness. A is for alert- the patient is awake and talking to you though they may not respond appropriately. V is for verbal stimulus- when a patient only responds upon your verbal command. P is for painful stimulation, which is the case in this scenario, when the patient responds to you after you inflict pain. Again, the patient may not communicate verbally to you, but they do pull back or withdraw when you inflict the pain stimulus. U is for unresponsive. These are patients that do not respond to you by any of the means mentioned above.
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You are treating a patient with shortness of breath. You want to deliver 15 L/min of oxygen at 100%. You should deliver this flow rate with a: (A) nasal cannula. (B) simple face mask. (C) partial re-breather mask. |
(D) In order to deliver 100% of oxygen at 15 L/min use a non-rebreather mask. Any of the other masks will not deliver 100% oxygen but are capable of flowing 15 L/min. A nasal cannula should have a maximum flow rate of 6 L/min. |
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During your assessment of a patient's chest you note that the left side of the chest moves opposite tot he right. This is called: (A) crepitus. (B) paradigmal motion. (C) subcutaneous emphysema. (D) paradoxical movement. |
(D) When the patient's left or right chest moves the opposite of the other side, this is referred to as paradoxical movement. In most instances this is indicative of a flailed segment. Crepitus and subcutaneous emphysema may be additional signs of the flailed segment.
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During your assessment you note a pulsating mass in the mid-upper portion of the abdomen. This is most likely indicative of a(n): (A) bruit. (B) ruptured liver. (C) abdominal pulse. (D) aneurysm. |
(D) A pulsating mass in the area is typically indicative of an aneurysm. An aneurysm is a blood vessel that has a weakened area that has ballooned out. It is similar to a bicycle tire that becomes weak in one area and a bulge occurs. The bulge lasts only for a short time before it ruptures. This is the same with an aneurysm. |
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When delivering your report tot he receiving hospital over the radio, you should report all the following EXCEPT: (A) your unit number. (B) the patient's sex and age. (C) the patient's name. (D) the patient's current illness. |
(C) When giving a report to the receiving hospital by radio you should give the following information: Your unit number, your level of certification, ETA, age and sex of the patient, chief complaint, brief pertinent history of the present illness, major past illness, mental status, baseline vital signs, pertinent findings, medical care given, and response to the medical treatment. You should never give the patient's name over the radio. This may be seen as a breach of patient confidentially. |
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While treating a patient with shortness of breath, you administer oxygen based on written guidelines from you medical director. You administer the oxygen based on: (A) protocols or standing orders. (B) on-line medical direction. (C) your EMT-B textbook. (D) the Medical Practice Care Act. |
(A) Your care is typically based upon written protocols or standing orders by your medical director. These are also referred to as off-line medical direction. On-line medical direction is when you contact the medical director for direction on how to care for the patient via a radio or telephone. |
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You arrive on the scene of an auto accident. There is one vehicle and an 18-year-old patient. The police officer advises you that the patient is fine and that she does not want any treatment, on scene or at a hospital. You should: (A) explain the consequences of not being treated ad brought to a hospital and have the patient sign a refusal. (B) have the police officer sign the refusal form stating the patient does not want to go to the hospital. (D) refrain from making any physical contact with the patient and notify dispatch that you have been cancelled by law enforcement. |
(A) In many instances law enforcement personnel are not medically trained and you should not rely on them to provide medical care. In this scenario, the most appropriate step is to explain tot he patient directly the consequences of refusing patient care and transport and have her sign a refusal form. It is also advisable that you have at least one witness sign to attest to this. |
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You arrive on the scene to find a patient with troubled breathing and chest pain. Upon assessment of the patient, she tells you that she had a salad for lunch at a local seafood restaurant. She notes during the assessment that she is allergic to shellfish. Upon further assessment you note hives around their mouth. You should consider treating this patient by: (A) assisting her in taking one of her nitroglycerin. (B) assisting her in taking her prescribed inhaler. (C) assisting her in taking her antacid. (D) assisting her in administering a prescribed epinephrine injector. |
(D) This patient appears to be having an allergic reaction. The shortness of breath and chest pain are symptoms of the allergic reaction. The key is that the patient ate at a seafood restaurant and is allergic to shellfish. Upon assessment you also noted the hives which is indicative of an allergic reaction. The most appropriate care for this patient is to assist in administering their epinephrine injector. Remember that it has to be prescribed tot hem and you need to get the approval from your medical director before administering the medication.
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You are treating a patient who ingested a poison. Poison Control advises that this poison is best treated with Activated Charcoal. Activated Charcoal works by: (A) adsorption. (B) inducing vomiting. (C) absorption. (D) inducing urination. |
(A) Activated Charcoal works by adsorbing the substance. Syrup of Ipecac works by inducing vomiting. There are really no side effects to Activated Charcoal which is a slurry mixture that can be very messy and does not taste good.
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You are treating a diabetic and consider administering glucose to the patient. Glucose will:
(A) lower the blood sugar. (B) raise the blood sugar. (C) lower the insulin levels. (D) raise the insulin levels. |
(B) Glucose is used to raise the blood sugar. Regardless of whether the patient is hypoglycemic or hyperglycemic, it will not hurt the patient to give them oral glucose. A patient that is hypoglycemic is in dire need of glucose and it is critical that they get the glucose in a short amount of time. A patient who is hyperglycemic will not be affected in a dire way by getting more glucose. At no time should an EMT-B give or assist in giving insulin. This is a very potent drug and can cause severe side effects if given improperly.
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Albuterol is a medication administered by: (A) injection. (B) inhalation. (D) orally. |
(B) Albuterol is given by inhalation. It is a medication for the treatment of breathing disorders, usually associated with asthma. It helps open the airways in the lungs, thus allowing for easier breathing.
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You are treating an elderly patient who has a fever, chills, cough with sputum production, and dyspnea. The patient also states that the symptoms have been progressing rapidly and you note breathing is difficult. This patient is most likely suffering from: (A) pneumonia. (B) COPD. (D) tuberculosis. |
(A) These are characteristic signs of pneumonia. The key here is the fever and chills. Pneumonia is typically caused by an infection which is indicated by fever. The treatment for this patient is general supportive care, including oxygen and transport tot he hospital. This patient should be transported in at least a semi-Fowlers position to aid breathing.
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You are treating a 5-year-old patient who has a foreign body partially obstructing his airway. You would suspect to hear: (A) wheezes. (B) rales. (C) stridor. (D) rhonchi. |
(C) Stridor is a high-pitched harsh sound heard during inspiration, which results from a narrowing in the upper airway. This is usually a result of a foreign body partially obstructing the airway. It is also commonly heard as a result of an infection, such as croup or epiglottitis. |
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The following are causes of pulmonary edema EXCEPT: (A) congestive heart failure. (B) severe infection. (C) smoke inhalation. (D) an embolism. |
(D) There are many conditions that cause pulmonary edema. The most common cause is congestive heart failure. Other conditions include: severe infections, smoke or toxic inhalations, high altitudes, narcotic overdoses, and fluid overload. |
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You are called to a local high school where you find a 17-year-old female breathing at a rate of 40 breaths per minute. She is complaining of tingling in her hands and feet and appears very agitated. You were told by her friend that she just broke up with her boyfriend. You suspect this patient is suffering from: (A) hyperventilation. (B) severe episode of dyspnea. (C) an asthma attack. (D) drug overdose. |
(A) This patient appears to be suffering from a classic case of hyperventilation. Patients who are breathing very fast, have tingling or numbness in their feet and hands, along with being agitated, and having a hunger for air are usually suffering from hyperventilation. This is usually a result of an emotional upset, as in this case.
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The treatment for the patient in the previous question would be to: (A) have the patient breath in a paper bag. (B) reassure and calm the patient. (C) administer oxygen 6 L/min. (D) administer oxygen 15 L/min. |
(B) It is no longer appropriate to have a patient breath into a paper bag. In this particular case, the most appropriate means of treatment is to calm and reassure the patient. Hyperventilation can also occur in diabetic patients who are in a diabetic coma. In this particular situation or when you are unsure why the patient is hyperventilating, you should not withhold oxygen.
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You arrive on the scene of a 2-year-old that has a barking cough, low-grade fever, and cold-like symptoms. You suspect this child is suffering from: (A) asthma. (B) bronchitis. (C) epiglottitis. (D) croup. |
(D) These are classic signs and symptoms of a patient with croup. The age of the patient is usually from 6 months to 3 years.
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Which of the following arrhythmias should be shocked using an AED? (A) asystole. (B) ventricular tachycardia. (D) atrial fibrillation. |
(B) Ventricular tachycardia without a pulse should be shocked using an AED. Any rhythm that has a disorganized electrical activity coupled with no pulse should be shocked using an AED. The other rhythm that is shocked on a common basis is ventricular fibrillation. Pulseless Electrical Activity, or PEA, has an organized electrical activity. In this rhythm, the patient has an underlying problem that needs to be resolved and defibrillation is not appropriate. A patient in asystole does not have any electrical activity and a shock will not benefit this patient. Atrial fibrillation is not a rhythm that an EMT-B will shock.
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You are treating a 45-year-od male who has a history of heart problems The patient tells you that he has chest pain after exerting himself, however it relieves itself when he rests. You would suspect this patient has: (A) angina pectoris. (B) myocardial infarction. (C) congestive heart failure. (D) muscular skeletal pain. |
(A) This patient has the signs and symptoms of angina pectoris. Chest pain brought on by exercise or exertion and relieved by resting is indicative of angina. This is caused by the narrowing of the blood vessels which is typically a result of atherosclerosis. |
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The patient in the previous question may also have his chest pain relieved by: (A) Albuterol. (B) Lasix. (C) epinephrine. (D) nitroglycerin. |
(D) Patients suffering from angina and who have had this condition in the past will typically have nitroglycerin prescribed to them. If the patient is still having chest pain, contact your medical director to get orders to assist the patient in taking his prescribed nitroglycerin. It is important that patients take medication that is prescribed only to them. |
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Which of the following patients should you connect to an AED? (A) 50-year-old unresponsive male. (B) 4-year-old unresponsive female with a pulse. (C) 45-year-old male complaining of chest pain. (D) 52-year-old female complaining of a fast heart beat. |
(A) The most appropriate patient is the 50-year-old male who is unresponsive. There is never a reason to connect an AED to a conscious patient regardless of their chief complaint. This is a question you cannot read anything into but take a face value and select the most appropriate answer. |
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You are treating a patient who appears to be having symptoms of a myocardial infarction. You know that one of the serious problems that a myocardial infarction may lead to is: (A) angina pectoris. (B) ventricular fibrillation. (C) ischemia. (D) cardiac tamponade. |
(B) One of the most serious problems or conditions that a myocardial infarction can lead to is cardiac arrest with ventricular fibrillation being the most common arrhythmia associated. If the patient goes unresponsive, it is essential you apply your AED immediately. Immediate defibrillation can be a life saver for these patients. Early defibrillation saves lives. |
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You are treating a 62-year-old female patient who is complaining of shortness of breath, chest pain and is coughing up a pink frothy sputum. You would suspect this patient has: (A) right sided congestive heart failure. (B) left sided congestive heart failure. (C) emphysema. (D) pneumonia. |
(B) This patient is suffering from congestive heart failure. In order to know if it is right or left depends on the patient's symptoms. In this case the patient has pink frothy sputum which is indicative of oxygenated blood. Essentially the left side of the heart is not able to keep and the blood backs up into the lungs and causes the pink frothy sputum. Right sided heart failure is when the right side of the heart cannot keep up with the blood flow and you typically see JVD.
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The treatment for the previous patient would be to: (A) administer oxygen at 6 L/min and transport in the supine position. (B) administer oxygen at 6 L/min and transport in the Fowlers position. (C) administer oxygen at 15 L/min and transport in the Fowlers position. (D) administer oxygen at 15 L/min and transport in the supine position. |
(C) This patient needs 100% supplemental oxygen delivered at 15 L/min via non-rebreather mask. The patient should also be transported in the Fowlers position or sitting up. If you put the patient in a supine position, they will feel like they are drowning. By placing them in the Fowlers position it allows the fluid in the lungs to migrate to the lower portion of the lungs and assist in their breathing. |
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A patient who is in a state of hypoperfusion caused by inadequate pumping action by the heart is known as: (A) cardiac introphy. (B) cardiogenic arrest. (C) cardiogenic shock. (D) cardiac tamponade. |
(C) This is the definition of cardiogenic shock. The pump has been damaged and cannot keep up with the blood flow causing the patient to go into shock, hence cardiogenic shock. |
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You are treating a patient with chest pain and know there are some contraindications to the administration of nitroglycerin. Which of the following is NOT a contraindication to the administration of nitroglycerin? (A) The patient is twenty years old. (B) The patient's systolic pressure is 90. (C) The patient has taken three nitroglycerin tablets. (D) The patient has a head injury. |
(A) Contraindication of nitroglycerin are: systolic blood pressure less than 100 mm Hg, a head injury, an infant or child patient, and/or the patient has taken three nitroglycerin tablets prior to your arrival. A twenty-year-old typically does not have a heart attack, however it is possible, and there is not contraindication for their age. |
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After administering a nitroglycerin tablet to the 50-year-old female patient you are caring for, your next step would be to: (A) give the patient another nitroglycerin if they continue to have chest pain. (B) ask the patient to chew the tablet so it is absorbed. (C) wait two minutes and take the patient's blood pressure. (D) check the date the nitroglycerin was filled. |
(C) After giving a patient nitroglycerin you should take their blood pressure approximately two minutes after administration. It is important to monitor a patient's blood pressure because nitroglycerin can cause patients to become hypotensive. You should check the dates on the medication bottle prior to giving the medication. It is important to check the dates but it is too late after you have given the medication. Nitroglycerin is administered sublingually, which means placing the tablet under the tongue and allowing it to dissolve. Never have the patient chew the tablet and do not give another nitroglycerin immediately. Check the patient's blood pressure and monitor changes in the patient. Nitroglycerin can be administered every 3 to 5 minutes until the pain is relieved, the patient has taken three nitroglycerin tablets or the systolic blood pressure is less than 100 mm Hg.
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In treating a patient in cardiac arrest, you applied the AED and have delivered one shock. The patient no has a pulse. Next, you should stop CPR and: (A) monitor the patient. (B) reassess the patient's breathing. |
(B) The next step is to reassess your patient. Even though the patient has a pulse, they may or may not have started breathing on their own. Any time the patient's condition changes, you should reassess the patient and treat accordingly. In this case reassess the breathing and continue care according to you findings.
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You and your partner are administering chest compressions to a 57-year-old. The rate of compressions would be: (A) no more than 80 compressions per minute. (B) no less than 120 compressions per minute. |
(D) The rate of compression for an adult patient is 80 to 100 compressions per minute. |
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The ratio of chest compressions to ventilations for a child during two-rescuer CPR as a health provider is: (A) 15:2 (B) 3:1 |
(A) The ratio of compressions to ventilations is 1 to 2. In other words, compress the chest 15 times; then the second rescuer gives two breaths.
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The rate for rescue breathing in an infant is: (A) 1: 1-3 (B) 1: 2-4 (C) 1: 3-5 (D) 1: 4-6 |
(C) The rate for rescue breathing in an infant is one breath every three to five seconds, or 12 to 20 breaths per minute. 1:3-5.
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You are doing two-rescuer CPR as a health care provider. You should switch between compressions and ventilations every: (A) one minute. (B) two minutes. |
(B) You should switch between performing compressions and administering ventilations every two minutes. It has been found that the most effective compressions can only be given by one person for a two-minute period. |
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The production of insulin occurs in the: (A) pancreas. (B) liver. (C) gall bladder. |
(A) The production of insulin occurs in the pancreas. |
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You are called to the scene of a female patient in her twenties who has an altered level of consciousness. Her boyfriend tells you that she takes insulin and has taken it as prescribed. He notes that they have been gone most of the day and she missed eating lunch. He said her glucose meter registered low when he took it. You would suspect this patient is: (A) overdosed on her insulin. (B) intoxicated. |
(D) Patients with low blood sugar are considered hypoglycemic. These episodes usually come on quickly as a result of the patient taking insulin but not eating. Patients who are hyperglycemic or have high blood sugar tend to have their symptoms occur over time. Hypolycemic patients need immediate treatment as this can be fatal if not treated in a timely fashion.
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You are treating a diabetic patient and his wife tells you that the doctor said the patient is NOT insulin dependent. You know this kind of diabetes is: (A) Type ll. (B)Type l. (C)Type lV. (D)Type lll. |
(A) Type ll is known as non-insulin dependent diabetes. It usually occurs later in life and is associated with obesity. Type l is known as insulin dependent diabetes and typically occurs in adolescence or early adulthood. Type l is thought to occur as a result of a virus that damages the pancreas.
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You are treating a patient suffering from anaphylactic shock. Which of the signs and symptoms would you likely see in this patient? (A) urticaria, bradycardia, tachypnea, and stridor (B) subcutaneous emphysema, bradycardia, dyspnea, and wheezing (C) urticaria, hypertension, tachypnea, and tachycardia (D) urticarial, tachycardia, tachypnea, and hypotention |
(D) Patients who are suffering from anaphylactic shock may exhibit a variety of signs and symptoms depending on the severity and the stage it is in. Patients typically have urticarial or hives, will be tachycardic, and may have tachypnea. In the late stages the patient will be hypotensive and have stridor as a result of the upper airway swelling closed. |
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Which of the following is NOT a contraindication of administering Syrup of Ipecac? (A) ingestion of caustic materials (B) ingestion of hydrocarbons |
(C) Syrup of Ipecac is a controversial medication and is not widely used any longer. You may still be called upon to administer it and need to know the contraindications of using it. It should not be used with patients that have ingested material or medication that could rapidly lead to a change in mental status, such as tricyclic antidepressants that can cause seizures without warning, is a contraindication in administering Syrup of Ipecac. Also, patients who have ingested any material a significant time prior to emergency care should not be administered Syrup of Ipecac.
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You are treating a patient with frostbite. Which of the following actions should be taken? (A) Break any blisters on the wound. (B) Apply direct heat to the affected area. (C) Rub or massage the affected area. (D) Remove any jewelry from the afflicted limb. |
(D) When treating a patient with frostbite you should AVOID breaking any of the blisters, directly apply heat or rewarming the body part, and rubbing or massaging the affected areas. Also, unless following prescribed guidelines, do not allow the patient to walk on or use the affected extremity. You should remove jewelry since swelling commonly occurs with frostbite and may further impede circulation to the limb. The frostbite should be covered with dry sterile dressing. |
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You are called to the scene of a possible poisoning. Upon arrival the patient is lying at the doorway of a lab. The patient is unconscious and you notice chemicals spilled in the room. Your next step would be to: (A) open the patient's airway. (B) remove the patient to another area. (C) identify the chemical. (D) do a rapid assessment. |
(B) If you can safely remove a patient from hazardous environment, do that first. If you cannot, retreat to a safe environment and call for additional help. It does not matter if the patient is breathing, has a pulse, or whatever if they are in a hazardous environment. Remember scene safety. |
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Which of the following is the correct dose of activated charcoal for an adult patient? (A) 12.5 to 25 g. (B) 25 to 50 g. (C) 50 to 75 g. |
(B) The correct dosage of activated charcoal fro an adult is 25 to 50 g. For a pediatric patient it is 12.5 to 25 g. |
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Which of the following heat emergencies is considered a true emergency? (A) heat cramps. (B) heat exhaustion. (C) heat infarction. (D) heat stroke. |
(D) Heat stroke are considered a true life threatening emergency. A heat stroke typically occurs after the patient has experienced heat cramps and heat exhaustion. A heat stroke patient has hot dry skin. They no longer are sweating. This will progress to seizures and unresponsiveness. Death is imminent without appropriate and immediate treatment. |
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You are treating a patient who has overdosed on a narcotic. The greatest risk for this patient is: (A) respiratory depression. (B) seizures. |
(A) The most important thing to note with a narcotic overdose s respiratory depression, which may lead to airway compromise. Narcotic medications depress the mental status of the patient.
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A 7-year-old burns her hand on a stove burner. This is an example of what type of heat transfer? (A) convection (B) radiation (D) evaporation |
(C) This is an example of conduction which is the direct heat exchange that occur when two or more different temperature surfaces come into direct contact. The temperature tries to equate by transferring the heat to the cooler object or the cooler object attempts to reduce the hotter object. |
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Which of the following would provide you with the greatest information when dealing with a poison patient? (A) medical director (B) chemtrec (D) poison control center |
(D) Your greatest resource for information regarding a patient who has a poisoning emergency is the poison control center. Your medical director is a wealth of information but he too relies on the poison control for information when dealing with patients. |
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A 27-year-old patient states that he opened the oven door and was burned from the heat of the oven. This is an example of what type of heat transfer? (A) convection (B) radiation (C) conduction (D) evaporation |
(B) Radiation is when heat is transferred or lost in the form of heat waves through air or water. The heat moves from the patient to other objects without direct contact. Convection creates heat loss by air currents moving across an exposed surface area. Evaporation is the change of a liquid into a gas, which requires heat. A common example of this type of heat loss is when the body tries to cool itself by sweating. |
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Your patient is suffering from frostbite. You would expect to see the following signs and symptoms: (A) blue-grayish skin; blisters filled with fluid; pitted edema. (B) ice covered skin; erupted blisters; skin hard to the touch. (D) blue skin; erupted blisters; pitted edema. |
(C) Deep frostbite has signs and symptoms that include: white and waxy, the skin is hard to touch, gross swelling, and fluid-filled blisters. If the skin becomes thawed or partially thawed, the skin may appear cyanotic or flushed with mottled areas. |
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A patient has suffered a burn that involves the epidermis, dermis, and the hypodermis. This is classified as a: (A) full thickness burn. (B) partial thickness burn. |
(A) A full thickness burn involves all the layers of the skin and the portion under the skin referred t as the hypodermis. This involves the nerves, therefore the patient will not complain of pain around the full thickness burn area. |
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You are assisting a patient who had a flash burn to both of his hands. The patient has charring of the skin and tissue damage through the skin and the underlying tissues. The signs and symptoms are indicative of a: (A) full thickness burn. (B) partial thickness burn. (D) dermis burn. |
(A) This patient has the signs and symptoms indicative of a full thickness burn.
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You respond to a structure fire. When you arrive on the scene a firefighter brings you a 57-year-old male. He has partial and full thickness burns to his arms and legs. You note partial thickness burns around his mouth and forehead. Your first priority with this patient is to: (A) apply burn dressings. (B) open the patient's airway. (C) maintain body temperature. |
(B) All of these are appropriate treatment protocols for this patient but your first priority is to ensure an open airway. This patient has probably incurred some upper respiratory burns making an airway important. This question does not state that the patient is still burning; therefore you can begin the cooling process after establishing an airway. In most circumstances this would be done simultaneously, however the airway is the first step. You also want to maintain the patient's body temperature. Burn patients will become hypothermic quickly. Finally, the patient needs to be transported to a hospital that can care for their burns. |
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Using the rule of nines, calculate the amount of body surface in the patient in the previous question. (A) 31.5% (B) 58.5% |
(B) When calculating the body surface area that is burned you use the rule of nines. Each leg is 9% for the front and 9% for the back which is 36% for this patient. The arms are 4.5% for the front and 4.5% for the back which is 18% for this patient. The patient has burns to the front of the head. The head is 9% total and therefore this accounts for 4.5% of the BSA burned on this patient for a total of 58.5%. |
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You are called to the scene of a possible drowning at a local pool. When you arrive on the scene, a bystander is holding the patient at the surface of the water. The patient is unconscious. Your next step is to: (A) begin rescue breathing. (B) remove the patient from the pool. |
(D) The best answer for this patient is to apply cervical and spinal immobilization. You do not want to begin rescue breathing since you have not assessed for breathing. The patient is unresponsive but that dos not mean they are not breathing. You do not want to remove the patient from the pool until you insure cervical and spinal immobilization. This patient may have struck their head and therefore you need this precaution. |
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You arrive on the scene of a patient who says that she was bitten by fire ants. She has bites all over her legs. Your first step in treating this patient would be to: (A) apply high flow oxygen and remove any jewelry. (C) transport the patient to the hospital. (D) use her epi-injector. |
(A) Your first step with this patient is to apply high flow oxygen and remove any jewelry. High flow oxygen should be used on any patient who has suffered a large amount of bites, unless they need ventilator assistance. Removing jewelry immediately is not necessarily a life-saving measure, however swelling is very common and removing jewelry initially will reduce complications later. You do not want to use the epi pen immediately because you need to make sure that it is the patient's and then call your medical director for permission to assist the patient in administering it to herself. The only symptoms at this time in this scenario are that the patient has been bitten by a large number of fire ants. Therefore, you would want to further assess the patient to see if she is having an allergic reaction to the bites.
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Your patient was sting by a bee. When you assess the sting site, you notice that the stinger is still in the patient's skin. You would: (A) leave the stinger in place. (B) use a pair of tweezers to remove the stinger. |
(C) To remove a stinger that is still in the patient's skin you would use a card, such as a credit card, to scrape the stinger off the skin. The stinger holds the venom and if you use a set of tweezers to remove the stinger, you may actually inject more venom into the patient. Likewise, you do not want to leave the stinger in the patient until you reach the hospital, and at no time should you be making any type of incision with a scalpel on the patient. |
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You are called to a home of a 60-year-old male who has been caring for his ill wife for the past year. The patient is very upset and tense. On your assessment you find the patient is diaphoretic, tachycardic, and is breathing rapidly. The patient tells you that he cannot take it any longer. You suspect this patient is suffering from: (A) a phobia of the patient's wife dying. (B) depression. (C) acute anxiety. |
(C) This patient exhibits the signs and symptoms of acute anxiety. Granted, he may be fearful his wife may die, but this is typically not a phobia. The same with depression and paranoia. He may be depressed, but his current signs and symptoms exemplify that of an acute anxiety attack. Calming and reassuring the patient is important in this scenario. |
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Which of the following is the most common cause of suicide? (A) alcohol (B) drugs (D) the holidays |
(C) Depression is the most common cause associated with suicide. The other three answers to this question may be a factor involved with suicide, but it almost always is in conjunction with depression. There is a myth that most suicides occur around the holidays, that is not true. More suicides occur in the spring of the year than any other time.
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Which of the following is NOT considered a risk factor for suicide? (A) male over the age of 55. (D) child of an alcoholic parent. |
(B) All of these risk factors except strong emotional bonds. The lack of strong emotional bonds is a risk factor. Other factors include depression, recent loss of spouse or significant other, chronic debilitating illness, financial set back or loss of a job, previous suicide attempt, substance abuse, or mental disorder. |
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You are asked to transport a violent patient who needs to be restrained. You would: (A) use soft cushioned restraints. (B) handcuff the patient tot he stretcher. (D) contact your medical director. |
(D) Restraining a patient is a very sensitive issue and must be handled appropriately. Medical direction needs to be consulted before a patient is restrained. A soft restraint should be used and you should thoroughly document the procedure.
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Which of the following is typically a result of osteoporosis? (A) broken bones. (B) kyphosis. (C) calcium deposits. (D) calphosis. |
(B) Osteoporosis typically causes kyphosis. This is seen in elderly patients and is identified by the curvature of the spine. Special consideration needs to be taken when immobilizing these patients.
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(A) By their first name. |
(B) When addressing an elderly patient or any patient for that matter it is appropriate to call them by their last name. You may call them by their first name only after you have gained their permission. It is never appropriate to call anyone by a slang name such as hon, honey, sweetie, etc. Also, using the terms grandma and gramps may be offensive to them.
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