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EMT Final
Material for EMT Final
413
Other
05/16/2012

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Term

As you begin ventilating an unresponsive apneic man, you hear gurgling in his upper airway. Your MOST immediate action should be to:

  • A: quickly turn the patient onto his side so secretions can drain.
  • B: suction the patient’s airway for no longer than 15 seconds.
  • C: reposition the patient’s airway and continue ventilations.
  • D: squeeze the bag-mask device with less force and reassess.
Definition
A: quickly turn the patient onto his side so secretions can drain.
Term

An elderly woman with COPD presents with a decreased level of consciousness, cyanosis to her face and neck, and labored respirations. Her pulse is rapid and weak and her oxygen saturation is 76%. You should:

  • A: insert a nasal airway and give her oxygen via a nonrebreathing mask.
  • B: avoid high-flow oxygen because this may cause her to stop breathing.
  • C: assist her ventilations with a bag-mask device and high-flow oxygen.
  • D: apply oxygen via nasal cannula and reassess her respiratory status.
Definition
C: assist her ventilations with a bag-mask device and high-flow oxygen.
Term

A 56-year-old man has labored, shallow breathing at a rate of 28 breaths/min. He is responsive to pain only. You should:

  • A: ventilate him with a bag-mask device at a rate of 30 breaths/min.
  • B: suction his mouth for 15 seconds and insert an oropharyngeal airway.
  • C: insert a nasopharyngeal airway and begin assisting his ventilations.
  • D: place him on his side and administer oxygen via nonrebreathing mask.
Definition
insert a nasopharyngeal airway and begin assisting his ventilations.
Term

How should treat an unresponsive, uninjured patient with respirations of 16 breaths/min and good chest expansion?

  • A: Jaw-thrust maneuver and frequent suctioning
  • B: Oropharyngeal suctioning and assisted ventilations
  • C: Suctioning as needed and artificial ventilations
  • D: Airway adjunct and oxygen via nonrebreathing mask
Definition
D: Airway adjunct and oxygen via nonrebreathing mask
Term

You are administering oxygen to a woman with asthma who took two puffs of her prescribed inhaler without relief prior to your arrival. Your next action should be to:

  • A: contact medical control for further advice.
  • B: provide immediate transport to the hospital.
  • C: confirm that her inhaler is prescribed to her.
  • D: administer one more puff from the inhaler.
Definition
A: contact medical control for further advice.
Term

Agonal respirations are not adequate because they are:

  • A: the result of an increase in tidal volume.
  • B: infrequent, gasping respiratory efforts.
  • C: associated with a prolonged inhalation phase.
  • D: characterized by a rapid, irregular pattern.
Definition
B: infrequent, gasping respiratory efforts.
Term

The active, muscular part of breathing is called:

  • A: inhalation.
  • B: expiration.
  • C: ventilation.
  • D: respiration.
Definition
A: inhalation
Term

ou are ventilating an apneic 50-year-old woman with a bag-mask device. After squeezing the bag and noting visible chest rise, you should:

  • A: suction the airway for up to 15 seconds.
  • B: allow the patient to completely exhale.
  • C: reopen the airway and ventilate again.
  • D: squeeze the bag again in 3 seconds.
Definition
B: allow the patient to completely exhale.
Term

A patient with a mild foreign body airway obstruction:

  • A: is typically not cyanotic.
  • B: has progressive difficulty breathing.
  • C: has a low oxygen saturation.
  • D: presents with a weak cough.
Definition
A: is typically not cyanotic
Term

Patients with a hypoxic drive:

  • A: are stimulated to breathe by low oxygen levels in the blood.
  • B: rarely become cyanotic because of high blood oxygen levels.
  • C: may hypoventilate if given low concentrations of oxygen.
  • D: are accustomed to low levels of carbon dioxide in the blood.
Definition
A: are stimulated to breathe by low oxygen levels in the blood.
Term

Which of the following describes the correct method for inserting a nasopharyngeal airway?

  • A: Apply firm, gentle pressure if you meet resistance during insertion.
  • B: Rotate the device as you insert it into the right nostril.
  • C: Insert the device with the bevel facing the septum.
  • D: Insert the device with the bevel facing the lateral part of the nose.
Definition
C: Insert the device with the bevel facing the septum
Term

When ventilating an apneic patient, you note decreased ventilatory compliance. This means that:

  • A: fluid is occupying the alveoli.
  • B: the upper airway is blocked.
  • C: you meet no resistance when ventilating.
  • D: the lungs are difficult to ventilate.
Definition
D: the lungs are difficult to ventilate.
Term

Which of the following patients has signs of inadequate breathing?

  • A: A 50-year-old woman with respirations of 12 breaths/min and pink, dry skin
  • B: A 41-year-old woman with shallow respirations of 14 breaths/min
  • C: A 30-year-old man with respirations of 12 breaths/min with adequate depth
  • D: A 60-year-old man with clear and equal breath sounds bilaterally
Definition
B: A 41-year-old woman with shallow respirations of 14 breaths/min
Term

Snoring respirations in an unresponsive patient are usually the result of:

  • A: swelling of the upper airway structures.
  • B: collapse of the trachea during breathing.
  • C: foreign body airway obstruction.
  • D: upper airway obstruction by the tongue.
Definition
D: upper airway obstruction by the tongue
Term

In which of the following situations should the jaw-thrust maneuver be used?

  • A: In a patient with apnea with no signs of trauma
  • B: In a patient who is in need of frequent suctioning
  • C: When the mechanism of injury is unclear
  • D: In any patient who is in cardiac arrest
Definition
C: When the mechanism of injury is unclear
Term

Which of the following devices should NOT be used in an unresponsive apneic patient with blunt chest trauma?

  • A: Oral airway
  • B: Oxygen-powered ventilator
  • C: Bag-mask device
  • D: Nasal airway
Definition
B: Oxygen-powered ventilato
Term

Which of the following is the preferred initial method for providing artificial ventilations to an apneic adult?

  • A: Flow-restricted, oxygen-powered ventilation device
  • B: Two-person bag-valve-mask technique with 100% oxygen
  • C: One-person bag-valve-mask technique with 100% oxygen
  • D: Mouth-to-mask technique with supplemental oxygen
Definition
D: Mouth-to-mask technique with supplemental oxygen
Term

During your assessment of an unresponsive adult female, you determine that she is apneic. You should:

  • A: deliver two rescue breaths.
  • B: place an oropharyngeal airway.
  • C: assess for a carotid pulse.
  • D: begin chest compressions.
Definition
C: assess for a carotid pulse.
Term

An elderly man is found lying unresponsive next to his bed. The patient's wife did not witness the events that led to his unresponsiveness. You should:

  • A: grasp the angles of the lower jaw and lift.
  • B: tilt the head back and lift up the chin.
  • C: assess the patient’s respirations.
  • D: apply 100% supplemental oxygen.
Definition
A: grasp the angles of the lower jaw and lift.
Term

Signs of inadequate breathing in an unresponsive patient include:

  • A: an irregular pulse.
  • B: cyanotic oral mucosa.
  • C: symmetrical chest rise.
  • D: warm, moist skin.
Definition
B: cyanotic oral mucosa
Term

A 50-year-old man, who fell approximately 20 feet and landed on a hard surface, is semiconscious. You should:

  • A: gently tilt the patient’s head back to assess for breathing.
  • B: check for a carotid pulse if the patient is breathing rapidly.
  • C: begin positive-pressure ventilations with a bag-mask device.
  • D: stabilize his head while performing the jaw-thrust maneuver.
Definition
D: stabilize his head while performing the jaw-thrust maneuver.
Term

Sonorous respirations are MOST rapidly corrected by:

  • A: initiating assisted ventilations.
  • B: correctly positioning the head.
  • C: suctioning the oropharynx.
  • D: inserting an oropharyngeal airway.
Definition
B: correctly positioning the head.
Term

A reduction in tidal volume would MOST likely occur from:

  • A: accessory muscle use.
  • B: unequal chest expansion.
  • C: increased minute volume.
  • D: flaring of the nostrils.
Definition
B: unequal chest expansion
Term

Which of the following airway sounds indicates a lower airway obstruction?

  • A: Stridor
  • B: Gurgling
  • C: Wheezing
  • D: Crowing
Definition
C: Wheezing
Term

Which of the following occurs during positive-pressure ventilation?

  • A: Oxygen is pulled into the lungs
  • B: Blood is drawn back to the heart
  • C: The esophagus remains closed
  • D: Intrathoracic pressure increases
Definition
D: Intrathoracic pressure increases
Term

A patient has severe facial injuries, inadequate breathing, and copious secretions coming from the mouth. How should this situation be managed?

  • A: Alternate suctioning for 15 seconds and ventilations for 2 minutes.
  • B: Provide artificial ventilations and suction for 30 seconds as needed.
  • C: Insert an oropharyngeal airway and suction until the secretions clear.
  • D: Turn the patient to the side and provide continuous oral suctioning.
Definition
A: Alternate suctioning for 15 seconds and ventilations for 2 minutes
Term

After an initial attempt to ventilate an unresponsive apneic patient fails, you reposition the patient's head and reattempt ventilation without success. You should next:

  • A: perform chest compressions, open the airway, and look in the mouth.
  • B: turn the patient onto his side and deliver 5 to 10 back slaps.
  • C: administer 5 to 10 abdominal thrusts and reattempt to ventilate.
  • D: perform continuous chest compressions until ALS personnel arrive.
Definition
A: perform chest compressions, open the airway, and look in the mouth
Term

Which of the following processes occurs during inhalation?

  • A: The intercostal muscles and diaphragm both contract.
  • B: The diaphragm descends and the intercostal muscles relax.
  • C: The diaphragm contracts and the intercostal muscles relax.
  • D: The intercostal muscles relax and the diaphragm descends.
Definition
A: The intercostal muscles and diaphragm both contract.
Term

During your assessment of a trauma patient, you note massive facial injuries, weak radial pulses, and clammy skin. What should be your MOST immediate concern?

  • A: Applying 100% supplemental oxygen
  • B: Potential obstruction of the airway
  • C: Providing rapid transport to a trauma center
  • D: Internal bleeding and severe shock
Definition
B: Potential obstruction of the airway
Term

Which of the following statements regarding the head tilt-chin lift maneuver is correct?

  • A: It should be used on all unresponsive patients that you encounter.
  • B: It should be used in conjunction with an appropriate airway adjunct.
  • C: It is the technique of choice for patients with potential spinal injury.
  • D: It can only be used in conjunction with an oropharyngeal airway.
Definition
B: It should be used in conjunction with an appropriate airway adjunct.
Term

Which of the following processes occurs during cellular/capillary gas exchange?

  • A: The cells give up oxygen to the capillaries.
  • B: The capillaries give up carbon dioxide to the cells.
  • C: The capillaries give up oxygen to the cells.
  • D: The cells receive carbon dioxide from the capillaries.
Definition
C: The capillaries give up oxygen to the cells.
Term

When ventilating an unresponsive apneic adult with a bag-mask device, you should ensure that:

  • A: ventilations occur at a rate of 20 breaths/min.
  • B: an airway adjunct has been inserted.
  • C: you are positioned alongside the patient.
  • D: manually occlude the pop-off relief valve.
Definition
B: an airway adjunct has been inserted.
Term

While providing initial ventilations to an apneic adult with a bag-mask device, you note minimal rise of the chest. You should:

  • A: increase the volume of your ventilations.
  • B: attach an oxygen reservoir to the bag-mask device.
  • C: suction the airway for up to 15 seconds.
  • D: switch to a smaller mask for the bag-mask device.
Definition
A: increase the volume of your ventilations.
Term

Which of the following injuries or conditions should be managed FIRST?

  • A: Bilateral fractures of the femurs
  • B: Fluid drainage from both ears
  • C: A large open abdominal wound
  • D: Bleeding within the oral cavity
Definition
D: Bleeding within the oral cavity
Term

The MOST effective way to determine if you are providing adequate volume during artificial ventilation is:

  • A: checking the pupils for increased reactivity.
  • B: assessing the pulse for an improving heart rate.
  • C: assessing the chest for adequate rise.
  • D: checking the skin for improvement of cyanosis.
Definition
C: assessing the chest for adequate rise
Term

While managing a patient with acute shortness of breath, you prepare and apply a nonrebreathing mask set at 12 L/min. The patient pulls the mask away from his face, stating that it is smothering him. You should:

  • A: inform the patient that refusing oxygen may result in his death.
  • B: reassure the patient and apply a nasal cannula instead.
  • C: increase the oxygen flow and reapply the mask.
  • D: securely tape the oxygen mask to the patient’s face.
Definition
B: reassure the patient and apply a nasal cannula instead
Term

A male patient overdosed on several drugs and is unresponsive with shallow breathing and facial cyanosis. As you continue your assessment, the patient suddenly vomits. You should:

  • A: begin assisting his ventilations.
  • B: suction his oropharynx at once.
  • C: insert an oropharyngeal airway.
  • D: turn the patient onto his side.
Definition
D: turn the patient onto his side
Term

Which of the following patients is the BEST candidate for an oropharyngeal airway?

  • A: An unresponsive patient with uncontrolled oropharyngeal bleeding
  • B: A semiconscious patient who ingested a large quantity of aspirin
  • C: An unresponsive trauma patient with blood draining from the nose
  • D: Any patient that you suspect of being acutely hypoxemic
Definition
C: An unresponsive trauma patient with blood draining from the nose
Term

A 22-year-old male has a shard of glass impaled in his cheek. You look inside his mouth and see minor bleeding. The patient is conscious and alert with adequate breathing. You should:

  • A: carefully stabilize the shard of glass and allow him to suction his own mouth.
  • B: remove the shard of glass and place gauze in his mouth to control the bleeding.
  • C: carefully remove the shard of glass in the same direction that it entered.
  • D: be prepared for severe bleeding as you carefully remove the shard of glass.
Definition
A: carefully stabilize the shard of glass and allow him to suction his own mouth.
Term

In what position would you expect a patient with severe dyspnea to be in?

  • A: Supine
  • B: Prone
  • C: Lateral recumbent
  • D: Fowler’s
Definition
D: Fowler’s
Term

A middle-aged woman presents with acute shortness of breath. Her breathing is labored and she is able to speak in broken sentences. You should:

  • A: deliver humidified oxygen and administer an inhaled bronchodilator.
  • B: place her supine and assist her ventilations with a bag-mask device.
  • C: ensure that her oxygen saturation does not fall below 85 percent.
  • D: administer high-flow oxygen and assess the quality of her breathing.
Definition
D: administer high-flow oxygen and assess the quality of her breathing.
Term

Clinically, reduced tidal volume would MOST likely present with respirations that are:

  • A: deep.
  • B: shallow.
  • C: eupneic.
  • D: slow.
Definition
B: shallow
Term

A 40-year-old man is conscious, but has an increased rate of breathing. You should:

  • A: assess the regularity and quality of breathing.
  • B: immediately insert a nasopharyngeal airway.
  • C: apply 100% oxygen via nonrebreathing mask.
  • D: assist his ventilations with a bag-mask device.
Definition
A: assess the regularity and quality of breathing
Term

When attaching an oxygen regulator to a D cylinder and preparing it for use, you should recall that:

  • A: the cylinder should be taken out of service and refilled when it contains less than 1,000 psi.
  • B: a pressure-compensated flowmeter should be used when lying the oxygen cylinder down.
  • C: the cylinder must remain in a standing position at all times or it will not deliver any oxygen.
  • D: oxygen supports combustion and should not be used where sparks are easily generated.
Definition
D: oxygen supports combustion and should not be used where sparks are easily generated.
Term

To obtain the MOST reliable assessment of a patient's tidal volume, you should:

  • A: look at the rise of the chest.
  • B: count the respiratory rate.
  • C: assess for retractions.
  • D: listen for airway noises.
Definition
A: look at the rise of the chest.
Term

Tidal volume is defined as the:

  • A: amount of air inhaled or exhaled per breath.
  • B: total volume of air that the lungs are capable of holding.
  • C: volume of air moved in and out of the lungs each minute.
  • D: volume of air that remains in the upper airway.
Definition
A: amount of air inhaled or exhaled per breath.
Term

Prior to applying a nonrebreathing mask on a patient with difficulty breathing, you should:

  • A: prefill the reservoir bag to ensure delivery of 100% oxygen.
  • B: set the flow rate to no more than 10 liters per minute.
  • C: insert a nasopharyngeal airway to maintain airway patency.
  • D: perform a complete exam to assess the degree of hypoxia.
Definition
A: prefill the reservoir bag to ensure delivery of 100% oxygen
Term

In which of the following situations would you MOST likely encounter agonal gasps?

  • A: Any patient who is unresponsive due to hypoxia
  • B: Significant hypoxemia, regardless of the cause
  • C: Shortly after becoming unresponsive and pulseless
  • D: Occlusion of the posterior pharynx by the tongue
Definition
C: Shortly after becoming unresponsive and pulseless
Term

Prescribed inhalers, such as albuterol (Ventolin), relieve respiratory distress by:

  • A: relaxing the smooth muscle of the bronchioles.
  • B: dilating the large mainstem bronchi of the airway.
  • C: constricting the bronchioles in the lungs.
  • D: contracting the smaller airways in the lungs.
Definition
A: relaxing the smooth muscle of the bronchioles.
Term

The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream is called:

  • A: respiration.
  • B: oxygenation.
  • C: diffusion.
  • D: ventilation.
Definition
B: oxygenation.
Term

A 60-year-old woman is experiencing severe respiratory distress. When you ask her a question, she can only say two words at a time. Treatment for her should include:

  • A: applying a nonrebreathing mask set at 15 L/min.
  • B: insertion of a nasopharyngeal airway.
  • C: applying a nasal cannula set at 2 to 6 L/min.
  • D: assisted ventilation with a bag-mask device.
Definition
D: assisted ventilation with a bag-mask device.
Term

A young woman who overdosed on heroin is unresponsive with slow, shallow breathing. As you attempt to insert an oropharyngeal airway, she begins to gag. You should:

  • A: remove the oropharyngeal airway and be prepared to suction her mouth.
  • B: make sure you are using the most appropriate size of oropharyngeal airway.
  • C: suction the patient’s oropharynx as you insert a nasopharyngeal airway.
  • D: place her on her side until she stops gagging and then suction her mouth.
Definition
A: remove the oropharyngeal airway and be prepared to suction her mouth.
Term

While ventilating an apneic patient with a bag-mask device, you note minimal rise of the chest each time you squeeze the bag. You should:

  • A: squeeze the bag harder to ensure delivery of adequate tidal volume.
  • B: suction the patient’s mouth for 15 seconds and reattempt ventilations.
  • C: evaluate the mask-to-face seal and the position of the patient's head.
  • D: ensure that the reservoir is properly attached to the bag-mask device.
Definition
C: evaluate the mask-to-face seal and the position of the patient's head
Term

When ventilating a patient with apnea with a pocket mask device, each breath should be delivered over:

  • A: 2 seconds.
  • B: 1 second.
  • C: 4 seconds.
  • D: 3 seconds.
Definition
B: 1 second.
Term

A 60-year-old woman presents with acute respiratory distress. She is conscious and alert, but restless. Her respiratory rate is 26 breaths/min with adequate chest expansion, and her breath sounds are clear to auscultation bilaterally. Which of the following is the MOST appropriate treatment for this patient?

  • A: A nasopharyngeal airway and assisted ventilations
  • B: Supplemental oxygen with a nonrebreathing mask
  • C: A nasal cannula with the flowmeter set at 4 to 6 L/min
  • D: A nasopharyngeal airway and supplemental oxygen
Definition
B: Supplemental oxygen with a nonrebreathing mask
Term

An unresponsive young man has shallow, gurgling respirations at a rate of 8 breaths/min. Initial treatment should include:

  • A: oxygen via nonrebreathing mask.
  • B: positive-pressure ventilations.
  • C: suctioning of the oropharynx.
  • D: oropharyngeal airway insertion.
Definition
C: suctioning of the oropharynx.
Term
Definition
Term

After an adult cardiac arrest patient has been intubated by a paramedic, you are providing ventilations as your partner performs chest compressions. When ventilating the patient, you should:

  • A: deliver each breath over 1 second at a rate of 8 to 10 breaths/min.
  • B: hyperventilate the patient to maximize carbon dioxide elimination.
  • C: deliver each breath over 2 seconds at a rate of 12 to 15 breaths/min.
  • D: deliver 2 breaths during a brief pause in chest compressions.
Definition
A: deliver each breath over 1 second at a rate of 8 to 10 breaths/min
Term

During the inhalation phase of breathing:

  • A: the diaphragm and intercostal muscles contract and ascend.
  • B: the muscles in between the ribs relax, which lifts the ribs up and out.
  • C: pressure within the thorax decreases and air is drawn into the lungs.
  • D: air passively enters the lungs as pressure within the thorax increases.
Definition
C: pressure within the thorax decreases and air is drawn into the lungs.
Term

If a 29-year-old male presents with a respiratory rate of 26 breaths/min, you should:

  • A: apply the pulse oximeter and assess his oxygen saturation.
  • B: begin assisting his ventilations with a bag-mask device.
  • C: apply oxygen via a nonrebreathing mask and take his vital signs.
  • D: evaluate his mental status and the depth of his respirations.
Definition
D: evaluate his mental status and the depth of his respirations.
Term

All of the following would cause an increased level of carbon dioxide in the arterial blood, EXCEPT:

  • A: reduced tidal volume.
  • B: slow, shallow breathing.
  • C: short exhalation phase.
  • D: deep, rapid breathing.
Definition
D: deep, rapid breathing.
Term

You are ventilating an apneic adult female with a bag-mask device and high-flow oxygen. Her pulse rate is 130 beats/min and she has cyanosis to her face and chest. The MOST reliable indicator of adequately performed ventilations in this patient is:

  • A: slight dissipation of her cyanosis.
  • B: a decrease in her heart rate to 90 beats/min.
  • C: decreased compliance with each ventilation.
  • D: noted abdominal rise with each ventilation.
Definition
B: a decrease in her heart rate to 90 beats/min.
Term

You receive a call for a 49-year-old woman who passed out. The patient's husband tells you that they were watching TV when the incident occurred. No trauma was involved. The patient is semiconscious and has cyanosis to her lips. After opening her airway with the head tilt-chin lift maneuver, you should:

  • A: begin ventilation assistance.
  • B: assess her respiratory effort.
  • C: insert a nasopharyngeal airway.
  • D: insert an oropharyngeal airway.
Definition
C: insert a nasopharyngeal airway.
Term

Occasional, irregular breaths that may be observed in a cardiac arrest patient are called:

  • A: Cheyne-Stokes respirations.
  • B: Biot respirations.
  • C: ataxic respirations.
  • D: agonal gasps.
Definition
D: agonal gasps.
Term
A 33-year-old female presents with acute respiratory distress. She is conscious but anxious, and tells you that she has a history of asthma. She took two puffs of her albuterol inhaler prior to your arrival, but states that it did not help. Her oxygen saturation reads 89% and you hear diffuse wheezing while auscultating her lungs. You should:A: ventilate her with a bag-mask device until her oxygen saturation is at least 94% and rapidly transport her to the closest appropriate medical facilityB: give her 100% humidified oxygen to dilate her bronchioles, monitor her oxygen saturation, and transport her to an appropriate medical facilityC: administer high-flow oxygen, contact medical control to request permission to assist her with another albuterol treatment, and prepare for transportD: assist her with a third albuterol treatment, contact medical control for further advice, give her high-flow oxygen, and transport her to the hospital.
Definition
C: administer high-flow oxygen, contact medical control to request permission to assist her with another albuterol treatment, and prepare for transport.
Term

At the peak of the inspiratory phase, the alveoli in the lungs contain:

  • A: equal levels of oxygen and carbon dioxide.
  • B: more oxygen than carbon dioxide.
  • C: high quantities of carbon dioxide.
  • D: minimal levels of oxygen and carbon dioxide.
Definition
B: more oxygen than carbon dioxide.
Term

A 22-year-old man crashed his motorcycle into a tree. He is found approximately 20 feet away from his bike and is responsive to pain only. He is not wearing a helmet. You are unable to effectively open his airway with the jaw-thrust maneuver. What should you do?

  • A: Insert an oral airway and assess his breathing.
  • B: Suction his oropharynx and reattempt the jaw-thrust.
  • C: Apply high-flow oxygen and assess his carotid pulse.
  • D: Carefully tilt his head back and lift up on his chin.
Definition
D: Carefully tilt his head back and lift up on his chin.
Term

Which of the following is the MOST correct technique for ventilating an apneic adult who has a pulse?

  • A: Deliver each breath over 1 second at a rate of 8 to 10 breaths/min.
  • B: Ventilate at a rate of 15 breaths/min and look for visible chest rise.
  • C: Hyperventilate at a rate between 20 and 24 breaths/min.
  • D: Deliver each breath over 1 second at a rate of 10 to 12 breaths/min.
Definition
D: Deliver each breath over 1 second at a rate of 10 to 12 breaths/min.
Term

You are performing abdominal thrusts on a 19-year-old male with a severe airway obstruction when he becomes unresponsive. After lowering him to the ground and placing him in a supine position, you should:

  • A: open his airway and look inside his mouth.
  • B: assess for a carotid pulse for up to 10 seconds.
  • C: continue abdominal thrusts until ALS arrives.
  • D: begin CPR, starting with chest compressions.
Definition
D: begin CPR, starting with chest compressions.
Term

Which of the following clinical findings is MOST consistent with a chronic history of a respiratory disease?

  • A: Impaired mental status
  • B: An irregular pulse
  • C: Use of accessory muscles
  • D: A barrel-shaped chest
Definition
D: A barrel-shaped chest
Term

You are administering oxygen at 15 L/min to a patient with respiratory distress. If you are using a D cylinder (cylinder constant, 0.16), which reads 1,500 psi, how long will it take before you need to replace the oxygen cylinder?

  • A: 18 minutes
  • B: 14 minutes
  • C: 9 minutes
  • D: 11 minutes
Definition
B: 14 minutes
Term

You are dispatched to a residence for an elderly female who has possibly suffered a stroke. You find her lying supine in her bed. She is semiconscious; has vomited; and has slow, irregular breathing. You should:

  • A: administer high-flow oxygen and place her on her side.
  • B: perform a head tilt-chin lift and insert an oral airway.
  • C: manually open her airway and suction her oropharynx.
  • D: insert a nasal airway and begin assisting her breathing.
Definition
C: manually open her airway and suction her oropharynx.
Term

You are assessing a middle-aged male who is experiencing respiratory distress. The patient has a history of emphysema and hypertension. He appears fatigued; has weak retractions; and labored, shallow breathing. Your MOST immediate action should be to:

  • A: assess his oxygen saturation with a pulse oximeter.
  • B: administer oxygen with a nonrebreathing mask.
  • C: assist his ventilations with a bag-mask device.
  • D: auscultate his breath sounds to detect wheezing.
Definition
C: assist his ventilations with a bag-mask device.
Term

The lower airway begins at the:

  • A: larynx.
  • B: cricoid cartilage.
  • C: epiglottis.
  • D: trachea.
Definition
A: larynx.
Term

An inaccurate pulse oximetry reading may be caused by:

  • A: excessive red blood cell production.
  • B: a heart rate greater than 100 beats/min.
  • C: severe peripheral vasoconstriction.
  • D: heat illnesses, such as heat stroke.
Definition
C: severe peripheral vasoconstriction.
Term

Which of the following signs or symptoms is indicative of cerebral hypoxia?

  • A: Diffuse wheezing on exhalation
  • B: Chief complaint of dyspnea
  • C: Heart rate greater than 120 beats/min
  • D: Decreased level of consciousness
Definition
D: Decreased level of consciousness
Term

A patient who is breathing with reduced tidal volume would MOST likely have:

  • A: a respiratory rate of 14 breaths/min.
  • B: shallow respirations.
  • C: warm, moist skin.
  • D: a prolonged inhalation phase.
Definition
B: shallow respirations.
Term

A nonrebreathing mask is MOST appropriate to use on patients who:

  • A: are cyanotic and have a low oxygen saturation.
  • B: are breathing less than 12 times per minute.
  • C: are semiconscious and breathing shallowly.
  • D: have an adequate rate and depth of breathing.
Definition
D: have an adequate rate and depth of breathing.
Term

The tidal volume of an unresponsive patient is rapidly assessed by:

  • A: counting the patient's respiratory rate.
  • B: auscultating his or her lung sounds.
  • C: observing for chest rise during inhalation.
  • D: evaluating for the presence of cyanosis.
Definition
C: observing for chest rise during inhalation.
Term

 

A 60-year-old female is found unresponsive. She is cyanotic, is making a snoring sound while she breathes, and has a slow respiratory rate. You should:

  • A: insert an airway adjunct.
  • B: ventilate her with a bag-mask device.
  • C: suction her airway for 15 seconds.
  • D: manually open her airway.

 

Definition
D: manually open her airway.
Term

Ventilation is defined as the:

  • A: volume of air inhaled into the lungs in a single breath.
  • B: movement of air into and out of the lungs.
  • C: exchange of oxygen and carbon dioxide at the cell level.
  • D: elimination of carbon dioxide from the body.
Definition
B: movement of air into and out of the lungs.
Term

 

Oxygen that is administered through a nasal cannula would be of LEAST benefit to a patient who:

  • A: is breathing greater than 12 times per minute.
  • B: has COPD and an oxygen saturation of 94%.
  • C: breathes through his or her mouth.
  • D: is in need of long-term oxygen therapy.

 

Definition
C: breathes through his or her mouth.
Term

Which of the following yields the lowest minute volume?

  • A: Respiratory rate of 16 breaths/min; tidal volume of 400 mL
  • B: Respiratory rate of 10 breaths/min; tidal volume of 500 mL
  • C: Respiratory rate of 14 breaths/min; tidal volume of 300 mL
  • D: Respiratory rate of 12 breaths/min; tidal volume of 500 mL
Definition
C: Respiratory rate of 14 breaths/min; tidal volume of 300 mL
Term

To ensure you deliver the highest concentration of oxygen with a nonrebreathing mask, you should:

  • A: set the flow rate to at least 10 to 12 L/min.
  • B: cover the flapper valves on the oxygen mask.
  • C: make sure that the reservoir bag is preinflated.
  • D: securely fasten the mask to the patient’s face.
Definition
C: make sure that the reservoir bag is preinflated.
Term

The MOST appropriate treatment for a semiconscious patient with slow, shallow respirations includes:

  • A: a nasopharyngeal airway and assisted ventilation with a bag-mask device.
  • B: an oropharyngeal airway and assisted ventilation with a bag-mask device.
  • C: a nasopharyngeal airway and high-flow oxygen via a nonrebreathing mask.
  • D: an oropharyngeal airway and high-flow oxygen via a nonrebreathing mask.
Definition
A: a nasopharyngeal airway and assisted ventilation with a bag-mask device.
Term

An unresponsive apneic patient’s chest fails to rise after two ventilation attempts. You should:

  • A: reposition the head and reattempt to ventilate.
  • B: immediately proceed to chest compressions.
  • C: attempt to ventilate again using more volume.
  • D: suction the airway and reattempt ventilations.
Definition
B: immediately proceed to chest compressions.
Term

During your initial attempt to ventilate an unresponsive apneic patient, you meet resistance and do not see the patient’s chest rise. You should:

  • A: begin CPR, starting with chest compressions.
  • B: suction the airway for no longer than 15 seconds.
  • C: assume that a foreign body is blocking the airway.
  • D: reposition the head and reattempt to ventilate.
Definition
D: reposition the head and reattempt to ventilate.
Term

You are assessing an elderly man with respiratory distress. He is coughing up bloody sputum and has an oxygen saturation of 85%. You auscultate his breath sounds and hear coarse crackles in all lung fields. This patient MOST likely has:

  • A: congestive heart failure.
  • B: decompensated asthma.
  • C: severe bacterial pneumonia.
  • D: acute onset emphysema.
Definition
A: congestive heart failure.
Term

What is the function of pulmonary surfactant?

  • A: It facilitates the production of mucous, which is expelled during coughing.
  • B: It dilates the bronchioles in the lungs and enhances the flow of air.
  • C: It carries fresh oxygen from the lungs to the left side of the heart.
  • D: It lubricates the alveolar walls and allows them to expand and recoil.
Definition
D: It lubricates the alveolar walls and allows them to expand and recoil.
Term

You are assessing a 66-year-old man who has emphysema and complains of worsened shortness of breath. He is confused, has a heart rate of 120 beats/min, and an oxygen saturation of 89%. Which of the following assessment findings should concern you the MOST?

  • A: Low oxygen saturation
  • B: Confusion
  • C: Worsened shortness of breath
  • D: Tachycardia
Definition
B: Confusion
Term

When suctioning copious secretions from a semiconscious adult’s airway, you should:

  • A: apply suction as you carefully insert the catheter into the mouth.
  • B: suction for up to 20 seconds while withdrawing the catheter.
  • C: use a flexible catheter because it will remove the secretions faster.
  • D: avoid touching the back of the airway with the suction catheter.
Definition
D: avoid touching the back of the airway with the suction catheter.
Term

A young female experienced massive facial trauma and is unresponsive. After several attempts, you are unable to adequately open her airway with the jaw-thrust maneuver. You should:

  • A: apply oxygen and reattempt the jaw-thrust maneuver.
  • B: carefully tilt her head back and lift up on her chin.
  • C: insert a nasopharyngeal airway and apply oxygen.
  • D: begin assisting her ventilations with a bag-mask device.
Definition
B: carefully tilt her head back and lift up on her chin.
Term

Which of the following would MOST likely occur if an adult patient is breathing at a rate of 45 breaths/min with shallow depth?

  • A: The lungs would become hyperinflated, potentially causing a pneumothorax.
  • B: Most of his or her inhaled air will not go beyond the anatomic dead space.
  • C: The volume of air that reaches the alveoli would increase significantly.
  • D: Alveolar minute volume would increase due to the rapid respiratory rate.
Definition
B: Most of his or her inhaled air will not go beyond the anatomic dead space.
Term

The method by which you administer supplemental oxygen to a hypoxic patient depends MOSTLY on the:

  • A: suspected underlying cause of the hypoxia.
  • B: presence or absence of cyanosis.
  • C: severity of hypoxia and adequacy of breathing.
  • D: patient’s level of consciousness and heart rate.
Definition
C: severity of hypoxia and adequacy of breathing.
Term

An unresponsive 60-year-old male is apneic and has a weak, rapid pulse. His oxygen saturation reads 79%. You should:

  • A: ventilate at a rate of 8 to 10 breaths/min, ensuring visible chest rise.
  • B: mildly hyperventilate him until his oxygen saturation improves.
  • C: deliver one breath over 1 second every 5 to 6 seconds.
  • D: use a pocket face mask to deliver 12 to 20 breaths/min
Definition
C: deliver one breath over 1 second every 5 to 6 seconds.
Term

The respiratory system functions by:

  • A: sending messages to the diaphragm that cause it to contract.
  • B: bringing oxygen into the lungs and eliminating carbon dioxide.
  • C: removing carbon dioxide from the cells and returning it to the lungs.
  • D: ensuring that adequate oxygen is delivered to the body’s tissues.
Definition
B: bringing oxygen into the lungs and eliminating carbon dioxide.
Term

A properly placed oropharyngeal airway:

  • A: will not stimulate a conscious patient’s gag reflex.
  • B: eliminates the need to perform a head tilt-chin lift.
  • C: prevents aspiration if the patient regurgitates.
  • D: keeps the tongue off of the posterior pharynx.
Definition
D: keeps the tongue off of the posterior pharynx.
Term

Which of the following patients obviously needs positive-pressure ventilation assistance?

  • A: Responsive to pain only; respiratory rate of 8 breaths/min and shallow
  • B: Combative; respiratory rate of 24 breaths/min and deep
  • C: Restless; respiratory rate of 12 breaths/min with adequate tidal volume
  • D: Semiconscious; respiratory rate of 14 breaths/min and good chest rise
Definition
A: Responsive to pain only; respiratory rate of 8 breaths/min and shallow
Term

Which of the following ventilation techniques will enable you to provide the greatest tidal volume AND allow you to effectively assess lung compliance?

  • A: One-rescuer mouth-to-mask ventilation
  • B: One-rescuer bag-mask ventilation
  • C: One-rescuer demand valve ventilation
  • D: Flow-restricted, oxygen-powered ventilation
Definition
A: One-rescuer mouth-to-mask ventilation
Term

Which of the following statements regarding artificial ventilation of an apneic patient who has dentures is correct?

  • A: Tight-fitting dentures should be left in place because they facilitate the delivery of adequate tidal volume.
  • B: Because of the risk of airway obstruction, the EMT should routinely remove a patient’s dentures.
  • C: The EMT should not attempt to remove a patient’s dentures because this may cause an airway obstruction.
  • D: If a patient’s dentures are loose, the EMT should use the jaw-thrust maneuver to keep the airway open.
Definition
A: Tight-fitting dentures should be left in place because they facilitate the delivery of adequate tidal volume.
Term

Hypoxia is defined as:

  • A: an excess amount of carbon dioxide in arterial blood.
  • B: decreased oxygen content in arterial blood.
  • C: inadequate oxygen to the body’s cells and tissues.
  • D: an absence of oxygen to the vital body organs.
Definition
C: inadequate oxygen to the body’s cells and tissues.
Term

 

Shallow respirations are an indication of:

  • A: increased carbon dioxide removal.
  • B: decreased tidal volume.
  • C: increased oxygen intake.
  • D: increased tidal volume.

 

Definition
B: decreased tidal volume.
Term

In which position should you place an uninjured, unresponsive patient with a respiratory rate of 14 breaths/min and adequate tidal volume?

  • A: Full-Fowler’s
  • B: Supine
  • C: Semi-Fowler’s
  • D: Lateral recumbent
Definition
D: Lateral recumbent
Term

 

An unresponsive patient’s respirations are 26 breaths/min and shallow. The MOST appropriate treatment includes:

  • A: a simple face mask set at 10 to 12 L/min.
  • B: assisted ventilations with 100% oxygen.
  • C: a nasal cannula set at 1 to 6 L/min.
  • D: a nonrebreathing mask set at 15 L/min.

 

Definition
B: assisted ventilations with 100% oxygen.
Term

If the level of carbon dioxide in the arterial blood increases:

  • A: the respiratory rate and depth decrease.
  • B: the respiratory rate and depth increase.
  • C: a reduction in tidal volume will occur.
  • D: the respiratory rate slows significantly.
Definition
B: the respiratory rate and depth increase.
Term

A patient's skin will MOST likely become cyanotic if he or she has:

  • A: an increase in the amount of arterial oxygen.
  • B: a decrease in the amount of carbon dioxide.
  • C: an overall increase in circulating red blood cells.
  • D: a decrease in the amount of arterial oxygen.
Definition
D: a decrease in the amount of arterial oxygen.
Term

A 56-year-old man with a history of heart disease reports pain in the upper midabdominal area. This region of the abdomen is called the:

  • A: mediastinum.
  • B: retroperitoneum.
  • C: epigastrium.
  • D: peritoneum.
Definition
C: epigastrium.
Term

The chest pain associated with an acute coronary syndrome is often described as:

  • A: cramping.
  • B: pressure.
  • C: sharp.
  • D: stabbing.
Definition
B: pressure.
Term

The automated external defibrillator (AED) should NOT be used in patients who:

  • A: have a nitroglycerin patch applied to the skin.
  • B: are between 1 and 8 years of age.
  • C: are apneic and have a weak carotid pulse.
  • D: experienced a witnessed cardiac arrest.
Definition
C: are apneic and have a weak carotid pulse.
Term

Which of the following assessment findings is LEAST suggestive of cardiac compromise?

  • A: Palpable pain to the chest
  • B: Nausea and epigastric pain
  • C: Rapid, irregular heart rate
  • D: Anxiety and pale, cool skin
Definition
A: Palpable pain to the chest
Term

A 45-year-old woman calls EMS because of severe chest pain. When you arrive, she advises you that she has taken two of her husband’s nitroglycerin (NTG) tablets without relief. What is your MOST appropriate course of action?

  • A: Call medical control and request permission to assist the patient with one more NTG tablet.
  • B: Apply oxygen, assess the patient's blood pressure, and give a third and final NTG tablet.
  • C: Attach the AED, administer 100% oxygen, and contact medical control for advice.
  • D: Apply supplemental oxygen and transport the patient to the hospital without delay.
Definition
D: Apply supplemental oxygen and transport the patient to the hospital without delay.
Term

Prior to administering nitroglycerin to a patient with chest pain, you should:

  • A: auscultate the patient's breath sounds.
  • B: obtain vital signs to detect hypotension.
  • C: elevate the patient's lower extremities.
  • D: inquire about an allergy to salicylates.
Definition
B: obtain vital signs to detect hypotension.
Term

 

What is the MOST detrimental effect that tachycardia can have on a patient experiencing a cardiac problem?

  • A: Increased stress and anxiety
  • B: Increased blood pressure
  • C: Decreased cardiac functioning
  • D: Increased oxygen demand

 

Definition
D: Increased oxygen demand
Term

A 50-year-old man presents with “crushing” chest pain of sudden onset. He is diaphoretic and nauseated. You should:

  • A: ask him if he takes nitroglycerin.
  • B: perform a complete physical exam.
  • C: obtain baseline vital signs.
  • D: apply supplemental oxygen.
Definition
D: apply supplemental oxygen.
Term

A 58-year-old man is found unresponsive by his wife. According to his wife, he was complaining of a "dull ache" in his chest the day before, but refused to allow her to call 9-1-1. His blood pressure is 70/50 mm Hg, his pulse is 120 beats/min and weak, and his respirations are 28 breaths/min and labored. Further assessment reveals that his skin is cool, pale, and clammy. You should suspect:

  • A: cardiogenic shock.
  • B: acute septic shock.
  • C: pulmonary embolism.
  • D: hypovolemic shock.
Definition
A: cardiogenic shock
Term

After applying the AED to a 56-year-old female in cardiac arrest, you analyze her cardiac rhythm and receive a shock advised message. Emergency medical responders, who arrived at the scene before you, tell you that bystander CPR was not in progress upon their arrival. You should:

  • A: detach the AED and prepare for immediate transport.
  • B: perform CPR for 2 minutes and then defibrillate.
  • C: deliver the shock as indicated followed immediately by CPR.
  • D: notify medical control and request permission to cease resuscitation.
Definition
C: deliver the shock as indicated followed immediately by CPR.
Term

In addition to supplemental oxygen, one of the MOST effective way to minimize the detrimental effects associated with acute coronary syndrome is to:

  • A: request ALS support for any patient who has chest pain.
  • B: transport the patient rapidly, using lights and siren.
  • C: give the patient up to four doses of nitroglycerin.
  • D: reassure the patient and provide prompt transport.
Definition
D: reassure the patient and provide prompt transport.
Term

Common signs and symptoms of a hypertensive emergency include:

  • A: chest discomfort, weak pulses, and cool skin.
  • B: unequal pupils, irregular pulse, and pallor.
  • C: vomiting without nausea and hemiparesis.
  • D: ringing in the ears, headache, and epistaxis.
Definition
D: ringing in the ears, headache, and epistaxis.
Term

When treating a patient with chest pain, pressure, or discomfort, you should first:

  • A: administer supplemental oxygen.
  • B: assess the blood pressure and give nitroglycerin.
  • C: request an ALS ambulance response to the scene.
  • D: place the patient in a position of comfort.
Definition
D: place the patient in a position of comfort.
Term

The wall that separates the left and right sides of the heart is called the:

  • A: septum.
  • B: mediastinum.
  • C: pericardium.
  • D: carina.
Definition
A: septum.
Term

Sudden cardiac arrest in the adult population MOST often is the result of:

  • A: respiratory failure.
  • B: accidental electrocution.
  • C: myocardial infarction.
  • D: a cardiac arrhythmia.
Definition
D: a cardiac arrhythmia
Term

The position of comfort for a patient with nontraumatic chest pain MOST commonly is:

  • A: supine with the legs elevated slightly.
  • B: semisitting.
  • C: on the side with the head elevated.
  • D: lateral recumbent.
Definition
B: semisitting.
Term

Aspirin may be contraindicated in patients with:

  • A: stomach ulcers.
  • B: glaucoma.
  • C: ibuprofen allergy.
  • D: diabetes.
Definition
A: stomach ulcers.
Term

A 56-year-old man is found to be pulseless and apneic. His wife states that he collapsed about 5 minutes ago. As your partner gets the AED from the ambulance, you should:

  • A: ask the wife if the patient has a living will.
  • B: begin CPR, starting with chest compressions.
  • C: provide rescue breaths until the AED is ready.
  • D: open the airway and give 2 rescue breaths.
Definition
B: begin CPR, starting with chest compressions.
Term

You are treating a 60-year-old man in cardiac arrest. After delivering a shock with the AED and performing CPR for 2 minutes, you achieve return of spontaneous circulation. Your next action should be to:

  • A: provide rapid transport to the hospital.
  • B: assess his airway and ventilatory status.
  • C: remove the AED and apply 100% oxygen.
  • D: reanalyze his rhythm for confirmation.
Definition
B: assess his airway and ventilatory status.
Term

Which of the following questions would be MOST appropriate to ask when assessing a patient with chest pain?

  • A: Does the pain radiate to your arm?
  • B: Is the pain worse when you take a deep breath?
  • C: What does the pain feel like?
  • D: Would you describe the pain as sharp?
Definition
C: What does the pain feel like?
Term

Chest compression effectiveness is MOST effectively assessed by:

  • A: measuring the systolic blood pressure during compressions.
  • B: carefully measuring the depth of each compression.
  • C: listening for a heartbeat with each compression.
  • D: palpating for a carotid pulse with each compression.
Definition
D: palpating for a carotid pulse with each compression.
Term

Which of the following is the BEST indicator of cardiac output?

  • A: Pulse rate and quality
  • B: Condition and color of the skin
  • C: Quality of the respirations
  • D: Systolic blood pressure
Definition
A: Pulse rate and quality
Term

A 50-year-old man's implanted defibrillator has fired twice within the last hour. He is conscious and alert and complains of a "sore chest." Further assessment reveals that his chest pain is reproducible to palpation and is localized to the area of his implanted defibrillator. In addition to supplemental oxygen, treatment for him should include:

  • A: application of the AED and transport to the hospital.
  • B: prompt transport with continuous monitoring en route.
  • C: deactivating his defibrillator by running a magnet over it.
  • D: up to three doses of nitroglycerin and prompt transport.
Definition
B: prompt transport with continuous monitoring en route.
Term

You are caring for a 66-year-old woman with severe pressure in her chest. As you administer oxygen to her, your partner should:

  • A: gather her medications.
  • B: notify medical control.
  • C: obtain a SAMPLE history.
  • D: obtain a set of vital signs.
Definition
D: obtain a set of vital signs.
Term

Which of the following patients would be the LEAST likely to present with classic signs and symptoms of acute myocardial infarction?

  • A: 64-year-old male with renal disease and depression.
  • B: 55-year-old female with COPD and frequent infections.
  • C: 72-year-old female with diabetes and hypertension.
  • D: 59 year-old male with alcoholism and angina pectoris.
Definition
C: 72-year-old female with diabetes and hypertension.
Term

The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is NOT indicated. You should:

  • A: reanalyze the cardiac rhythm for positive confirmation.
  • B: resume CPR, starting with chest compressions.
  • C: assess for a pulse for no more than 10 seconds.
  • D: open the patient's airway and check for breathing.
Definition
B: resume CPR, starting with chest compressions.
Term

 

Which of the following statements regarding the automated external defibrillator (AED) is correct?

  • A: AEDs will analyze the patient’s rhythm while CPR is in progress
  • B: The AED should be applied to patients at risk for cardiac arrest
  • C: The AED should not be used in patients with an implanted defibrillator
  • D: AEDs can safely be used in infants and children less than 8 years of age

 

Definition
D: AEDs can safely be used in infants and children less than 8 years of age
Term

Which of the following effects does nitroglycerin possess when administered to patients with suspected cardiac chest pain?

  • A: Vasoconstriction and increased cardiac oxygen demand
  • B: Vasodilation and increased myocardial oxygen supply
  • C: Vasoconstriction and increased myocardial workload
  • D: Vasodilation and decreased myocardial oxygen supply
Definition
B: Vasodilation and increased myocardial oxygen supply
Term

Which of the following describes the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest?

  • A: Allow full recoil of the chest after each compression, compress the chest to a depth of 2”, deliver compressions at a rate of at least 80/min
  • B: Compress the chest at least 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions
  • C: Minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min
  • D: Do not interrupt chest compressions for any reason, compress the chest no more than 1 1/2”, allow partial recoil of the chest after each compression
Definition
B: Compress the chest at least 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions
Term

Which of the following chambers of the heart has the thickest walls?

  • A: Left ventricle
  • B: Right ventricle
  • C: Left atrium
  • D: Right atrium
Definition
A: Left ventricle
Term

Ischemic heart disease is a condition in which:

  • A: there is a decrease in blood flow to one or more portions of the heart muscle.
  • B: a portion of the heart muscle dies because of a prolonged lack of oxygen.
  • C: an acute event leads to a significant decrease in the pumping force of the heart.
  • D: the coronary arteries dilate, thus preventing effective blood flow to the heart.
Definition
A: there is a decrease in blood flow to one or more portions of the heart muscle.
Term

A 65-year-old man has generalized weakness and chest pressure. He has a bottle of prescribed nitroglycerin, but states that he has not taken any of his medication. As your partner prepares to administer oxygen, you should:

  • A: assist the patient with his nitroglycerin with medical control approval.
  • B: administer up to 325 mg of aspirin if the patient is not allergic to it.
  • C: perform a secondary assessment and obtain baseline vital signs.
  • D: apply the AED and prepare the patient for immediate transport.
Definition
B: administer up to 325 mg of aspirin if the patient is not allergic to it.
Term

Which of the following structures is the primary pacemaker, which sets the normal rate for the heart?

  • A: Bundle of His
  • B: Purkinje fibers
  • C: Atrioventricular node
  • D: Sinoatrial node
Definition
D: Sinoatrial node
Term

The middle, muscular layer of the heart is called the:

  • A: pericardium.
  • B: epicardium.
  • C: myocardium.
  • D: endocardium.
Definition
C: myocardium.
Term

Freshly oxygenated blood returns to the heart via the:

  • A: pulmonary artery.
  • B: aorta.
  • C: pulmonary vein.
  • D: vena cavae.
Definition
C: pulmonary vein.
Term

Which of the following patients is the BEST candidate for the administration of nitroglycerin?

  • A: A woman who has taken three doses of prescribed nitroglycerin without relief of chest pain
  • B: A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg
  • C: A man with chest pain, expired nitroglycerin spray, and a blood pressure of 110/80 mm Hg
  • D: An elderly man with crushing substernal chest pain and a blood pressure of 80/60 mm Hg
Definition
B: A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg
Term

Which of the following statements regarding one-rescuer CPR is correct?

  • A: The chest should be allowed to fully recoil after each compression.
  • B: A compression to ventilation ratio of 15:2 should be delivered.
  • C: Ventilations should be delivered over a period of 2 to 3 seconds.
  • D: You should assess the patient for a pulse after 3 cycles of CPR.
Definition
A: The chest should be allowed to fully recoil after each compression.
Term

Which of the following patients would MOST likely present with vague or unusual or symptoms of an acute myocardial infarction?

  • A: 66-year-old male with angina
  • B: 55-year-old obese female
  • C: 75-year-old male with hypertension
  • D: 72-year-old female with diabetes
Definition
D: 72-year-old female with diabetes
Term

Which of the following is MOST indicative of a primary cardiac problem?

  • A: Tachypnea
  • B: Sudden fainting
  • C: Irregular pulse
  • D: Tachycardia
Definition
C: Irregular pulse
Term

A patient who is experiencing an acute myocardial infarction:

  • A: has chest pain or discomfort that does not change with each breath.
  • B: most often describes his or her chest pain as being sharp or tearing.
  • C: often complains of a different type of pain than a patient with angina.
  • D: often experiences relief of his or her chest pain after taking nitroglycerin.
Definition
A: has chest pain or discomfort that does not change with each breath.
Term

Which of the following is a common side effect of nitroglycerin?

  • A: Nausea
  • B: Hypertension
  • C: Headache
  • D: Anxiety
Definition
C: Headache
Term

The myocardium receives its blood supply from the coronary arteries that branch directly from the:

  • A: aorta.
  • B: left atrium.
  • C: right ventricle.
  • D: vena cava.
Definition
A: aorta.
Term

While assessing an elderly man who is complaining of chest pain, he suddenly becomes unresponsive. You should immediately:

  • A: apply the AED.
  • B: assess for breathing.
  • C: assess for a pulse.
  • D: open the airway.
Definition
B: assess for breathing.
Term

Your partner has applied the AED to a cardiac arrest patient and has received a shock advised message. While the AED is charging, you should:

  • A: cease all contact with the patient until the AED has delivered the shock.
  • B: continue chest compressions until your partner tells you to stand clear.
  • C: perform rescue breathing only until the AED is charged and ready to shock.
  • D: retrieve the airway equipment and prepare to ventilate the patient.
Definition
B: continue chest compressions until your partner tells you to stand clear.
Term

In which of the following patients is nitroglycerin contraindicated?

  • A: 41-year-old male with crushing substernal chest pressure, a blood pressure of 160/90 mm Hg, and severe nausea
  • B: 58-year-old male with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol
  • C: 66-year-old female with chest pressure of 6 hours’ duration, lightheadedness, and a blood pressure of 110/58 mm Hg
  • D: 53-year-old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra
Definition
D: 53-year-old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra
Term

While assessing a patient with chest pain, you note that his pulse is irregular. This indicates:

  • A: a dysfunction in the left side of the patient’s heart
  • B: acute myocardial infarction or angina pectoris.
  • C: abnormalities in the heart’s electrical conduction system.
  • D: high blood pressure that is increasing cardiac workload.
Definition
C: abnormalities in the heart’s electrical conduction system.
Term

When assessing a patient with a complaint of chest pain, which of the following questions would you ask to assess the "R" in OPQRST?

  • A: Is there anything that makes the pain worse?
  • B: Is the pain in one place or does it move around?
  • C: Did the pain begin suddenly or gradually?
  • D: What were you doing when the pain began?
Definition
B: Is the pain in one place or does it move around?
Term

How can you help maximize cardiac output during CPR?

  • A: Allow the chest to fully recoil in between compressions
  • B: Deliver rescue breaths until the chest expands widely
  • C: Compress the chest at a rate of no more than 100/min
  • D: Ventilate the patient through an advanced airway device
Definition
A: Allow the chest to fully recoil in between compressions
Term

In patients with heart disease, acute coronary syndrome is MOST often the result of:

  • A: coronary artery rupture.
  • B: atrial damage.
  • C: coronary artery spasm.
  • D: atherosclerosis.
Definition
D: atherosclerosis.
Term

A 60-year-old man presents with chest pain and difficulty breathing. He is pale, diaphoretic, and in severe pain. As your partner applies supplemental oxygen, you assess his vital signs. His blood pressure is 180/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. You ask him if has taken any nitroglycerin and he tells you that he does not have any but his wife does. You should:

  • A: have him swallow up to four enteric-coated aspirin, continue oxygen therapy, and promptly transport him to the hospital.
  • B: transport at once, apply the AED in case he develops cardiac arrest, and monitor his vital signs en route to the hospital.
  • C: complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital.
  • D: contact medical control and request permission to assist the patient with up to three doses of his wife’s nitroglycerin.
Definition
C: complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital.
Term

Aspirin is beneficial to patients experiencing an acute coronary syndrome because it:

  • A: effectively relieves their chest pain.
  • B: destroys the clot that is blocking a coronary artery.
  • C: prevents a clot from getting larger.
  • D: decreases cardiac workload by lowering the BP.
Definition
C: prevents a clot from getting larger.
Term

 

Which of the following would clearly be detrimental to a patient in cardiac arrest?

  • A: Performing CPR before defibrillation
  • B: Using a pocket face mask without high-flow oxygen
  • C: Interrupting CPR for more than 10 seconds
  • D: Ventilating just until the chest rises

 

Definition
C: Interrupting CPR for more than 10 seconds
Term

Sudden cardiac arrest in the adult population is MOST often the result of:

  • A: an acute stroke.
  • B: myocardial infarction.
  • C: a cardiac dysrhythmia.
  • D: respiratory failure.
Definition
C: a cardiac dysrhythmia.
Term

 

Which of the following is an abnormal finding when using the Cincinnati stroke scale to assess a patient who presents with signs of a stroke?

  • A: One of the pupils is dilated and does not react to light.
  • B: Both arms drift slowly and equally down to the patient’s side.
  • C: One arm drifts down compared with the other side.
  • D: The patient’s face is symmetrical when he or she smiles.

 

Definition
C: One arm drifts down compared with the other side.
Term

The pain associated with acute aortic dissection:

  • A: typically comes on gradually and progressively worsens.
  • B: originates in the epigastrium and radiates down both legs.
  • C: is usually preceded by nausea, sweating, and weakness.
  • D: is typically described as a stabbing or tearing sensation.
Definition
D: is typically described as a stabbing or tearing sensation.
Term

Which of the following describes pulseless electrical activity (PEA)?

  • A: The presence of a palpable pulse in the absence of any electrical activity in the heart
  • B: A disorganized, chaotic quivering of the heart muscle that does not generate a pulse
  • C: Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
  • D: A rapid cardiac rhythm that does not produce a pulse, but responds to defibrillation
Definition
C: Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
Term

Shortly after assisting a 60-year-old woman with her second nitroglycerin treatment, she tells you that she is lightheaded and feels like she is going to faint. Her symptoms are MOST likely due to:

  • A: an irregular heartbeat.
  • B: low blood pressure.
  • C: nervousness and anxiety.
  • D: a drop in her blood sugar.
Definition
B: low blood pressure.
Term

During your assessment of a 70-year-old man with crushing chest pain, you note that his blood pressure is 80/50 mm Hg. Your MOST important action should be to:

  • A: give high-flow oxygen.
  • B: keep the patient warm.
  • C: assess his oxygen saturation.
  • D: transport without delay.
Definition
D: transport without delay.
Term

After attaching the AED and pushing the analyze button on an adult patient in cardiac arrest, the AED states that a shock is advised. What cardiac rhythm is the patient MOST likely in?

  • A: Pulseless electrical activity
  • B: Asystole
  • C: Ventricular fibrillation
  • D: Ventricular tachycardia
Definition
C: Ventricular fibrillation
Term

A 66-year-old female presents with an acute onset of confusion, slurred speech, and weakness to her right arm and leg. Her airway is patent and she is breathing adequately. The MOST important initial information to determine regarding this patient is:

  • A: her initial blood pressure reading.
  • B: whether or not her pupils are equal.
  • C: when her symptoms were first noted.
  • D: what she was doing when this began.
Definition
C: when her symptoms were first noted.
Term

The energy setting for a biphasic AED:

  • A: is manufacturer specific.
  • B: must be manually set by the EMT.
  • C: is typically 360 joules.
  • D: increases by 50 joules with each shock.
Definition
A: is manufacturer specific.
Term

Which of the following types of stroke would MOST likely present with a sudden, severe headache?

  • A: Thrombotic
  • B: Ischemic
  • C: Embolic
  • D: Hemorrhagic
Definition
D: Hemorrhagic
Term
Definition
Term

 

After administering nitroglycerin to a patient with chest discomfort, it is MOST important for you to:

  • A: ask the patient if the discomfort has improved.
  • B: reassess his or her blood pressure within 5 minutes.
  • C: place the patient supine and elevate his or her legs.
  • D: find out how long the discomfort has been present

 

Definition
B: reassess his or her blood pressure within 5 minutes.
Term

You should be MOST suspicious that a patient with chest pressure has an underlying cardiac problem if his or her pulse is:

  • A: rapid.
  • B: slow.
  • C: irregular.
  • D: bounding.
Definition
C: irregular.
Term

The MOST important initial treatment for a patient whose cardiac arrest was witnessed is:

  • A: defibrillation.
  • B: high-quality CPR.
  • C: rapid transport.
  • D: cardiac drug therapy.
Definition
B: high-quality CPR
Term

A patient whose artificial pacemaker has failed would MOST likely experience:

  • A: hypertension and a headache.
  • B: weakness and bradycardia.
  • C: dizziness and excessive tachycardia
  • D: irreversible ventricular fibrillation.
Definition
B: weakness and bradycardia.
Term

A middle-aged woman took three of her prescribed nitroglycerin tablets after she began experiencing chest pain. She complains of a bad headache and is still experiencing chest pain. You should assume that:

  • A: she has ongoing cardiac ischemia.
  • B: her blood pressure is elevated.
  • C: her chest pain is not cardiac-related.
  • D: her nitroglycerin is no longer potent.
Definition
A: she has ongoing cardiac ischemia.
Term

An elderly man in unresponsive and has agonal breathing. You should:

  • A: check for a carotid pulse for up to 10 seconds.
  • B: perform rescue breathing at 10 to 12 breaths/min.
  • C: begin CPR, starting with chest compressions.
  • D: open his airway and deliver 2 rescue breaths.
Definition
A: check for a carotid pulse for up to 10 seconds.
Term

When an error occurs while using the AED, it is MOST often the result of:

  • A: excess patient movement during the analyze phase.
  • B: battery failure secondary to operator error.
  • C: misinterpretation of the patient’s cardiac rhythm.
  • D: malfunction of the microchip inside the AED.
Definition
B: battery failure secondary to operator error.
Term

Which of the following questions would be the MOST effective in determining if a patient's chest pain radiates away from his or her chest?

  • A: Is there anything that makes the pain better or worse?
  • B: Is there any other part of your body where you have pain?
  • C: Do you also have pain in your arm, jaw, or back?
  • D: Does the pain stay in your chest or move anywhere else?
Definition
D: Does the pain stay in your chest or move anywhere else?
Term

A 60-year-old man is in cardiac arrest. You begin CPR while your partner applies the AED. What should you do if you receive a no shock message?

  • A: Ensure that the AED electrodes are properly applied.
  • B: Assess for a carotid pulse for up to 10 seconds.
  • C: Reanalyze his cardiac rhythm after 30 seconds of CPR.
  • D: Resume CPR, starting with chest compressions.
Definition
D: Resume CPR, starting with chest compressions.
Term

Switching compressors during two-rescuer CPR:

  • A: should take no more than 10 seconds to accomplish.
  • B: is performed after every 10 to 20 cycles of adult CPR.
  • C: is only necessary if the compressor becomes fatigued.
  • D: should occur every 2 minutes throughout the arrest
Definition
D: should occur every 2 minutes throughout the arrest
Term

You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. Your FIRST action should be to:

  • A: insert an oropharyngeal airway and continue CPR
  • B: attach the AED and analyze his cardiac rhythm.
  • C: stop CPR so you can assess breathing and pulse.
  • D: check the effectiveness of the CPR in progress.
Definition
C: stop CPR so you can assess breathing and pulse.
Term

In addition to chest pain or discomfort, a patient experiencing an acute coronary syndrome would MOST likely present with:

  • A: irregular breathing and low blood pressure.
  • B: profound cyanosis, dry skin, and a headache.
  • C: ashen skin color, diaphoresis, and anxiety.
  • D: severe projectile vomiting and flushed skin.
Definition
C: ashen skin color, diaphoresis, and anxiety.
Term

After defibrillating a man in cardiac arrest, you resume CPR. As you are about to reanalyze his cardiac rhythm 2 minutes later, your partner tells you she can definitely feel a strong carotid pulse. You should:

  • A: ask her to obtain a blood pressure reading.
  • B: assess the patient’s breathing effort.
  • C: continue with the rhythm analysis.
  • D: remove the AED pads from the patient’s chest.
Definition
B: assess the patient’s breathing effort
Term

Which of the following interventions would the EMT be the LEAST likely to perform while attempting to resuscitate a cardiac arrest patient?

  • A: Ventilation with a bag-mask device
  • B: Assisting a paramedic with intubation
  • C: Insertion of a laryngeal mask airway
  • D: Rhythm analysis with the AED
Definition
C: Insertion of a laryngeal mask airway
Term

The quickest way to reduce cardiac ischemia in a patient experiencing an acute coronary syndrome is to:

  • A: elevate the patient’s legs.
  • B: sit or lay the patient down.
  • C: keep the patient warm.
  • D: give supplemental oxygen.
Definition
B: sit or lay the patient down.
Term

After delivering one shock with the AED and performing 2 minutes of CPR on a woman in cardiac arrest, you reanalyze her cardiac rhythm and receive a no shock advised message. This means that:

  • A: the first shock restored a rhythm and pulse.
  • B: her rhythm has deteriorated to asystole.
  • C: she is not in a shockable rhythm.
  • D: she has electrical activity but no pulse.
Definition
C: she is not in a shockable rhythm.
Term

Nitroglycerin is contraindicated in all of the following situations, EXCEPT:

  • A: the presence of a head injury.
  • B: history of cardiac bypass surgery.
  • C: recent use of Cialis.
  • D: systolic BP of 80 mm Hg.
Definition
B: history of cardiac bypass surgery.
Term

Which of the following statements regarding ventricular fibrillation (V-Fib) is correct?

  • A: In V-Fib, the heart is not pumping any blood and the patient is pulseless.
  • B: Loss of consciousness occurs within minutes after the onset of V-Fib.
  • C: Patients in V-Fib should be defibrillated after every 60 seconds of CPR.
  • D: Any patient in V-Fib must receive CPR for 2 minutes prior to defibrillation
Definition
A: In V-Fib, the heart is not pumping any blood and the patient is pulseless.
Term

You should suspect that your patient has pulmonary edema if he or she:

  • A: has swollen feet and ankles.
  • B: has a dry, nonproductive cough.
  • C: is hypertensive and tachycardic.
  • D: cannot breathe while lying down.
Definition
D: cannot breathe while lying down.
Term

You have analyzed a cardiac arrest patient's rhythm three times with the AED, separated by 2-minute cycles of CPR, and have received no shock messages each time. You should:

  • A: request a paramedic unit at the scene.
  • B: consider terminating resuscitation.
  • C: continue CPR and transport at once.
  • D: remove the AED and continue CPR.
Definition
C: continue CPR and transport at once.
Term

Following administration of nitroglycerin to a man with crushing chest pressure, he experiences a significant increase in his heart rate. This is MOST likely the result of:

  • A: coronary vasoconstriction.
  • B: preexisting hypertension.
  • C: a cardiac dysrhythmia.
  • D: a drop in blood pressure.
Definition
D: a drop in blood pressure
Term

Your assessment of a middle-aged female with chest pressure reveals that she is confused, diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST important for you to:

  • A: request an ALS unit to respond to the scene.
  • B: prepare for immediate transport to the hospital.
  • C: reassess her vital signs at least every 5 minutes.
  • D: assist her with her nitroglycerin if she has any.
Definition
B: prepare for immediate transport to the hospital.
Term

Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it causes:

  • A: increased cardiac filling in between beats.
  • B: increased cardiac oxygen usage and demand.
  • C: an associated increase in breathing difficulty.
  • D: a profound decrease in oxygen consumption.
Definition
B: increased cardiac oxygen usage and demand.
Term

Treatment for a patient with congestive heart failure and shortness of breath may include:

  • A: nitroglycerin if his or her systolic BP is greater than 90 mm Hg.
  • B: prophylactic suctioning of the airway every 3 to 5 minutes.
  • C: positioning the patient supine and elevating his or her legs.
  • D: hyperventilation with a bag-mask device and high-flow oxyge
Definition
A: nitroglycerin if his or her systolic BP is greater than 90 mm Hg
Term

When the vital organs of an 85-year-old patient need additional blood flow, the heart may not be able to meet the increased need because:

  • A: stroke volume increases as a person ages.
  • B: the patient’s blood vessels become more elastic.
  • C: the reserve capacity of the heart is reduced.
  • D: blood pressure decreases as a person ages.
Definition
C: the reserve capacity of the heart is reduced.
Term

When assessing a patient with a possible stroke, you should remember that:

  • A: the majority of strokes involve bleeding into the brain tissue.
  • B: right-sided weakness indicates a stroke in the right cerebral hemisphere.
  • C: fibrinolytic therapy must be given within 6 hours following the stroke.
  • D: the patient may be unable to communicate, but can often understand.
Definition
D: the patient may be unable to communicate, but can often understand.
Term

You assess an unresponsive 65-year-old man and find that he is apneic and pulseless. The patient's wife tells you that he has an automatic implanted cardiac defibrillator. After initiating CPR, you should:

  • A: apply the AED as soon as possible and analyze his cardiac rhythm.
  • B: ask the wife why and when he had the automatic defibrillator implanted.
  • C: deactivate the implanted defibrillator by running a magnet over it.
  • D: avoid using the AED because the implanted defibrillator is more effective.
Definition
A: apply the AED as soon as possible and analyze his cardiac rhythm.
Term

A middle-aged male was found unresponsive by his wife. When you arrive at the scene, you assess the patient and determine that he is apneic and pulseless. You should:

  • A: immediately apply the AED, analyze his cardiac rhythm, deliver a shock if indicated, and begin CPR.
  • B: immediately begin CPR, reassess for a carotid pulse after 60 seconds, and then apply the AED.
  • C: perform CPR with a compression-to-ventilation ratio of 15:2, apply the AED, and request backup.
  • D: begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup.
Definition
D: begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup.
Term

Which of the following statements regarding sudden cardiac arrest and ventricular fibrillation is correct?

  • A: Patients with ventricular fibrillation are typically unconscious, apneic, and have a weak and irregular pulse.
  • B: For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%.
  • C: Most patients develop ventricular fibrillation within 10 minutes after the onset of sudden cardiac arrest.
  • D: High-quality CPR often reverses ventricular fibrillation if it is initiated within 2 minutes of the onset.
Definition
B: For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%.
Term

 

All of the following are components of the Cincinnati stroke scale, EXCEPT:

  • A: pupil size.
  • B: arm movement.
  • C: speech pattern.
  • D: facial droop

 

Definition
A: pupil size
Term

When performing two-rescuer CPR on a 35-year-old patient whose airway has not been secured with an advanced device, you should:

  • A: not attempt to synchronize compressions with ventilations
  • B: have your partner pause after 30 compressions as you give 2 breaths.
  • C: continue ventilations as the AED analyzes the patient’s cardiac rhythm.
  • D: slowly compress the chest to a depth of about 2 inches.
Definition
B: have your partner pause after 30 compressions as you give 2 breaths
Term

You are assessing a 70-year-old male who complains of pain in both of his legs. He is conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distention. This patient's primary problem is MOST likely:

  • A: right heart failure.
  • B: pulmonary edema.
  • C: chronic hypertension.
  • D: left heart failure.
Definition
A: right heart failure.
Term

After restoring a pulse in a cardiac arrest patient, you begin immediate transport. While en route to the hospital, the patient goes back into cardiac arrest. You should:

  • A: analyze the patient’s rhythm with the AED.
  • B: tell your partner to stop the ambulance.
  • C: begin CPR and proceed to the hospital.
  • D: contact medical control for further advice.
Definition
B: tell your partner to stop the ambulance.
Term

You arrive at the scene of a 56-year-old man who collapsed. The patient's wife tells you that he suddenly grabbed his chest and then passed out. Your assessment reveals that he is apneic and pulseless. As your partner begins one-rescuer CPR, you should:

  • A: insert an airway adjunct.
  • B: obtain a SAMPLE history.
  • C: prepare the AED for use.
  • D: notify medical control.
Definition
C: prepare the AED for use.
Term

Which of the following is the MOST appropriate response when a patient with chest pain asks you if he or she is having a heart attack?

  • A: I don’t know, but we will take good care of you.
  • B: I believe you are, but only a physician can tell for sure.
  • C: Probably not, but we should transport you to be safe.
  • D: Yes, so I recommend going to the hospital.
Definition
A: I don’t know, but we will take good care of you.
Term

A middle-aged female with a history of hypertension and high cholesterol complains of chest discomfort. She asks you to take her to the hospital where her personal physician practices, which is 15 miles away. Her blood pressure is 130/70 mm Hg, pulse is 84 beats/min and regular, and respirations are 18 breaths/min and unlabored. Which of the following actions is clearly NOT appropriate for this patient?

  • A: Allowing her to walk to the ambulance
  • B: Contacting her physician via phone
  • C: Giving oxygen via nasal cannula
  • D: Taking her to her choice hospital
Definition
A: Allowing her to walk to the ambulance
Term

After assisting a patient with his or her prescribed nitroglycerin, you would NOT expect him or her to experience a:

  • A: pounding headache.
  • B: syncopal episode.
  • C: fizzing sensation under the tongue.
  • D: burning sensation in the mouth.
Definition
B: syncopal episode.
Term

During transport of an elderly woman who was complaining of nausea, vomiting, and weakness, she suddenly becomes unresponsive. You should:

  • A: feel for a carotid pulse for at least 5 seconds.
  • B: open her airway and ensure that it is clear.
  • C: analyze her heart rhythm with the AED.
  • D: quickly look at her chest for obvious movement.
Definition
D: quickly look at her chest for obvious movement.
Term
Definition
Term

In addition to high-flow oxygen, the MOST appropriate treatment for a patient with widespread full-thickness burns should include:

  • A:moist; sterile dressings; warmth; and rapid transport.
  • B:dry, sterile dressings; warmth; and rapid transport.
  • C:moist; sterile dressings; burn ointment; and rapid transport.
  • D:dry; sterile dressings; burn ointment; and rapid transport.
Definition
B:dry, sterile dressings; warmth; and rapid transport.
Term

Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment, you note that an area to the left side of his chest collapses during inhalation and bulges during exhalation. These are signs of a/an:

 

  • A:isolated rib fracture.
  • B:flail chest.
  • C:pulmonary contusion.
  • D:pneumothorax.
Definition
B:flail chest
Term

Damaged small blood vessels beneath the skin following blunt trauma causes:

 

  • A:mottling.
  • B:ecchymosis.
  • C:hematoma.
  • D:cyanosis.
Definition
B:ecchymosis.
Term

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

  • A:Pedal
  • B:Radial
  • C:Popliteal
  • D:Brachial
Definition
B:Radial
Term

The pneumatic antishock garment may be indicated for patients with:

  • A:femur fractures and crackles in the lungs.
  • B:blunt chest trauma and hypotension.
  • C:pelvic instability and signs of shock.
  • D:any severe injury above the nipple line.
Definition
C:pelvic instability and signs of shock.
Term

A 22-year-old man was stabbed in the chest with a large knife. The patient is pulseless and apneic, and the knife is impaled in the center of his chest. Treatment should include:

  • A:removing the knife, applying an occlusive dressing, and providing rapid transport.
  • B:stabilizing the knife, starting CPR, and providing rapid transport.
  • C:removing the knife, starting CPR, and providing rapid transport.
  • D:stabilizing the knife, applying an occlusive dressing, and providing rapid transport.
Definition
C:removing the knife, starting CPR, and providing rapid transport.
Term

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

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

Displaced fractures of the proximal femur are characterized by:

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

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

 

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

Which of the following BEST describes the mechanism of injury?

  • A:Your concern for potentially serious injuries
  • B:The energy of an object in motion
  • C:The product of mass, force of gravity, and height
  • D:The way in which traumatic injuries occur
Definition
D:The way in which traumatic injuries occur
Term

A 21-year-old man partially amputated his right arm when the chainsaw he was using to trim trees slipped. You can feel a weak radial pulse and his arm is cool to the touch. Dark red blood is flowing heavily from the wound. You should:

  • A:control the bleeding, manipulate the arm to improve circulation, and apply a splint.
  • B:apply a tourniquet proximal to the injury and tighten it until the bleeding stops.
  • C:apply bulky compression dressings to the wound and splint the extremity.
  • D:carefully pack sterile dressings into the wound and fully splint the extremity.
Definition
C:apply bulky compression dressings to the wound and splint the extremity
Term

During a soccer game, a 20-year-old man collided shoulder-to-shoulder with another player. He has pain and a noticeable anterior bulge to the left shoulder. Which of the following is the MOST effective method of immobilizing this injury?

  • A:A sling to support the left arm and swathes to maintain downward traction
  • B:An air-inflatable splint with the left arm immobilized in the flexed position
  • C:A long board splint with the left arm immobilized in the extended position
  • D:A sling to support the left arm and swathes to secure the arm to the body
Definition
D:A sling to support the left arm and swathes to secure the arm to the body
Term

A 33-year-old male struck a parked car with his motorcycle and was ejected from the motorcycle. He was not wearing a helmet. He is unresponsive, has a depressed area to his forehead, bilaterally deformed femurs, and widespread abrasions with capillary bleeding. Which of the following statements regarding this patient is NOT correct?

  • A:Femur fractures are a common injury when a motorcyclist is ejected from his or her motorcycle.
  • B:Internal hemorrhage cannot be controlled in the field and requires prompt surgical intervention.
  • C:You should suspect that the patient has a skull fracture and increased intracranial pressure.
  • D:You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock.
Definition
D:You must stop the bleeding from his abrasions immediately or he will die from hypovolemic shock.
Term

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

 

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

During your assessment of a patient with a gunshot wound to the chest, you note that his skin is pale. This finding is the result of:

 

  • A:a critically low blood pressure.
  • B:peripheral dilation of the vasculature.
  • C:increased blood flow to the skin.
  • D:decreased blood flow to the skin.
Definition
D:decreased blood flow to the skin.
Term

A patient experienced blunt chest trauma and has asymmetrical chest wall movement. This MOST likely indicates:

  • A:decreased air movement into one lung.
  • B:accumulation of blood in both of the lungs.
  • C:shallow breathing secondary to severe pain.
  • D:several ribs broken in numerous places.
Definition
A:decreased air movement into one lung
Term

A 22-year-old female woman was shot by her husband. Law enforcement is at the scene and has the husband in custody. The patient is conscious, but extremely restless, and is pale and diaphoretic. As your partner administers high-flow oxygen, you should:

 

  • A:keep her warm by applying blankets.
  • B:take her BP to detect hypotension.
  • C:compare her carotid and radial pulses.
  • D:look for and control any bleeding.
Definition
D:look for and control any bleeding.
Term

Following blunt injury to the anterior trunk, a patient is coughing up bright red blood. You should be MOST suspicious of:

  • A:intraabdominal bleeding.
  • B:bleeding within the lungs.
  • C:severe myocardial damage.
  • D:gastrointestinal bleeding.
Definition
B:bleeding within the lungs.
Term

Prior to your arrival at the scene, a young female was removed from the water after being submerged for an unknown period of time. You should manage her airway appropriately while considering the possibility of:

  • A:spinal injury.
  • B:internal bleeding.
  • C:airway obstruction.
  • D:hyperthermia.
Definition
A:spinal injury
Term

An elderly woman, who was removed from her burning house by firefighters, has full-thickness burns to approximately 50% of her body. Appropriate treatment for this patient should include:

  • A:applying moist, sterile dressings to the burned areas and preventing hypothermia.
  • B:peeling burned clothing from the skin and removing all rings, necklaces, and bracelets.
  • C:covering the burns with dry, sterile dressings and preventing further loss of body heat.
  • D:cooling the burns with sterile saline and covering them with dry, sterile burn pads.
Definition
C:covering the burns with dry, sterile dressings and preventing further loss of body heat.
Term

Patients with significant closed head injuries often have pupillary abnormalities and:

  • A:hypertension.
  • B:paralysis.
  • C:tachycardia.
  • D:paresthesia.
Definition
A:hypertension
Term

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

 

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

The presence of subcutaneous emphysema following blunt trauma to the anterior neck should make you MOST suspicious for a:

  • A:carotid artery injury.
  • B:pneumothorax.
  • C:ruptured esophagus.
  • D:fractured larynx.
Definition
D:fractured larynx
Term

A 21-year-old male was bitten on the left forearm by a dog. He is conscious and alert and denies any other injuries. An animal control officer is at the scene and has contained the dog. Your assessment of the patient's arm reveals a large avulsion with a peeled back flap of skin. Distal circulation is adequate and the patient is able to feel and move his fingers. In addition to bleeding control, you should:

  • A:replace the avulsed flap to its original position.
  • B:perform a rapid head-to-toe assessment.
  • C:irrigate the wound for at least 15 minutes.
  • D:apply oxygen via a nonrebreathing mask.
Definition
A:replace the avulsed flap to its original position.
Term

A 33-year-old factory worker was pinned between two pieces of machinery. When you arrive at the scene, you find him lying supine on the ground complaining of severe pain to his pelvis. He is restless, diaphoretic, and tachycardic. After performing a rapid head-to-toe assessment, you should:

 

  • A:prepare for immediate transport.
  • B:carefully log roll him to check his back.
  • C:palpate his pelvis to assess for crepitus.
  • D:perform a detailed secondary exam.
Definition
A:prepare for immediate transport.
Term

A 42-year-old man was ejected from his car after it struck a bridge pillar at a high rate of speed. You find him in a prone position approximately 50 feet from his car. He is not moving and does not appear to be breathing. You should:

 

  • A:administer high-flow oxygen.
  • B:use the jaw-thrust maneuver.
  • C:assess his breathing effort.
  • D:manually stabilize his head.
Definition
D:manually stabilize his head.
Term

A 30-year-old woman has an open deformity to her left leg and is in severe pain. She is conscious and alert, has a patent airway, and is breathing adequately. Your primary concern should be:

  • A:administering high-flow oxygen.
  • B:covering the wound to prevent infection.
  • C:controlling any external bleeding.
  • D:assessing pulses distal to the injury.
Definition
C:controlling any external bleeding.
Term

If a vehicle strikes a tree at 60 MPH, the unrestrained driver would likely experience the MOST severe injuries during the:

  • A:second collision.
  • B:third collision.
  • C:fourth collision.
  • D:first collision.
Definition
B:third collision.
Term

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

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

Basic shock treatment includes:

 

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

A patient presents with a swollen, painful deformity to the lateral bone of the left forearm. You should recognize that he has injured his:

  • A:clavicle.
  • B:ulna.
  • C:humerus.
  • D:radius.
Definition
D:radius.
Term

Initial treatment for a patient with external blood loss depends upon:

  • A:his or her signs and symptoms.
  • B:his or her past medical history.
  • C:whether or not hypotension is present.
  • D:the amount of estimated blood loss.
Definition
A:his or her signs and symptoms
Term

Which of the following patients would be MOST in need of a rapid head-to-toe assessment?

  • A:A responsive 22-year-old man with a small caliber gunshot wound to the abdomen
  • B:A responsive 25-year-old woman who fell 9 feet from a roof and landed on her side
  • C:A 60-year-old man who fell from a standing position and has small abrasions on his cheek
  • D:A 43-year-old woman with a unilaterally swollen, painful deformity of the midshaft femur
Definition
A:A responsive 22-year-old man with a small caliber gunshot wound to the abdomen
Term

A 56-year-old man was the unrestrained driver of a small passenger car that rolled over twice after he rounded a corner too fast. He is unresponsive; has rapid, shallow respirations; and has a rapid, weak pulse. His left arm is completely amputated just below the elbow. As you and your partner are treating the patient, other responders are trying to find the amputated arm. Which of the following statements regarding this scenario is MOST correct?

  • A:You should transport the patient immediately, even if the other responders recover his arm before you depart the scene.
  • B:Quickly move the patient to the ambulance, continue treatment, and wait for the other responders to recover his arm.
  • C:Your priority should be to recover the man’s arm because a vascular surgeon may be able to successfully reattach it.
  • D:If the patient’s arm has not been recovered by the time you are ready to transport, you should transport without delay.
Definition
D:If the patient’s arm has not been recovered by the time you are ready to transport, you should transport without delay.
Term

Shock following major trauma is MOST often the result of:

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

Which of the following signs would you expect to see in the early stages of shock?

  • A:Hypotension
  • B:Unconsciousness
  • C:Restlessness
  • D:Thready pulses
Definition
C:Restlessness
Term

Which of the following indicates that a patient is in decompensated shock?

  • A:Diaphoresis and pallor
  • B:Falling blood pressure
  • C:Tachycardia and tachypnea
  • D:Restlessness and anxiety
Definition
B:Falling blood pressure
Term

In which of the following situations would external bleeding be the MOST difficult to control?

  • A:Jugular vein laceration, BP of 104/54 mm Hg
  • B:Femoral artery laceration, BP of 140/90 mm Hg
  • C:Scalp laceration, BP of 120/70 mm Hg
  • D:Carotid artery laceration, BP of 70/50 mm Hg
Definition
B:Femoral artery laceration, BP of 140/90 mm Hg
Term

You respond to a shooting at a local bar. Law enforcement is present and the scene has been secured. Your patient is a young male, who is sitting against the wall screaming in pain. Bright red blood is spurting from a wound near his groin. You should:

 

  • A:ensure an open airway.
  • B:transport the patient at once.
  • C:apply pressure to the wound.
  • D:administer high-flow oxygen.
Definition
C:apply pressure to the wound.
Term

A football player complains of severe neck pain and tingling in his arms and legs after being tackled. He is conscious and alert, has a patent airway, and is breathing adequately. He is in a supine position and is still wearing his helmet, which is tight-fitting. The MOST appropriate treatment for this patient includes:

  • A:manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.
  • B:manually stabilizing his head, leaving his helmet on, applying a vest-style spinal immobilization device, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.
  • C:manually stabilizing his head, carefully removing his helmet, administering high-flow oxygen, applying a cervical collar, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.
  • D:carefully removing his helmet, manually stabilizing his head, applying a cervical collar, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.
Definition
A:manually stabilizing his head with his helmet still on, removing the face mask, administering high-flow oxygen, placing him onto a long backboard, and restricting spinal motion with straps and a lateral head stabilizer.
Term

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

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

Which of the following questions is of LEAST pertinence initially when assessing a responsive 40-year-old woman who fell from a standing position?

  • A:Have you fallen before?
  • B:Did you hit your head?
  • C:Can you move your hands and feet?
  • D:Did you faint before you fell?
Definition
A:Have you fallen before?
Term

Which of the following assessment parameters is the MOST reliable when determining if a patient with a head injury is improving or deteriorating?

  • A:rate and depth of breathing.
  • B:pupillary reaction.
  • C:systolic blood pressure.
  • D:level of consciousness.
Definition
D:level of consciousness.
Term

You are called to a local nightclub for an injured patient. Upon arrival, you see a young man who is lying on the ground screaming in pain; bright red blood is spurting from an apparent stab wound to his groin area. You should:

 

  • A:prevent hypothermia.
  • B:control the bleeding.
  • C:ensure an open airway.
  • D:apply 100% oxygen.
Definition
B:control the bleeding.
Term

A 23-year-old unrestrained female struck the steering wheel with her chest when her passenger car collided with a tree at a high rate of speed. Your assessment reveals that she is conscious, but has signs of shock and an irregular pulse. The MOST appropriate treatment for this patient includes:

  • A:high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport.
  • B:applying an AED in case she develops cardiac arrest, high-flow oxygen, full spinal precautions, and rapid transport.
  • C:insertion of an oral airway, assisted ventilations with a bag-mask device, full spinal precautions, and rapid transport.
  • D:high-flow oxygen, summoning a paramedic unit to the scene to assess her cardiac rhythm, a cervical collar, and transport as soon as possible.
Definition
A:high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep her warm, and rapid transport.
Term

You are assessing a 33-year-old male's Glasgow Coma scale (GCS) score. The patient opens his eyes in response to pain, is speaking with incomprehensible words, and is flexing his upper extremities. What is his GCS score?

  • A:7
  • B:6
  • C:9
  • D:8
Definition
A:7
Term

A 19-year-old man was struck in the side of the head with a steel pipe. Blood-tinged fluid is draining from the ear and bruising appears behind the ear. The MOST appropriate treatment for this patient includes:

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

Which of the following mechanisms of injury would necessitate performing a rapid head-to-toe assessment?

 

  • A:A 5 foot, 9 inch tall adult who fell 12 feet from a roof and landed on his side
  • B:An impaled object in the patient’s lower extremity with minimal venous bleeding
  • C:Amputation of three toes from the patient’s left foot with controlled bleeding
  • D:A stable patient involved in a motor-vehicle crash, whose passenger was killed
Definition
D:A stable patient involved in a motor-vehicle crash, whose passenger was killed
Term

A young male has an open abdominal wound through which a small loop of bowel is protruding. There is minimal bleeding. The BEST way to treat his injury is to:

  • A:gently clean the exposed loop of bowel with warm sterile saline, carefully replace it back into the wound, and cover it with a dry sterile dressing.
  • B:cover the wound with a dry sterile trauma dressing and tightly secure it in place by circumferentially wrapping roller gauze around the abdomen.
  • C:apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing.
  • D:apply dry sterile gauze pads to the wound and then keep them continuously moist by pouring sterile saline or water on them throughout transport.
Definition
C:apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing.
Term

Rapid extrication of a patient from an automobile should be performed by:

 

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

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

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

A soft-tissue injury that results in a flap of torn skin is called a/an:

  • A:laceration.
  • B:incision.
  • C:abrasion.
  • D:avulsion.
Definition
D:avulsion.
Term

A young male has a large laceration to his lateral neck, directly over his jugular vein. His airway is patent and his breathing is adequate. Your MOST immediate priority should be to:

  • A:apply high-flow oxygen via a nonrebreathing mask.
  • B:keep air out of the wound and control the bleeding.
  • C:obtain vital signs to determine if he is hypotensive.
  • D:perform a rapid assessment to detect other injuries.
Definition
B:keep air out of the wound and control the bleeding.
Term

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

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

An unresponsive patient with multi-systems trauma has slow, shallow breathing; weak radial pulses; and severe bleeding from a lower extremity wound. You should direct your partner to:

 

  • A:radio for a paramedic ambulance to respond to the scene.
  • B:prepare the long spine board and straps for rapid spinal immobilization.
  • C:apply oxygen via nonrebreathing mask while you control the bleeding.
  • D:assist the patient's ventilations while you control the bleeding.
Definition
D:assist the patient's ventilations while you control the bleeding.
Term

When assessing distal circulation in a patient with a swollen deformed femur, you should:

  • A:palpate for a dorsalis pedis pulse.
  • B:ask the patient to wiggle his toes.
  • C:touch his foot with a blunt object.
  • D:assess the pulse behind the knee.
Definition
A:palpate for a dorsalis pedis pulse.
Term

When caring for a critically injured patient, it is MOST appropriate to perform your secondary assessment:

  • A:while you are en route to the hospital.
  • B:immediately following the primary assessment.
  • C:immediately after taking baseline vital signs.
  • D:after all life threats have been ruled out.
Definition
A:while you are en route to the hospital.
Term

During which part of your assessment would you MOST likely to discover a small caliber gunshot wound to the back with minimal bleeding?

  • A:General impression
  • B:Detailed secondary assessment
  • C:Primary assessment
  • D:Rapid head-to-toe assessment
Definition
D:Rapid head-to-toe assessment
Term

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

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

A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow, and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-flow oxygen, you should:

  • A:suspect that the patient has a tension pneumothorax and notify the trauma center as soon as possible.
  • B:control the bleeding from the stab wound with a sterile porous dressing and reassess his vital signs.
  • C:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly.
  • D:perform a detailed physical exam at the scene to ensure that you locate and treat less obvious injuries.
Definition
C:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly
Term

Which of the following is MOST indicative of compensated shock in an adult?

  • A:Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg
  • B:Unresponsive, pallor, absent radial pulses, tachypnea
  • C:Weak carotid pulse, cool skin, increased respiratory rate
  • D:Confusion, mottling, tachycardia, BP of 88/60 mm Hg
Definition
A:Restless, diaphoresis, tachypnea, BP of 104/64 mm Hg
Term

General care for an amputated body part includes:

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

Factors that affect a person's ability to compensate for internal or external blood loss include all of the following, EXCEPT:

  • A:high cholesterol in the blood.
  • B:advanced age.
  • C:blood-thinning medications.
  • D:the rate of blood loss.
Definition
A:high cholesterol in the blood
Term

During your rapid assessment of a critically-injured patient, you should assess the chest for:

  • A:crepitus and distention.
  • B:symmetry and pain.
  • C:distention and guarding.
  • D:rigidity and guarding.
Definition
B:symmetry and pain.
Term

You are called to a local knife-throwing contest, where a 42-year-old man has a large dagger impaled in the center of his chest. He is unresponsive, pulseless, and apneic. You should:

  • A:carefully remove the knife, control the bleeding, and begin CPR.
  • B:stabilize the knife with bulky dressings, begin CPR, and transport at once.
  • C:carefully remove the knife, control the bleeding, and apply the AED.
  • D:secure the knife in place with a bulky dressing and transport immediately.
Definition
A:carefully remove the knife, control the bleeding, and begin CPR.
Term

While removing a hot radiator cap, a 30-year-old man sustained partial-thickness burns to the anterior chest and both anterior arms. Based on the Rule of Nines, what percentage of his body surface area has been burned?

  • A:9%
  • B:36%
  • C:27%
  • D:18%
Definition
D:18%
Term

Following penetrating trauma to the abdomen, a 50-year-old woman has a large laceration with a loop of protruding bowel. How should you manage this injury?

  • A:Carefully replace the bowel and apply an occlusive dressing.
  • B:Apply a moist, sterile dressing, covered by a dry, sterile dressing.
  • C:Apply a dry, sterile dressing covered by an occlusive dressing.
  • D:Carefully replace the bowel and cover the wound with a moist, sterile dressing.
Definition
B:Apply a moist, sterile dressing, covered by a dry, sterile dressing.
Term

Which of the following injury mechanisms is associated with hangings?

  • A:Axial loading
  • B:Hyperextension
  • C:Distraction
  • D:Subluxation
Definition
C:Distraction
Term

Internal or external bleeding would be especially severe in a patient:

  • A:who is hypotensive.
  • B:with hemophilia.
  • C:with heart disease.
  • D:who takes aspirin.
Definition
B:with hemophilia
Term

A 44-year-old man has a traumatic leg amputation just below the knee. He is unresponsive; is breathing rapidly and shallowly; and has pale, cool, clammy skin. He is lying in a large pool of blood and the wound is bleeding profusely. To control this bleeding, you should:

  • A:apply a pressure dressing and elevate the injured extremity at least 12 inches.
  • B:locate the femoral artery and apply pressure to it until the bleeding stops.
  • C:apply an icepack to the wound to constrict the vessels and stop the bleeding.
  • D:cover the wound with a trauma dressing and apply a proximal tourniquet.
Definition
D:cover the wound with a trauma dressing and apply a proximal tourniquet.
Term

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

  • A:18%
  • B:45%
  • C:36%
  • D:27%
Definition
D:27%
Term

Following a head injury, a young female is semiconscious and is bleeding from the nose and left ear. You should:

  • A:place a pressure dressing over her ear to prevent blood loss.
  • B:insert a nasal airway to keep her tongue from blocking the airway.
  • C:control the bleeding from her nose by pinching her nostrils closed.
  • D:cover her ear and nose with a loose gauze pad to collect the blood.
Definition
D:cover her ear and nose with a loose gauze pad to collect the blood.
Term

Immediate treatment for a large avulsion includes:

  • A:immobilizing the injured area.
  • B:controlling any bleeding.
  • C:cleaning the wound.
  • D:assessing distal circulation.
Definition
B:controlling any bleeding
Term

You arrive at a residence where you find a man lying unresponsive in his front yard. There were no witnesses to the event. In assessing this man, you should assume that he:

  • A:is having a heart attack.
  • B:has a heat-related emergency.
  • C:has sustained an injury.
  • D:is having a diabetic reaction.
Definition
C:has sustained an injury.
Term

A 19-year-old male was assaulted and has trauma to multiple body systems. After performing your primary assessment and treating any immediate life-threatening injuries, you should:

  • A:fully immobilize his spine and transport.
  • B:obtain a full set of baseline vital signs.
  • C:transport at once and intercept with ALS.
  • D:perform a rapid head-to-toe assessment.
Definition
D:perform a rapid head-to-toe assessment.
Term

During the rapid head-to-toe assessment of a patient with multiple injuries, you expose the chest and find an open wound with blood bubbling from it. You should:

  • A:prevent air from entering the wound.
  • B:apply high-flow supplemental oxygen.
  • C:place a porous dressing over the wound.
  • D:stop your assessment and transport.
Definition
A:prevent air from entering the wound.
Term

Firefighters have rescued a man from his burning house. He is conscious and alert, but is experiencing significant respiratory distress. He has a brassy cough and singed nasal hairs. The MOST immediate threat to this patient's life is:

  • A:severe infection.
  • B:airway swelling.
  • C:hypothermia.
  • D:severe burns.
Definition
B:airway swelling.
Term

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

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

Which of the following actions is MOST important when immobilizing a patient with a suspected spinal injury?

  • A:A vest-style immobilization device should routinely be used.
  • B:Secure the patient’s head prior to immobilizing the torso.
  • C:Select and apply the appropriate size of extrication collar.
  • D:Check range of motion by asking the patient to move the head.
Definition
C:Select and apply the appropriate size of extrication collar
Term

Despite direct pressure, a large laceration to the medial aspect of the arm continues to bleed profusely. You should:

  • A:pack the inside of the laceration with sterile gauze.
  • B:locate and apply pressure to the brachial artery.
  • C:quickly apply a tourniquet proximal to the injury.
  • D:continue direct pressure and elevate the extremity
Definition
C:quickly apply a tourniquet proximal to the injury.
Term

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

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

If a passenger strikes his or her head on the windshield during a motor-vehicle crash:

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

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

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

A gang member was cut on the left side of the neck during a fight and is bleeding heavily from the wound. His airway is patent and his breathing is adequate. You should immediately:

  • A:perform a head-to-toe assessment to find and treat other injuries.
  • B:apply high-flow oxygen via a nonrebreathing mask at 15 L/min.
  • C:cover the wound with an occlusive dressing and apply direct pressure.
  • D:apply a tight pressure dressing and secure it in place with tape
Definition
C:cover the wound with an occlusive dressing and apply direct pressure.
Term

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

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

In contrast to an incision, a laceration:

  • A:is a jagged cut.
  • B:bleeds more severely.
  • C:usually involves an artery.
  • D:is a superficial injury.
Definition
A:is a jagged cut.
Term

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

  • A:apply direct pressure by pinching his nostrils together.
  • B:place a chemical icepack over his nose.
  • C:ensure that he is sitting up and leaning forward.
  • D:determine if he has any visual disturbances.
Definition
C:ensure that he is sitting up and leaning forward.
Term

A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and severely deformed. Her leg is cold to the touch and you are unable to palpate a distal pulse. You should:

  • A:manually stabilize her injury and contact medical control for further stabilization instructions.
  • B:carefully straighten her leg until you restore a distal pulse and then apply padded board splints.
  • C:apply gentle longitudinal traction as you straighten her leg and then apply a traction splint.
  • D:place a pillow behind her knee and stabilize the injury by applying padded board splints.
Definition
A:manually stabilize her injury and contact medical control for further stabilization instructions.
Term

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

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

Upon discovering an open chest wound, you should:

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

You are dispatched to the scene of a motorcycle crash. Upon arrival, you find the patient lying facedown approximately 25 feet from his bike. He is not wearing a helmet and is moaning. You should:

  • A:apply a cervical collar.
  • B:evaluate the status of his airway.
  • C:log roll him to a supine position.
  • D:stabilize his head manually.
Definition
D:stabilize his head manually.
Term

You are performing a secondary assessment on a severely injured patient while en route to a trauma center. During the assessment, you note that the patient's respiratory rate has increased. You should:

  • A:immediately notify the receiving facility.
  • B:assess his oxygen saturation with a pulse oximeter.
  • C:repeat the primary assessment and treat as needed.
  • D:count the number of respirations per minute.
Definition
C:repeat the primary assessment and treat as needed.
Term

Which of the following is the MOST reliable indicator of a fracture to a spinal vertebra?

  • A:Decreased grip strength in the upper extremities
  • B:Lack of pain at the site of the injury
  • C:Palpable pain at the site of the injury
  • D:Decreased movement on one side of the body
Definition
C:Palpable pain at the site of the injury
Term

Which of the following is MOST indicative of decompensated shock in a trauma patient with internal bleeding?

  • A:Restlessness
  • B:Clammy skin
  • C:Hypotension
  • D:Tachycardia
Definition
C:Hypotension
Term

In which of the following circumstances would external bleeding be the LEAST difficult to control?

  • A:Lacerated jugular vein; BP of 100/60 mm Hg
  • B:Lacerated femoral vein; BP of 70/40 mm Hg
  • C:Lacerated brachial artery; BP of 140/90 mm Hg
  • D:Lacerated carotid artery; BP of 90/50 mm Hg
Definition
B:Lacerated femoral vein; BP of 70/40 mm Hg
Term

A patient with a closed head injury opens his eyes in response to pain, is mumbling words that you can’t understand, and pulls his arm away when you apply a painful stimulus. His Glasgow Coma Scale score is:

  • A:6
  • B:9
  • C:7
  • D:8
Definition
D:8
Term

Appropriate care for an amputated body part includes all of the following, EXCEPT:

  • A:laying the wrapped body part on a bed of ice.
  • B:keeping the part cool, but not allowing it to freeze.
  • C:wrapping it in a sterile dressing and placing it in a plastic bag.
  • D:placing it directly on ice to prevent tissue damage.
Definition
D:placing it directly on ice to prevent tissue damage.
Term

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

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

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

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

A patient with a spinal injury may still be able to use his or her diaphragm to breathe, but would lose control of the intercostal muscles, if the spinal cord is injured:

  • A:above the C5 level.
  • B:above the C3 level.
  • C:below the C5 level.
  • D:between C1 and C2.
Definition
C:below the C5 level.
Term
Definition
Term

A 32-year-old man who was stung by a bee has generalized hives, facial swelling, and difficulty breathing. When he breathes, you hear audible stridor. What does this indicate?

  • A:Swelling of the upper airway structures
  • B:Narrowing of the two mainstem bronchi
  • C:Narrowing of the bronchioles in the lungs
  • D:Swelling of the lower airway structures
Definition
A:Swelling of the upper airway structures
Term

Which of the following signs or symptoms is MOST suggestive of a systemic reaction following ingestion of a poison?

  • A:Tachycardia and hypotension
  • B:Burns around the mouth
  • C:Nausea and vomiting
  • D:Painful or difficult swallowing
Definition
A:Tachycardia and hypotension
Term

When caring for a patient with severe hypothermia who is in cardiac arrest, you should:

  • A:perform BLS and transport.
  • B:perform rescue breathing only.
  • C:avoid using the AED.
  • D:hyperventilate the patient.
Definition
A:perform BLS and transport
Term

Early signs and symptoms of hepatitis include all of the following, EXCEPT:

  • A:fatigue.
  • B:jaundice.
  • C:fever and vomiting.
  • D:loss of appetite.
Definition
B:jaundice.
Term

A young woman reports significant weight loss over the last month, persistent fever, and night sweats. When you assess her, you note the presence of dark purple lesions covering her trunk and upper extremities. You should suspect:

  • A:tuberculosis.
  • B:end-stage cancer.
  • C:HIV/AIDS.
  • D:rheumatic fever.
Definition
C:HIV/AIDS.
Term

Which of the following patients with diabetes is the BEST candidate for oral glucose?

  • A:An unresponsive patient who took too much insulin
  • B:A confused patient who has cool, clammy skin
  • C:A semiconscious patient with pale, clammy skin
  • D:A confused patient with suspected hyperglycemia
Definition
B:A confused patient who has cool, clammy skin
Term

The daughter of an elderly patient states that her mother is acting confused and talking incoherently. This nature of illness is MOST consistent with:

  • A:altered mental status.
  • B:diabetic complications.
  • C:cardiac compromise.
  • D:behavioral problems.
Definition
A:altered mental status.
Term

After removing a patient from the water, your assessment reveals that he is not breathing and is continuously regurgitating large amounts of water. You should:

  • A:alternate suctioning with artificial ventilations.
  • B:begin rescue breathing after he stops regurgitating.
  • C:place him on his side and press on his abdomen.
  • D:perform abdominal thrusts to remove the water.
Definition

 

  • A:alternate suctioning with artificial ventilations.
Term

You are transporting a 35-year-old male who has a history of alcoholism. He stopped drinking 4 days ago and is now disoriented, diaphoretic, and tachycardic. You should be MOST concerned that he:

  • A:may have a seizure.
  • B:will develop a high fever.
  • C:will begin hallucinating.
  • D:is severely dehydrated.
Definition
A:may have a seizure
Term

A 73-year-old male presents with confusion; cool, pale, clammy skin; absent radial pulses; and a blood pressure of 70/44 mm Hg. The patient's wife tells you that he has had abdominal pain for a week and began vomiting a coffee-ground substance yesterday. His past medical history includes hypertension and gastric ulcer disease. Your MOST immediate concern should be that:

  • A:he is bleeding from his gastrointestinal tract.
  • B:he is in shock and requires prompt transport.
  • C:his blood glucose level is probably too high.
  • D:his condition requires surgery within 2 hours.
Definition
B:he is in shock and requires prompt transport.
Term

A middle-aged man is experiencing an obvious allergic reaction after being stung by a scorpion. He tells you that he does not have his own epinephrine; however, his wife is allergic to bees and has a prescribed epinephrine auto-injector. You should:

  • A:assist the patient with one half the usual dose of the wife’s epinephrine.
  • B:give the patient some of the epinephrine you carry on your ambulance.
  • C:provide rapid transport and consider an ALS rendezvous.
  • D:assist the patient with the wife’s prescribed epinephrine.
Definition
C:provide rapid transport and consider an ALS rendezvous.
Term
Definition
Term

Which of the following would MOST likely cause a rapid drop in a patient’s blood glucose level?

  • A:Mild exertion after eating a meal
  • B:Forgetting to take prescribed insulin
  • C:Eating a meal after taking insulin
  • D:Taking too much prescribed insulin
Definition
D:Taking too much prescribed insulin
Term

You and your partner arrive at the home of a 60-year-old man with shortness of breath. As you enter the residence, you find the patient sitting in his recliner; he is in obvious respiratory distress. As you approach him, he becomes verbally abusive, stating that it took you too long to get to his home. A small handgun is sitting on a table next to his recliner. You should:

  • A:turn around, rapidly exit the residence, and notify law enforcement.
  • B:verbally distract the patient as your partner attempts to retrieve the gun.
  • C:slowly back your way out of the residence and call law enforcement.
  • D:explain the reason for your delay as your partner administers oxygen.
Definition
C:slowly back your way out of the residence and call law enforcement
Term

Which of the following statements regarding heatstroke is MOST correct?

  • A:Not all patients experiencing heatstroke have dry skin.
  • B:As core body temperature rises, the patient becomes more agitated.
  • C:Heatstroke is caused by a hyperactive sweating mechanism.
  • D:Heatstroke is more likely to occur when the humidity is low.
Definition
A:Not all patients experiencing heatstroke have dry skin.
Term

An 80-year-old woman has pain in the right upper quadrant of her abdomen and a yellow tinge to her skin. You should suspect dysfunction of the:

  • A:liver.
  • B:spleen.
  • C:gallbladder.
  • D:pancreas.
Definition
A:liver.
Term

Which of the following conditions would MOST likely cause flushed skin?

  • A:Blood loss
  • B:Low blood pressure
  • C:Exposure to heat
  • D:Hypothermia
Definition
C:Exposure to heat
Term

When restraining a violent patient, you should make sure that:

  • A:someone talks to the patient during the process.
  • B:at least two EMTs restrain the patient.
  • C:consent for restraint has been obtained from a family member.
  • D:the patient is restrained using maximal force.
Definition
A:someone talks to the patient during the process.
Term

How should you classify a patient's nature of illness if he or she has a low blood glucose level, bizarre behavior, and shallow breathing?

  • A:Cardiac compromise
  • B:Respiratory emergency
  • C:Altered mental status
  • D:Behavioral emergency
Definition
C:Altered mental status
Term

A 60-year-old male complains of a tearing sensation in his abdomen. He tells you the pain began suddenly and feels like someone is sticking a knife into his abdomen. He is conscious and alert with a blood pressure of 148/88 mm Hg, a pulse of 120 beats/min, and respirations of 22 breaths/min. In addition to administering high-flow oxygen, you should:

  • A:auscultate over his epigastrium to assess for bowel sounds.
  • B:perform a rapid head to toe assessment and prepare for transport.
  • C:transport at once and be prepared to treat him for severe shock.
  • D:vigorously palpate his abdomen to assess for a pulsating mass.
Definition
C:transport at once and be prepared to treat him for severe shock.
Term

You receive a call to a restaurant where a 34-year-old man is experiencing shortness of breath. When you arrive, you immediately note that the man has urticaria on his face and arms. He is conscious, but restless, and is in obvious respiratory distress. You should:

  • A:ask the patient if he has an epinephrine auto-injector.
  • B:place a nonrebreathing mask set at 15 L/min on the patient.
  • C:obtain a set of baseline vital signs and a SAMPLE history.
  • D:remove the patient’s shirt to inspect his chest for urticaria.
Definition
B:place a nonrebreathing mask set at 15 L/min on the patient.
Term

You respond to a grocery store where a 39-year-old man reportedly experienced a seizure. When you arrive at the scene, a clerk begins to escort you to the patient. She tells you that the man stopped seizing about 5 minutes ago. If the patient truly experienced a seizure, you will MOST likely find that he:

  • A:has a slow heart rate.
  • B:is not breathing and is cyanotic.
  • C:is confused and disoriented.
  • D:is fully conscious and alert.
Definition
C:is confused and disoriented
Term

All of the following are signs of gastrointestinal bleeding, EXCEPT:

  • A:melena.
  • B:hematemesis.
  • C:hemoptysis.
  • D:tachycardia.
Definition
C:hemoptysis.
Term

Which of the following organs is NOT part of the endocrine system?

  • A:Pancreas
  • B:Thyroid
  • C:Gallbladder
  • D:Pituitary
Definition
C:Gallbladder
Term

Your FIRST action in managing a patient with an altered mental status should be to:

  • A:determine if the patient is breathing adequately.
  • B:ask a family member how the patient normally acts.
  • C:administer one tube of oral glucose.
  • D:administer high-flow supplemental oxygen.
Definition
A:determine if the patient is breathing adequately.
Term

After having been bitten on the leg by a rattlesnake, a 45-year-old hiker complains of generalized weakness and shortness of breath. His blood pressure is 90/50 mm Hg, and his pulse rate is 120 beats/min. In addition to high-flow oxygen, the MOST appropriate treatment for this patient includes:

  • A:proximal arterial constricting band and splinting.
  • B:elevation of the affected part and ice packs.
  • C:splinting and lowering of the affected part.
  • D:ice packs to the wound and splinting.
Definition
C:splinting and lowering of the affected part.
Term

Which of the following is the MOST significant finding in a patient with a severe headache?

  • A:Pain in both legs
  • B:Chest discomfort
  • C:Abdominal tenderness
  • D:Unilateral weakness
Definition
D:Unilateral weakness
Term

A 34-year-old female complains of persistent fever, fatigue, and night sweats. During your assessment, you note that she has purple blotches on her arms and legs. She MOST likely has:

  • A:HIV/AIDS.
  • B:viral hepatitis.
  • C:tuberculosis.
  • D:chickenpox.
Definition
A:HIV/AIDS
Term

You are dispatched to a residence for a 20-year-old male with respiratory distress. When you arrive, you find that the patient has a tracheostomy tube and is ventilator dependent. His mother tells you that he was doing fine, but then suddenly began experiencing breathing difficulty. You should:

  • A:remove the ventilator tubing and place an oxygen mask over the tracheostomy tube.
  • B:remove him from the mechanical ventilator and ventilate him manually.
  • C:detach the ventilator, suction the tracheostomy tube, and reassess the patient.
  • D:check the settings on the ventilator to ensure that it is functioning properly.
Definition
B:remove him from the mechanical ventilator and ventilate him manually.
Term

A patient who overdosed on heroin would be expected to present with:

  • A:deep breathing.
  • B:tachycardia.
  • C:hypotension.
  • D:dilated pupils.
Definition
C:hypotension.
Term

Which of the following is the MOST significant finding in a patient experiencing an allergic reaction to a bee sting?

  • A:Hoarseness
  • B:Widespread rash.
  • C:Abdominal cramps.
  • D:Headache
Definition
A:Hoarseness
Term

When caring for a patient with an acute behavioral crisis, your primary concern should be:

  • A:gathering all of the patient’s medications.
  • B:ensuring you and your partner’s safety.
  • C:obtaining a complete past medical history.
  • D:providing safe transport to the hospital.
Definition
B:ensuring you and your partner’s safety.
Term

Which of the following signs and symptoms are MOST characteristic of hyperglycemic ketoacidosis?

  • A:Cool, clammy skin and a slow onset
  • B:Warm, dry skin and a rapid onset
  • C:Warm, dry skin and a slow onset
  • D:Cool, clammy skin and a rapid onset
Definition
C:Warm, dry skin and a slow onset
Term

A patient with a core body temperature of 94°F would MOST likely present with:

  • A:shivering and pale skin.
  • B:joint and muscle stiffness.
  • C:decreased muscle activity.
  • D:an altered mental status.
Definition
A:shivering and pale skin.
Term

Body temperature is regulated by which of the following structures located within the brain?

  • A:Cerebrum
  • B:Medulla oblongata
  • C:Hypothalamus
  • D:Cerebellum
Definition
C:Hypothalamus
Term

Which of the following mechanisms cause respiratory and circulatory collapse during anaphylactic shock?

  • A:Bronchoconstriction and vasodilation
  • B:Bronchoconstriction and vasoconstriction
  • C:Bronchodilation and vasodilation
  • D:Bronchodilation and vasoconstriction
Definition
A:Bronchoconstriction and vasodilation
Term

Which of the following organs are contained within the right upper quadrant of the abdomen?

  • A:Stomach and gallbladder
  • B:Liver and spleen
  • C:Liver and gallbladder
  • D:Liver and stomach
Definition
C:Liver and gallbladder
Term

An elderly man is found unresponsive in his kitchen. The patient’s wife tells you that her husband has diabetes and that he took his insulin, but did not eat anything. You should suspect:

  • A:ketoacidosis.
  • B:hyperglycemia.
  • C:hypoglycemia.
  • D:diabetic coma
Definition
C:hypoglycemia.
Term

A 56-year-old diabetic man is found unresponsive by his wife. She tells you that he ate breakfast this morning, but is unsure if he took his insulin. His respirations are rapid and shallow, his skin is cool and profusely diaphoretic, and his pulse is rapid and weak. Which of the following statements regarding this patient is correct?

  • A:The fact that he ate breakfast makes hypoglycemia highly unlikely.
  • B:He needs glucose as soon as possible because he is likely hypoglycemic.
  • C:You should request an ALS unit so they can give the patient his insulin.
  • D:He probably did not take his insulin and has a high blood glucose level.
Definition
B:He needs glucose as soon as possible because he is likely hypoglycemic.
Term

When caring for any patient with an altered mental status, your primary concern should be the:

  • A:possibility of a spinal injury.
  • B:potential for airway compromise.
  • C:possibility of a drug overdose.
  • D:patient’s blood glucose level.
Definition
B:potential for airway compromise.
Term

A known diabetic female is found unresponsive. Her respirations are rapid and shallow; her skin is cool, clammy, and pale; and her pulse is rapid and weak. Which of the following BEST explains the cause of her condition?

 

  • A:High blood sugar
  • B:Insulin overdose
  • C:Failure to take insulin
  • D:Excessive eating
Definition
B:Insulin overdose
Term

Which of the following signs is LEAST suggestive of a diabetic emergency?

  • A:Bradycardia
  • B:Fruity breath odor
  • C:Tachycardia
  • D:Combativeness
Definition
A:Bradycardia
Term

A 30-year-old man with a history of schizophrenia cut his wrists and is bleeding profusely. He is confused, combative, and has slurred speech. With the assistance of law enforcement personnel, you and your partner physically restrain him in order to provide care and transport. In this situation, a court of law would MOST likely:

  • A:agree that you and your partner are guilty of assault and battery.
  • B:determine that the patient had decision-making capacity.
  • C:conclude that you should have had a court order to restrain.
  • D:consider your actions in providing care to be appropriate.
Definition
D:consider your actions in providing care to be appropriate.
Term

Approximately 5 minutes after being stung by a bee, a 21-year-old male develops hives and begins experiencing difficulty breathing. When you arrive at the scene, you note that his level of consciousness is decreased, his breathing is labored, and wheezing can be heard without a stethoscope. The patient has a bee sting kit, but has not used it. You should:

  • A:assist his ventilations with a bag-mask device, administer epinephrine from his bee sting kit after receiving approval from medical control, and prepare for immediate transport.
  • B:administer high-flow oxygen via a nonrebreathing mask, apply a chemical cold pack to the sting, transport at once, and be prepared to administer the epinephrine from his bee sting kit.
  • C:provide positive-pressure ventilations, initiate rapid transport, and coordinate a rendezvous with a paramedic unit so they can administer the epinephrine from his bee sting kit.
  • D:give him high-flow oxygen via a nonrebreathing mask, cover him with a blanket and elevate his legs, and assist him in swallowing the antihistamine tablets that are in his bee sting kit.
Definition
A:assist his ventilations with a bag-mask device, administer epinephrine from his bee sting kit after receiving approval from medical control, and prepare for immediate transport.
Term

Hypoglycemia and acute ischemic stroke can present similarly because:

  • A:the most common cause of a stroke is hypoglycemia.
  • B:they are both caused by low levels of glucose in the blood.
  • C:the majority of stroke patients have a history of diabetes.
  • D:both oxygen and glucose are needed for brain function.
Definition
D:both oxygen and glucose are needed for brain function
Term

When assessing a conscious patient who overdosed on a drug, you should FIRST ascertain:

  • A:the patient’s weight in kilograms.
  • B:a history of prior drug overdoses.
  • C:when the medication was ingested.
  • D:the type of medication ingested.
Definition
D:the type of medication ingested.
Term

You should not attempt to actively rewarm a patient with moderate or severe hypothermia in the field because:

  • A:the risk of inadvertently inducing hyperthermia is too high.
  • B:rewarming too quickly can cause a fatal cardiac dysrhythmia.
  • C:active rewarming has been shown to cause severe hypertension.
  • D:it is painful for the patient and you cannot give analgesic drugs.
Definition
B:rewarming too quickly can cause a fatal cardiac dysrhythmia
Term

Hypoxia-induced unresponsiveness during a submersion injury is usually the result of:

  • A:a cardiac dysrhythmia.
  • B:laryngospasm.
  • C:associated hypothermia.
  • D:water in the lungs.
Definition
B:laryngospasm.
Term

Rapid transport of a patient who ingested a large dose of Tylenol is important because:

  • A:liver failure usually occurs within 6 hours following a Tylenol overdose.
  • B:it only takes a small dose of Tylenol to cause cardiopulmonary arrest.
  • C:an antidote may prevent liver failure if administered early enough.
  • D:activated charcoal cannot be given to patients who ingested Tylenol.
Definition
C:an antidote may prevent liver failure if administered early enough.
Term

Which of the following actions should be carried out during the primary assessment of an unresponsive patient?

  • A:Auscultating the lungs
  • B:Assessing the skin
  • C:Obtaining a blood pressure
  • D:Palpating the cranium
Definition
B:Assessing the skin
Term

A young male experienced a syncopal episode after working in the heat for several hours. He is conscious and alert; has cool, clammy skin; and complains of nausea and lightheadedness. You should:

  • A:provide rapid cooling.
  • B:advise him to go home and rest.
  • C:give him cold water to drink.
  • D:transport him on his side.
Definition
D:transport him on his side.
Term

When you arrive at a residence for a man who is “not acting right,” you enter the house and find him sitting on his couch. Which of the following findings would be MOST indicative of an altered mental status?

  • A:Tired appearance.
  • B:Odor of alcohol.
  • C:Slurred speech.
  • D:Eyes are closed.
Definition
C:Slurred speech.
Term

You are caring for a conscious patient who you believe is having an acute ischemic stroke. After administering oxygen, your next priority should include:

  • A:closely monitoring the blood pressure every 15 to 20 minutes.
  • B:providing prompt transport for possible fibrinolytic therapy.
  • C:administering 1 tube of oral glucose to rule out hypoglycemia.
  • D:determining whether the patient has prescribed nitroglycerin.
Definition
B:providing prompt transport for possible fibrinolytic therapy.
Term

A behavioral crisis is MOST accurately defined as:

  • A:any reaction to an event that interferes with the activities of daily living or has become unacceptable to the patient, family, or community.
  • B:a chronic mental health problem in which the patient experiences frequent thoughts of suicide or other self-destructive behavior.
  • C:a persistent feeling of sadness, despair, or hopelessness that incapacitates the patient and prevents him or her from interacting socially.
  • D:an acute psychiatric emergency characterized by violent behavior, mood swings, and a loss of connection to reality.
Definition
A:any reaction to an event that interferes with the activities of daily living or has become unacceptable to the patient, family, or community
Term

Assessment and treatment of a patient with severe abdominal pain should include:

  • A:giving the patient small sips of water.
  • B:administering high-flow oxygen.
  • C:placing the patient in a supine position.
  • D:vigorously palpating the abdomen.
Definition
B:administering high-flow oxygen.
Term

A 60-year-old man presents with a severe right-sided headache. He is conscious and alert. As you are assessing him, he tells you that the left side of his body feels weak. His blood pressure is 190/100 mm Hg, pulse is 88 beats/min, and respirations are 14 breaths/min. His past medical history includes diabetes, arthritis, and hypertension. You should be MOST concerned with:

  • A:the location of his headache.
  • B:his current blood pressure.
  • C:his blood glucose level.
  • D:the presence of hemiparesis.
Definition
D:the presence of hemiparesis.
Term

Immediately following a generalized motor seizure, most patients are:

  • A:hyperactive.
  • B:confused.
  • C:apneic.
  • D:awake and alert.
Definition
B:confused.
Term

Which of the following is a physiologic effect of epinephrine when used to treat anaphylaxis?

  • A:As a vasodilator, it increases the blood pressure.
  • B:As an antihistamine, it blocks chemicals that cause the reaction.
  • C:As a bronchodilator, it improves the patient's breathing.
  • D:As a vasoconstrictor, it lowers the blood pressure.
Definition
C:As a bronchodilator, it improves the patient's breathing.
Term

Activated charcoal is contraindicated for a patient who is:

  • A:emotionally upset and has ingested two bottles of aspirin.
  • B:awake and alert and has swallowed a commercial drain cleaner.
  • C:agitated and claims to have ingested a bottle of Tylenol.
  • D:conscious and alert and has ingested a large amount of Motrin.
Definition
B:awake and alert and has swallowed a commercial drain cleaner.
Term

A 24-year-old female presents with a rash to her left leg and swollen, painful knee joints. She tells you that she and her friends returned from a hiking trip in the mountains a week ago. She is conscious and alert with a blood pressure of 112/62 mm Hg, a pulse of 84 beats/min, and respirations of 14 breaths/min. Her symptoms are MOST likely the result of:

  • A:a localized allergic reaction.
  • B:tetanus.
  • C:Rocky Mountain spotted fever.
  • D:Lyme disease.
Definition
D:Lyme disease.
Term

A 50-year-old female complains of severe pain to the right lower quadrant of her abdomen. You should:

  • A:quickly palpate that area first to assess for rigidity.
  • B:keep her supine with her legs fully extended.
  • C:suspect that she has an acute problem with her liver.
  • D:palpate the left upper quadrant of her abdomen first.
Definition
D:palpate the left upper quadrant of her abdomen first.
Term

In the patient with diabetes, insulin shock typically presents with:

  • A:dry skin and a slow onset.
  • B:clammy skin and a rapid onset.
  • C:clammy skin and a slow onset.
  • D:dry skin and a rapid onset.
Definition
B:clammy skin and a rapid onset.
Term

A 28-year-old woman has severe lower quadrant abdominal pain. When assessing her abdomen, you should:

  • A:auscultate for bowel sounds for approximately 2 to 5 minutes.
  • B:ask her where the pain is located and palpate that area last.
  • C:ask her where the pain is located and palpate that area first.
  • D:encourage the patient to lie supine with her legs fully extended.
Definition
B:ask her where the pain is located and palpate that area last.
Term

You receive a call for a 54-year-old female who is having a seizure. When you arrive at the scene, the patient is actively seizing. Her husband tells you that she has a history of seizures, and that she has been seizing continuously for 20 minutes. It is MOST important for you to recognize that:

  • A:her husband’s description is consistent with status epilepticus.
  • B:the patient may have stopped taking her seizure medication.
  • C:her seizure could be the result of a low blood glucose level.
  • D:the patient is hypoxic and needs oxygen as soon as possible.
Definition
D:the patient is hypoxic and needs oxygen as soon as possible.
Term

A 50-year-old woman who is conscious and alert complains of a severe migraine headache. When caring for her, you should avoid:

  • A:applying ice packs to her forehead.
  • B:unnecessarily checking her pupils.
  • C:dimming the lights in the ambulance.
  • D:transporting her in a supine position.
Definition
B:unnecessarily checking her pupils.
Term

A 44-year-old woman was bitten on the ankle by an unidentified snake while working in her garden. She is conscious and alert, has stable vital signs, and denies shortness of breath. Her only complaint is a burning sensation to the wound. Your assessment reveals two small puncture wounds, redness, and swelling. You should:

  • A:elevate her leg, cover the wound with a dry sterile dressing, and apply ice to reduce pain and swelling.
  • B:administer high-flow oxygen, apply a constricting band proximal to the bite, and use ice to prevent venom spread.
  • C:give supplemental oxygen, splint her leg to decrease movement, and keep her leg below the level of her heart.
  • D:conclude that envenomation likely did not occur, provide reassurance, and allow a friend to take her to the hospital
Definition
C:give supplemental oxygen, splint her leg to decrease movement, and keep her leg below the level of her heart.
Term

You are at the scene where a man panicked while swimming in a small lake. Your initial attempt to rescue him should include:

  • A:swimming to the victim to rescue him.
  • B:throwing a rope to the victim.
  • C:reaching for the victim with a long stick.
  • D:rowing a small raft to the victim.
Definition
C:reaching for the victim with a long stick.
Term

A 50-year-old woman with a history of epilepsy is actively having a seizure. Care for this patient should focus primarily on:

  • A:protecting her from injury and ensuring adequate ventilation.
  • B:placing a bite block in between her molars and giving her oxygen.
  • C:frequently suctioning her airway and carefully restraining her.
  • D:administering high-flow oxygen and requesting an ALS ambulance.
Definition
A:protecting her from injury and ensuring adequate ventilation.
Term

In general, a frostbitten body part should NOT be rewarmed in the field if:

  • A:you are unable to obtain water that is at least 120°F.
  • B:the affected part could refreeze after rewarming.
  • C:arrival at the emergency department will be delayed.
  • D:a paramedic is not present to administer analgesia
Definition
B:the affected part could refreeze after rewarming.
Term

The bite of a brown recluse spider is characterized by:

  • A:immediate pain, swelling at the site, and painful muscle spasms.
  • B:rapid swelling within 30 minutes and a decline in mental status.
  • C:two small puncture marks, swelling, and delayed onset of pain.
  • D:delayed onset of pain, swelling, and blister formation at the site
Definition
D:delayed onset of pain, swelling, and blister formation at the site. 
Term

Which of the following conditions would be the LEAST likely to occur in a patient who was submerged in water?

  • A:Laryngospasm
  • B:Spinal injury
  • C:Hyperglycemia
  • D:Gastric distention
Definition
C:Hyperglycemia
Term

You are transporting a 30-year-old man who is experiencing an emotional crisis. The patient does not speak when you ask him questions. How should you respond to his unwillingness to speak?

  • A:Remain silent until the patient speaks to you.
  • B:Do not speak to the patient, even if he begins to speak to you.
  • C:Tell the patient that you cannot help if he won’t talk.
  • D:Continually encourage the patient to talk to you.
Definition
A:Remain silent until the patient speaks to you
Term

A 55-year-old woman with a history of diabetes is found unresponsive with rapid, shallow respirations. The patient's husband tells you that he does not know when his wife last took her insulin. Management of this patient should include:

  • A:oral glucose and oxygen via nonrebreathing mask.
  • B:subcutaneous injection of insulin and 100% oxygen.
  • C:assisted ventilations and rapid transport.
  • D:assisted ventilations and oral glucose.
Definition
C:assisted ventilations and rapid transport
Term

After moving a hypothermic patient to a warmer area, your primary focus should be to:

  • A:provide rapid rewarming.
  • B:prevent further body heat loss.
  • C:assess his or her body temperature.
  • D:give warm, humidified oxygen.
Definition
B:prevent further body heat loss.
Term

When dealing with an emotionally disturbed patient, you should be MOST concerned with:

  • A:safely transporting to the hospital.
  • B:whether the patient could harm you.
  • C:gathering all of the patient’s medications.
  • D:obtaining a complete medical history.
Definition
B:whether the patient could harm you
Term

Unresponsiveness, shallow breathing, and constricted pupils are indicative of what type of drug overdose?

  • A:Narcotic
  • B:Amphetamine
  • C:Marijuana
  • D:Barbiturate
Definition
A:Narcotic
Term

A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20 minutes ago. Medical control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal should you administer?

 

  • A:51 g
  • B:60 g
  • C:57 g
  • D:54 g
Definition
C:57 g
Term

A 36-year-old male, who is a known diabetic, presents with severe weakness, diaphoresis, and tachycardia. He is conscious, but confused. His blood pressure is 110/58 mm Hg, pulse is 120 beats/min and weak, and respirations are 24 breaths/min. The glucometer reads error after several attempts to assess his blood glucose level. In addition to high-flow oxygen, medical control will MOST likely order you to:

  • A:transport only and closely monitor him.
  • B:assist the patient in taking his insulin.
  • C:give him a salt-containing solution to drink.
  • D:give at least one tube of oral glucose.
Definition
D:give at least one tube of oral glucose. 
Term

A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal. The MOST effective way to prevent another seizure is to:

  • A:dim the lights in the back of the ambulance.
  • B:place him in the recovery position.
  • C:administer high-flow supplemental oxygen.
  • D:give him oral glucose if he can swallow
Definition
C:administer high-flow supplemental oxygen.
Term

Which of the following statements regarding the function of insulin is correct?

  • A:It promotes the entry of glucose from the cell into the bloodstream.
  • B:It facilitates the uptake of glucose from the bloodstream into the cell.
  • C:It causes the pancreas to produce glucose based on the body’s demand.
  • D:It stimulates the liver to release glucose into the bloodstream.
Definition
B:It facilitates the uptake of glucose from the bloodstream into the cell.
Term

Immediately following a generalized seizure involving tonic-clonic activity, most patients:

  • A:experience prolonged apnea and require positive-pressure ventilations.
  • B:have a slow heart rate because of cardiac depression during the seizure.
  • C:are unresponsive but gradually regain consciousness.
  • D:return to a normal level of consciousness but cannot recall the event.
Definition
C:are unresponsive but gradually regain consciousness.
Term

A 40-year-old woman presents with widespread hives that she noticed about 45 minutes after taking penicillin for an ear infection. She is conscious and alert and denies difficulty breathing. Her breath sounds are clear to auscultation bilaterally, her vital signs are stable, and her oxygen saturation is 98% on room air. She tells you she is allergic to wasps and has an epinephrine auto-injector. You should:

  • A:give supplemental oxygen and transport her to the hospital.
  • B:give high-flow oxygen and administer 100 mg of Benadryl.
  • C:advise her that she can probably drive herself to the hospital.
  • D:assist her in administering epinephrine via her auto-injector.
Definition
A:give supplemental oxygen and transport her to the hospital.
Term

A patient who overdosed on methamphetamine would be expected to have all of the following clinical signs, EXCEPT:

  • A:agitation.
  • B:bradycardia.
  • C:dilated pupils.
  • D:hypertension.
Definition
B:bradycardia.
Term

The two MOST important steps in treating a patient with a contact poisoning are:

  • A:determining when the exposure occurred and irrigating the patient’s entire body with copious amounts of water.
  • B:avoiding self-contamination and removing the irritating or corrosive substance from the patient as rapidly as possible.
  • C:donning a pair of gloves and performing a physical examination to determine if a significant exposure occurred.
  • D:immediately washing any dry chemicals off of the patient’s skin and removing his or her clothing as soon as possible.
Definition
B:avoiding self-contamination and removing the irritating or corrosive substance from the patient as rapidly as possible
Term

Your patient is a 75-year-old female who, according to her son, tripped on a throw rug and fell. The patient is conscious and alert, is sitting on the couch, and has a hematoma to her forehead. When you ask her what happened, her son interjects by saying, “I already told you, she tripped and fell.” As you further question her, you find that she is hesitant to answer your questions and keeps looking at her son. You should:

  • A:ask the patient if someone hurt her intentionally.
  • B:notify law enforcement and have the son removed.
  • C:interview the patient and her son separately if possible.
  • D:tell the son that you suspect his mother has been abused.
Definition
C:interview the patient and her son separately if possible.
Term

The MOST obvious way to reduce heat loss from radiation and convection is to:

  • A:move away from a cold object.
  • B:increase metabolism by shivering.
  • C:move to a warmer environment.
  • D:wear a thick wind-proof jacket.
Definition
C:move to a warmer environment.
Term

You are called to the residence of a 39-year-old male with flu-like symptoms. The patient tells you that he has been feeling ill for the last 2 days. He has a fever, headache, and diarrhea, and asks that you take him to the hospital. His blood pressure is 120/60 mm Hg, his pulse is 110 beats/min, and his respirations are 16 breaths/min. You should:

  • A:advise him that he can drive himself to his family physician.
  • B:ask him if he has a history of HIV infection or hepatitis.
  • C:request an ALS ambulance to the scene to start an IV line.
  • D:offer oxygen and transport him in a position of comfort.
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